Rehabilitation of cerebral palsy in a developing country: The need for comprehensive assessment

Records of 100 children with cerebral palsy from rural India attending a cerebral palsy clinic were analysed to determine the frequency of associated handicaps and to evaluate whether appropriate intervention had been instituted for these handicaps. All the children underwent speech, hearing, psychological, ophthalmologic, neurological, physical, functional and orthopaedic evaluations on their visit to the clinic. History was elicited from the parents of the patients to identify which of the disabilities were recognized either by them or their primary care physician, and whether any intervention had been instituted. The mean age of the patients was 6.9 years. Eighty-two per cent of the children had one or more disabilities apart from locomotor disabilities, visual defects being the commonest (54%). Fifty-four per cent of the children had more than one associated disability. Although 43% of the patients had been referred by a primary care physician, one or more associated disabilities had not been recognized and epilepsy was the only associated problem that had been treated prior to the evaluation. The study emphasizes the need for comprehensive evaluation of all children with cerebral palsy to enable proper rehabilitation.