Vol. 5 No. 3 (2026): May-June
10-19
2026-06-29
Open Access

Early Detection and Early Intervention in Cerebral Palsy: A Narrative Review of Current Evidence and Its Application in Resource-Limited Settings

N.Sh. Islomova
https://doi.org/10.56121/MSU-2026-4-%25x

Received: 2026-09-03

Published: 2026-06-29

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Abstract

Cerebral palsy is the most common cause of physical disability in childhood, yet for most of the twentieth century it was diagnosed only after the first birthday, long after the period of greatest neuroplasticity had passed. Over the past decade this has changed. Combinations of neonatal magnetic resonance imaging, the Prechtl General Movements Assessment and the Hammersmith Infant Neurological Examination now permit accurate detection before six months of corrected age, and an international clinical practice guideline has defined what should be offered to infants once they are identified. This narrative review synthesises the current evidence on detection tools and their reported accuracy, on early intervention and its documented limits, and on the specific obstacles that arise where magnetic resonance imaging, trained assessors and structured rehabilitation are scarce. Particular attention is given to the applicability of these approaches in Central Asia, where published local data remain sparse. The review argues that the principal barrier to earlier diagnosis in such settings is no longer technological but organisational, and outlines what a feasible detection pathway would require.

Keywords

List of references

  1. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171(9):897-907. https://doi.org/10.1001/jamapediatrics.2017.1689

  2. Morgan C, Fetters L, Adde L, Badawi N, Bancale A, Boyd RN, et al. Early intervention for children aged 0 to 2 years with or at high risk of cerebral palsy: international clinical practice guideline based on systematic reviews. JAMA Pediatr. 2021;175(8):846-858. https://doi.org/10.1001/jamapediatrics.2021.0878

  3. King AR, Al Imam MH, McIntyre S, Morgan C, Khandaker G, Badawi N, et al. Early diagnosis of cerebral palsy in low- and middle-income countries. Brain Sci. 2022;12(5):539. https://doi.org/10.3390/brainsci1 2050539

  4. Singhi P, Saini AG. Etiology and diagnosis of cerebral palsy in resource-limited regions. Semin Pediatr Neurol. 2025;55:101226. https://doi.org/10.1016/j.spen.2025.101226

  5. Mo’minova O, Axmedova V. Bolalarda uchraydigan serebral falaj turlari [Types of cerebral palsy occurring in children]. Universal xalqaro ilmiy jurnal. 2025;2(4.1):434-437. (In Uzbek.) https://doi.org/10.71337/inlibrary.uz.universaljurnal.86261

  6. Allambergenova MX, Tairova Z. Bolalar serebral falajida yuzaga keladigan nutq buzilishlarining o’ziga xos tomonlari va ularni bartaraf etish [Specific features of speech disorders arising in children’s cerebral palsy and their remediation]. Multidisciplinary Journal of Science and Technology. 2025;5(6):2266-2268. (In Uzbek.) https://doi.org/10.5281/zenodo.15762591

  7. Fayzullayeva ST. Bolalar serebral falajligi [Cerebral palsy in children]. In: Proceedings of the International Conference on Educational Discoveries and Humanities; 2024 Feb 1. p. 187-193. (In Uzbek.) https://doi.org/None

  8. Nemkova SA, Boldyrev VG. Rannyaya differentsial’naya diagnostika i vosstanovitel’noe lechenie detskogo tserebral’nogo paralicha [Early differential diagnosis and restorative treatment of cerebral palsy]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2024;124(1):24-37. (In Russ.) https://doi.org/10.17116/jnevro202412401124

  9. McIntyre S, Goldsmith S, Webb A, Ehlinger V, Hollung SJ, McConnell K, et al. Global prevalence of cerebral palsy: a systematic analysis. Dev Med Child Neurol. 2022;64(12):1494-1506. https://doi.org/10.1111/dmcn.15346

  10. Smit hers-Sheedy H, Waight E, Goldsmith S, Reid S, Gibson C, Watson L, et al. Declining trends in birth prevalence and severity of singletons with cerebral palsy of prenatal or perinatal origin in Australia: a population-based observational study. Dev Med Child Neurol. 2022;64(9):1114-1122. https://doi.org/10.1111/dmcn.15195

  11. Larsen ML, Rackauskaite G, Greisen G, Laursen B, Uldall P, Krebs L, et al. Continuing decline in the prevalence of cerebral palsy in Denmark for birth years 2008-2013. Eur J Paediatr Neurol. 2020. Epub ahead of print. https://doi.org/10.1016/j.ejpn.2020.10.003

  12. Arnautovic T, Sinha S, Laptook AR. Neonatal hypoxic-ischemic encephalopathy and hypothermia treat-ment. Obstet Gynecol. 2023;143(1):67-81. https://doi.org/10.1097/AOG.0000000000005392

  13. Martin T, McIntyre S, Waight E, Baynam G, Watson L, Langdon K, et al. Prevalence and trends for Aboriginal and Torres Strait Islander children living with cerebral palsy: a birds-eye view. Dev Med Child Neurol. 2023;65(11):1475-1485. https://doi.org/10.1111/dmcn.15617

  14. Hajiyeva IE. Zabolevaemost’ detskim tserebral’nym paralichom v gorode Baku [Morbidity rate of children’s cerebral palsy in Baku city]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2024;124(1):143-146. (In Russ.) https://doi.org/10.17116/jnevro2024124011143

  15. Romeo DM, Velli C, Sini F, Pede E, Cicala G, Cowan FM, et al. Neurological assessment tool for screening infants during the first year after birth: the Brief-Hammersmith Infant Neurological Examination. Dev Med Child Neurol. 2024;66(9):1173-1180. https://doi.org/10.1111/dmcn.15871

  16. Kapil N, Majmudar-Sheth B, Johnson T. Hammersmith Infant Neurological Examination subscores are predictive of cerebral palsy. Pediatr Neurol. 2023;151:84-89. https://doi.org/10.1016/j.pediatrneurol.2023.11.016

  17. Howard GT, Baque E, Colditz PB, Chatfield MD, Ware RS, Boyd RN, et al. Diagnostic accuracy of the Hammersmith Neonatal Neurological Examination in predicting motor outcome at 12 months for infants born very preterm. Dev Med Child Neurol. 2023;65(8):1061-1072. https://doi.org/10.1111/dmcn.15512

  18. Glass HC, Li Y, Gardner M, Barkovich AJ, Novak I, McCulloch CE, et al. Early identification of cerebral palsy using neonatal MRI and general movements assessment in a cohort of high-risk term neonates.

  19. Pediatr Neurol. 2021;118:20-25. https://doi.org/10.1016/j.pediatrneurol.2021.02.003

  20. Moss SN, Keene JC, Winter SL, Baserga M, Ayala L, Evans WG, et al. General movements assessment and Hammersmith Infant Neurological Examination for early diagnosis of cerebral palsy in infants born at term treated with therapeutic hypothermia. Dev Med Child Neurol. 2025;67(9):1186-1194. https://doi.org/10.1111/dmcn.16277

  21. Jackman M, Morgan C, Luke C, Korostenski L, Zawada K, Juarez M, et al. The predictive validity of HINE, Bayley, general movements and MOS-R in infancy. Early Hum Dev. 2025;203:106226. https://doi.org/10.1016/j.earlhumdev.2025.106226

  22. Gao Q, Yao S, Tian Y, Zhang C, Zhao T, Wu D, et al. Automating general movements assessment with quantitative deep learning to facilitate early screening of cerebral palsy. Nat Commun. 2023;14(1):8294. https://doi.org/10.1038/s41467-023-44141-x

  23. Karim T, Te Velde A, Webb A, Morgan C, Badawi N, Novak I, et al. Early detection of cerebral palsy among a high-risk cohort in Bangladesh. BMJ Paediatr Open. 2025;9(1):e003921. https://doi.org/10.1136/bmjpo-2025-003921

  24. Damiano DL, Longo E. Early intervention evidence for infants with or at risk for cerebral palsy: an overview of systematic reviews. Dev Med Child Neurol. 2021;63(7):771-784. https://doi.org/10.1111/dmcn.14855

  25. Boyd RN, Greaves S, Ziviani J, Novak I, Badawi N, Pannek K, et al. Randomized comparison trial of rehabilitation very early for infants with congenital hemiplegia. J Pediatr. 2024;277:114381. https://doi.org/10.1016/j.jpeds.2024.114381

  26. Carton de Tournai A, Herman E, Ebner-Karestinos D, Gathy E, Araneda R, Renders A, et al. Hand-arm bimanual intensive therapy including lower extremities in infants with unilateral cerebral palsy: a random-ized clinical trial. JAMA Netw Open. 2024;7(11):e2445133. https://doi.org/10.1001/jamanetworkopen. 2024.45133

  27. Shin Y, Park EJ, Lee A. Early intervention for children with developmental disabilities and their families via telehealth: systematic review. J Med Internet Res. 2025;27:e66442. https://doi.org/10.2196/66442

  28. Nemkova SA, Boldyrev VG. Kompleksnaya diagnostika i lechenie kognitivnykh narusheniy pri detskom tserebral’nom paraliche [Complex diagnostics and treatment of cognitive dysfunctions in cerebral palsy]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2022;122(9, vyp. 2):51-61. (In Russ.) https://doi.org/10.17116/jnevro202212209251

  29. Klochkova OA, Kurenkov AL, Argunova GV, Duibanova NV, Zatravkina TY, Krasavina DA, i dr. Inek-tsii abobotulinumtoksina A dlya korrektsii khronicheskoy sialorei u detey: rossiyskoe retrospektivnoe mnogotsentrovoe issledovanie [AbobotulinumtoxinA injections for chronic sialorrhea correction in chil-dren: Russian retrospective multicenter study]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2025;125(1):53-61. (In Russ.) https://doi.org/10.17116/jnevro202512501153

  30. Gaynetdinova DD, Afandieva LZ. Sistemnoe vospalenie pri spasticheskikh formakh detskogo tsere-bral’nogo paralicha: patogeneticheskaya rol’ i vozmozhnosti modulyatsii s primeneniem Meksidola [Systemic inflammation in spastic forms of cerebral palsy: pathogenetic role and modulation possibilities using Mexidol]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2026;126(5):74-82. (In Russ.) https://doi.org/10.17116/jnevro202612605174

  31. Bonezzi L, Accorinti I, Papoff FMA, Orsi M, D’Arcangelo G, Bartolini E, et al. Cerebral palsy in a rural desert population of southern Algeria: a cross-sectional study of epidemiology of comorbidities and unmet needs. J Child Neurol. 2025;40(9):757-766. https://doi.org/10.1177/08830738251336486

  32. Makhoul Z, Muhumuza MF, Kyarisiima B, Amongin G, Nakibirango M, Moore C, et al. Undernutrition and feeding difficulties among children with disabilities in Uganda: a cross-sectional study. Nutrients. 2026;18(2):200. https://doi.org/10.3390/nu18020200

  33. Lonn H, Ndep AO, Ekpenyong BN, Cockburn L, Chirac AJ, Tchiaze ATG, et al. Experiences and challenges of caregivers of children with cerebral palsy in Magba subdivision, Cameroon: a qualitative analysis. BMC Neurol. 2026;26(1). https://doi.org/10.1186/s12883-026-04976-5

  34. Hepperlen RA, Rabaey P, Lunda E, Mwandileya W, Mwansa M, Hearst MO. Caregiver experiences of providing care to a child with cerebral palsy in Zambia: a photovoice project. Child Care Health Dev. 2026;52(2):e70252. https://doi.org/10.1111/cch.70252

  35. Imam MH, Jahan I, Muhit M, Das MC, Power R, Khan A, et al. Supporting ultra poor people with rehabilitation and therapy among families of children with cerebral palsy in rural Bangladesh (SUPPORT CP): protocol of a randomised controlled trial. PLoS One. 2021;16(12):e0261148. https://doi.org/10.137 1/journal.pone.0261148

  36. Karimova UN, Rakhmanova LK, Yusupova GA, Israilova NA. Clinical and neurological manifestations of pathology of the nervous system in chronic kidney disease in children. Medical Science of Uzbekistan. 2023;2(3):04-08. https://doi.org/10.56121/2181-3612-2023-3-04-08

  37. Nurmatova DA, Sayfitdinhuzhaev ZF, Okhunboev ZM. Tic epilepsy in the Uzbek population: clinical and encephalographic aspects (pilot study). Medical Science of Uzbekistan. 2025;4(3):40-42. https://doi.org/10.56121/2181-3612-2025-3-40-42

  38. Yakovenko MP, Kleshenko EI, Kayumova DA. Iskhody razvitiya gluboko nedonoshennykh i ekstremal’no nedonoshennykh detey v 12 mesyatsev skorrektirovannogo vozrasta [Developmental outcomes of very preterm and extremely preterm infants at 12 months corrected age]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2023;123(10):97-100. (In Russ.) https://doi.org/10.17116/jnevro202312310197

  39. Antipenko EA, Shulyndin AV. Povyshenie kachestva zhizni i vozmozhnosti patogeneticheskoy terapii u vzroslykh patsientov s detskim tserebral’nym paralichom [Improving the quality of life and the possibility of pathogenetic therapy in adult patients with cerebral palsy]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2025;125(10):75-84. (In Russ.) https://doi.org/10.17116/jnevro202512510175.

About the Authors

N.Sh. Islomova
nigoraxonsh@icloud.com
Central Asian Medical University

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1.
Early Detection and Early Intervention in Cerebral Palsy: A Narrative Review of Current Evidence and Its Application in Resource-Limited Settings. MSU [Internet]. 2026 Jun. 29 [cited 2026 Sep. 6];5(3):10-9. Available from: https://fdoctors.uz/index.php/journal/article/view/281
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