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Birth Injuries

The Classification of Cerebral Palsy

Many factors are involved in the diagnosis of cerebral palsy. Due to the number of specialists that are needed, the classification system is associated with numerous factors. An orthopedic specialist would be needed if the child’s limbs need to be examined to reach possible treatment options. This can also be said for the neurologist and other specialists. Which leads to parents requiring to think about their child’s cerebral palsy classification from a global perspective. Additionally, medical professionals are adhering to a universal classification to aid in treatment options for children who have been diagnosed with cerebral palsy. The following ways are in which cerebral palsy can be classified:
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Motor Function Classification
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Gross Motor Function Classification
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Topographical Distribution Classification
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Communication Classification System

Motor Function Classification

This classification system examines the areas of the brain that controls the motor functions for the baby such as using their muscles. If a child is suffering from cerebral palsy, their muscles become impaired, which in turn can lead to hypotonia and or hypertonia (Mixed Cerebral Palsy if both are present). There are four types of cerebral palsy associated with the motor function classification system found below:
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Spastic Cerebral Palsy
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Athetoid Cerebral Palsy
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Mixed Cerebral Palsy
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Ataxic Cerebral Palsy

Gross Motor Function Classification

This classification system involves your baby’s ability to use their arms, hand, legs, feet, or the entire body. Gross motor function is essential to make large movements. When babies conduct movements, such as walking, crawling, running, or jumping, the gross motor functions are on display. An injury to these areas of the brain can eventually lead to impairment.

There is a 5-level classification system associated with the Gross Motor Function Classification System that assesses the gross level function of the child, with the highest level indicating the most severe case of cerebral palsy. This system closely examines walking, sitting, and wheeled mobility. This system in conjunction with other systems helps doctors and other medical professionals to develop treatment plans that include assisting devices to help the child gain independence.

Gross Motor Function Classification System Level 1

Level 1 informs the doctors and medical staff that the child can walk at home and in various other places in their community, along with using stairs without a railing. Although the child for the most part can move without limitations, things such as speed, balance, and coordination may take a toll.

Gross Motor Function Classification System Level 2

The Level 2 classification system tells us that the child can walk in many settings and when stairs are present, a rail will be needed for guidance. Long distance walking may also present a challenge, especially when having to use balance on surfaces that are uneven or in crowded areas. When this occurs, physical devices or wheelchairs should be used to help with long distance mobility. Running and jumping is impaired.

Gross Motor Function Classification System Level 3

Under the Level 3 classification system, handheld mobility devices are utilized indoors, and climbing stairs is done with the assistance of railings and supervision. Like level 2, wheeled mobility is necessary for long distances while self-propelled devices are used for short distances.

Gross Motor Function Classification System Level 4

Level 4 of the classification system, methods of mobility require physical or motored assistance in many environments. Children will need wheelchairs or powered mobility devices that will assist in settings like schools and other areas of the community. In the home, the child may be able to walk in a limited manner, with the assistance of wheelchairs, powered mobility devices, or body support devices.

Gross Motor Function Classification System Level 5

Under the Level 5 classification system, the child will need a manual wheelchair in all settings. It is important to note that the head and limb movements are impaired (holding the head up and/or the limbs).

Severity Level Classification

Cerebral palsy has a severity scale that ranges from mild, moderate and severe and is used to help determine the challenges that the child may face if diagnosed with cerebral palsy. Although this scale is not as specific as the Gross Motor Function Classification System, it still has vital information that is important for you to know. The severity level classification for cerebral palsy is as follows:
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Mild: This is when a child who has cerebral palsy can move for the most part without assistance. Little to no limitations are present when performing essential daily tasks.
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Moderate: A child with moderate cerebral palsy will be required to have a wheelchair, among other things to assist with daily activities.
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Severe: A child with severe cerebral palsy will need wheelchair assistance. Along with other devices for mobility. The child will also face difficulty accomplishing daily tasks.

Topographical Distribution Classification

Topographical distribution classification targets the area of the body that is affected by the cerebral palsy diagnosis and is helpful when developing a treatment plan for the child. The following areas of concentration are associated with topographical distribution classification:
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Pentaplegia: All limbs are affected, with the head and neck suffering from paralysis. Eating and breathing problems can also be present with the child.
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Monoplegic: Only one limb is affected. In many instances, the arm will be affected, but also can be the leg.
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Hemiplegic: Two limbs on the same side of the body are affected (right arm, right leg)
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Double Hemiplegic: Both arms and legs are affected, with an emphasis on one side of the body more so than the other.
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Diplegic: The lower extremities (legs) are generally affected more so than the arms.
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Paraplegic: Both legs and the lower body are affected
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Triplegic: 3 limbs are affected, generally both arms and a leg
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Quadriplegic: All 4 limbs are affected

Communication Function Classification System

The communication function system’s purpose is to classify everyday communication of an individual diagnosed with cerebral palsy. A five level communication platform has been developed to be utilized between a person who is familiar with the communication of the person who is diagnosed with cerebral palsy and helps with the classification. Those who suffer from cerebral palsy experience a lack of “speech”, but can still communicate in other ways such as gestures, facial expressions, speech, etc. These styles of communication are used in the communication function classification system. Below are the levels:
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Level 1: Effective sending/receiving information with unfamiliar and familiar partners
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Level 2: Effective but slower sending/receiving information with unfamiliar and familiar partners
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Level 3: Effective sending/receiving information with familiar partners not so much with unfamiliar partners
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Level 4: Inconsistent sending and/or receiving information with familiar partners
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Level 5: Seldom able to communicate effectively even with familiar people
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