Motor Impairment Referrals to an International Child Development Clinic: It Isn’t Always Cerebral Palsy

Background The majority of the estimated 50 to 100 million children living with disability worldwide reside in low- or middle-income countries (LMIC). As families migrate to avoid humanitarian crises, children with developmental disability and delay warrant particular attention in refugee and international health settings. During transitions, medical documentation may be lost and diagnoses may not be fully understood, contributing to the challenges of determining etiologies of motor impairment. Methods Of the first 100 refugee children who were referred to the International Child Developmetnal Clinic, we identified a subset of children referred for motor impairment or cerebral palsy. Data on their presentation, diagnoses following work-up, and therapeutic services required was collected by retrospective chart review. Results 20 children were referred for motor impairment and cerebral palsy. Average age was 8.9 years old. 45% were female. 8 children were eventually diagnosed with cerebral palsy and 12 had alternate or inconclusive diagnoses. Microcephaly was more common in children diagnosed with ccerebral palsy. Discussion The frequent differences between referral and final diagnoses in refugee children referred for cerebral palsy highlights the need for pediatricians’ careful exam and diagnostic reasoning upon initial presentation.