Common Signs and Symptoms of Cerebral Palsy in Infants

Around 1 in 400 babies born in the UK have a type of cerebral palsy — a condition that affects movement and coordination caused by damage to the brain either before or during birth (usually due to oxygen deprivation). But how do you recognise the signs and symptoms of cerebral palsy in your own child?

The symptoms of cerebral palsy (CP) aren’t normally obvious when a baby is born, and many people don’t notice anything unusual in their baby’s development over the first few months.

Generally, signs of CP start to become more noticeable in the few first years of an infant’s life as they begin to develop; this is around the time that CP is typically diagnosed. However, signs and symptoms can be present much earlier.

Diagnosing CP as soon as possible means that treatments and therapy can begin to minimise symptoms and maximise your child’s abilities. That’s why it’s useful to be able to recognise common signs of CP in infants. These signs can vary because there are different types of CP and different levels of severity, but there are some clear indicators that you can look for.

In this post, we’ll cover the common signs and symptoms of CP in infants. We’ve separated these signs into two age groups: babies (up to 12 months) and toddlers (12-24 months).

Cerebral palsy signs in babies

Signs in younger infants are harder to spot, and if it’s your first child, it may be difficult to notice abnormalities because you have no frame of reference. However, there are still signs you can look out for:

Low muscle tone

If your baby feels ‘floppy’ when you pick him or her up, it may be a sign of CP. CP can affect muscle quality and cause poor muscle tone and movement.

Weak arms and legs, going floppy when held, and being unable to hold up his or her head when lying or sitting, are all early signs that your baby may have cerebral palsy.

Stiffness and muscle spasms

On the other hand, a baby that seems too ‘stiff’ may also indicate cerebral palsy. CP can cause muscle tone that is too high, resulting in stiffness.

This stiffness can result in poor muscle control, muscle spasms (known as spasticity) and an abnormally overextended posture — as if your baby is arching their back away from you when held. Your baby may also show stiff legs which can cross or scissor.

Delays in reaching development milestones

Delayed development can be another indication that your infant has CP.

During their childhood, a baby should be reaching certain developmental milestones by a certain age. Of course, all babies are different, and what one baby can achieve at six months, another may not until 12 months.

However, there are still some recognised milestones that should be achievable, and an infant not reaching these milestones is a sign of CP. Not rolling over or sitting up independently by around six months are two of them.

Older babies (around 10 months) may also show delays or difficulties with crawling. They might crawl in a lopsided way, dragging one side, or bottom-shuffle rather than crawling at all.

Cerebral palsy signs in toddlers

The signs of CP tend to become more obvious as an infant grows and develops. In toddlers with CP, physical development can be delayed and more difficult. Here are the most common signs of CP in toddlers:

Scissor-walking, toe-walking or not walking at all

Difficulties with walking are common in children with CP because of issues with muscle development and spasticity in the legs.

This can lead to scissor-walking (a gait typically associated with spastic cerebral palsy in which the legs bend and cross over when walking) or toe-walking (where the child stands on tiptoes with no contact between heels and the ground).

Some toddlers with CP don’t walk at all; if your child isn’t walking by 18 months, then it may be a sign of cerebral palsy.

Poor coordination, clumsiness and control

Children with CP can struggle with coordination and muscle control, making movements clumsy or jerky.  They may also have random, uncontrolled movements such as involuntary, rhythmic muscular contractions, and show delayed reflexes.

They can also appear clumsier or more awkward than other children their age — struggling with balance, falling over more than usual or having difficult coordinating limbs.

Sensory difficulties

Children with CP may have hearing impairment or hearing loss as a result. If you notice that your toddler doesn’t seem to be responding or reacting to noises or engagement, they may be suffering from some form of hearing impairment.

Another sensory difficulty associated with cerebral palsy is visual impairment. This is quite common in kids with CP, with around 50% affected.

If your toddler has difficulty focusing when looking at objects (squinting) or appears to have trouble recognising familiar faces, they may be visually impaired. They might also cover their eyes while trying to read, hold books and other objects close to their face, or move their head when looking at something (rather than moving their eyes).

Difficulties and delays with speech and communication

Another common sign of cerebral palsy in young children are difficulties with speech. Learning to talk is another big milestone in childhood; if your child isn’t really speaking at 18 months, or using simple sentences by 24 months, this could be an indication of CP.

They may also struggle to communicate their needs — having difficulties making sounds, forming syllables and saying full words.

 These are some of the most common signs and symptoms of cerebral palsy in infants. However, as there are various forms of CP which can range from mild to severe, not all children with CP will show all of these signs.

 If you are noticing any of these signs or symptoms in your child or you’re concerned about your child’s health and development, then it’s a good idea to consult your GP or paediatrician. The symptoms above could indicate CP or be down to something else, but a healthcare professional will be able to do some checks and tests to find out more. 

 About the author: Dr Don Grant (MB, ChB, DRCOG, MRCGP, is the clinical lead at The Independent Pharmacy, one of the UK’s leading independent online pharmacies