If your baby has trouble learning to roll over, sit, crawl or walk, see your pediatrician. Delays in development and problems controlling movement or posture may be early signs of cerebral palsy (CP), a group of chronic disorders that stem from abnormalities or damage to the brain.

Cerebral palsy begins before, during, or after birth in the first years of life. Premature babies and others with low birth weight are at greater risk for it. Infection, head injury and other factors can cause CP, but most of the time no one knows why it happens.

Doctors may use physical examination, medical history and diagnostic imaging tools to determine if your child has cerebral palsy.

Cerebral palsy affects the central nervous system and changes the tone of muscles. It takes mild, moderate and severe forms and generally does not get progressively worse. Symptoms vary and may include:

• Tight muscles (increased tone), causing spasms and rigidity.
• Loose muscles (low tone), making limbs weak and floppy.
• Impaired reflexes, coordination and balance.

Some people with CP also have mental impairment (i.e., retardation or learning disabilities); seizures; vision difficulties; shortened limbs; curvature of the spine (scoliosis); dental problems; complete or partial hearing loss; or problems with joints (i.e., contracture). There is no cure for CP, but with early treatment, most children improve their capabilities significantly.

When a child is about 2 years old, the doctor may be able to diagnose the type of CP he or she has. There are four main types:

• Spastic:
  In spastic CP, the most common form, there is increased muscle tone/tightness. Legs, arms and back are stiff and contracted, making movement difficult. If both legs are affected (spastic diplegia), tight muscles in the hips and legs cause legs to turn inward and cross at the knees when walking. If only one side of the body is affected (spastic hemiplegia), the arm is often more severely affected than the leg. If all four limbs and the trunk are affected (spastic quadriplegia or total body involved), the muscles of the mouth and tongue may also be affected.
• Athetoid:
  (dyskinetic): In athetoid CP there is low muscle tone/looseness, leading to uncontrolled movements of the entire body. It may be difficult to sit straight or walk.
• Ataxic:
  A rare form, ataxic CP affects balance and depth perception. There is poor coordination, unsteady walking and difficulty with precise movements such as using a pen or buttoning a shirt.
• Mixed:
  In mixed CP, there are symptoms of both spastic and athetoid CP. Some muscles are tight and others are loose. There is both stiffness and involuntary movements.

Sometimes people with cerebral palsy need help from their families throughout their lives. If your child has CP, you may want to work with a treatment team of health care professionals to identify and meet the child's individual needs. The goal is to help your child reach his or her potential and maximize independence. Treatment teams often include:

• Orthopaedic surgeons to treat problems with bones, muscles, tendons, nerves or joints.
• Physical therapists to improve movement and strength.
• Occupational therapists to teach skills required for daily living (i.e., eating and dressing).
• Speech and language specialists to treat communication problems.
• Social workers to help locate community assistance and education programs.
• Psychologists to help patients and families cope with stress and/or behavioral therapists to foster social and emotional development.
• Other medical specialists such as eye doctors, neurologists and nutritionists.