1. Every 20 hours an Australian baby is born with CP 

Data from the Australian Cerebral Palsy Register shows a decline in the prevalence of cerebral palsy (CP) over the past 30 years, from 2.4 per 1000 live births in 1997–98 to 1.5 in 2015–16 (ACPR 2023, ACPR 2025). 

One in 700 babies was born with CP in 2015–16, down from one in 400 in 1997–98, a drop of 40 per cent. There has also been a decrease in severity. 

Fewer children born with CP require mobility aids than previously: 0.5 per 1000 live births in 2015–16 compared with 0.8 in 1997–98. 

However, while the decline in prevalence has been consistent for children born at 32 weeks or later, the rate of CP among children born very preterm (28–31 weeks) and extremely preterm (≤ 27 weeks) appears to be increasing. 

The ACPR report (2023) shows us that 30 per cent of children with CP live in regional, rural or remote Australia, shining a spotlight on the need to ensure that children have access to high quality, timely services regardless of where they live. 

It feels particularly pertinent to highlight this at a time when cuts to travel funding under the NDIS are impacting service provision to some of our most vulnerable people. The need to advocate for regional, rural and remote families remains a priority.

2. Multiple motor disorders are common in CP 

Cerebral palsy is a heterogeneous condition in which multiple motor disorders are present. 

People with CP can present with spasticity, dystonia, choreoathetosis, ataxia and generalised hypotonia with increased reflexes. 

A motor disorder may be present in isolation or in any combination. 

A recent study by Dar et al (2024) identified multiple motor disorders in over 50 per cent of children and young people with CP attending a tertiary rehabilitation clinic. 

Spasticity and dystonia in combination was identified in 50 per cent of children and young people. 

Dystonia was seen in 60 per cent of children, although only six per cent of children had dystonia as a single motor disorder. 

Dystonia was also associated with more severe functional impairments and intellectual impairment. 

The heterogeneity of presentations among children with cerebral palsy poses a challenge to families and clinicians trying to choose the ‘right’ interventions. 

No one intervention will address all the needs of all children (Golland 2016). 

Common interventions used in the management of spastic CP (such as botulinum toxin-A injections, orthoses and casting) often provoke unpredictable responses or are ill tolerated in children with dystonia (Stewart 2018). 

Accurate identification of motor disorders is essential to support intervention choices and prognosis (Dar et al 2024, Stewart 2018). 

3. Early diagnosis of CP is possible and necessary 

Nearly 60 per cent of babies with CP in Australia are born at or near term (37+ weeks) (ACPR 2025). Unless they are unwell at birth, most babies are not followed up through neonatal clinics. 

Parents are often the first to raise concerns that their child is not developing as they would expect and often seek support through child and family health nurses, GPs, paediatricians and physiotherapists. 

Best practice no longer supports a ‘wait and see’ approach—CP can be accurately diagnosed before six months of age using a combination of standardised assessments. Combining the General Movements Assessment, MRI and the Hammersmith Infant Neurological Exam accurately identifies CP in 98 per cent of infants under five months. 

After five months, the Hammersmith Infant Neurological Exam and MRI are most predictive (90 per cent). 

Early identification is critical in ensuring that babies get access to CP-specific early intervention to optimise motor and cognitive neuroplasticity and are monitored for known secondary impairments such as hip displacement. 

Early diagnosis has also been shown to support parental wellbeing. 

Signs that a baby should be assessed for CP include early hand preference (before 12 months), persistent fisting of one or both hands (beyond four months), stiffness or tightness in the legs (between six and 12 months), persistent head lag (beyond four months), inability to sit without support (beyond nine months) and consistent asymmetry of posture or movement (beyond four months) (Novak et al 2017, Boychuck et al 2019). 

4. Guideline aims to improve physical function in children with CP 

All people with CP are unique and intervention plans should reflect individual goals and aspirations as well as personal preferences and motivators (Novak 2014, Jackman et al 2021). 

To support clinicians working with children and young people with CP, an international good practice guideline has been released. 

The guideline aligns with the World Health Organization’s International Classification of Functioning, Disability and Health framework and the ‘F words’ for child development: functioning, family, fitness, fun, friends and future. 

It identifies nine good-practice recommendations and four evidence-based recommendations for improving physical function (Jackman et al 2021). 

To improve physical function, intervention should be based on a client’s self-chosen goals; focus on active practice of these goals; involve whole-task practice; be fun and motivating; occur in an environment relevant to the goal, such as at home or in the community; and ensure that practice occurs at a high enough dose to achieve functional goals. 

Goal-directed approaches are recommended across all motor types and severities, with the addition of environmental adaptations and assistive technology for children and young people with more severe physical impairments. 

At all times, child and family preferences, age and ability need to inform the choice of interventions. 

5. The leading CP body is now the Oceania Academy

The Australasian Academy of Cerebral Palsy and Developmental Medicine has formally changed its name to the Oceania Academy of Cerebral Palsy and other Childhood-onset Disabilities. 

The new name better reflects the work of the academy in supporting children and adults with cerebral palsy and childhood-onset conditions across all of Oceania, not just Australia and New Zealand. 

The name also recognises a lifelong approach to supporting people with disabilities that begin in childhood and continue throughout life. 

The Oceania Academy continues to provide multidisciplinary scientific education for health professionals and to promote excellence in research and best practice clinical care. 

Its website houses a collection of resources and educational material to support clinicians and families, including the Australian hip surveillance guidelines for children with cerebral palsy 2020, the Dyskinesia toolkit for clinicians and a consensus statement: Prevention and management of respiratory disease in young people with cerebral palsy as well as the previously mentioned international clinical practice guideline on improving physical function. 

Membership of the Oceania Academy provides access to members-only educational material, networking opportunities and discounted registration for its biennial conference. 

Hobart will host the next Oceania Academy conference on 3–7 March 2026. 

>>Prue Golland APAM is a physiotherapist with over 20 years’ clinical experience in cerebral palsy and developmental disability. She previously led the clinical governance team at Cerebral Palsy Alliance and is the founder of mobile physiotherapy service the Collaborative Physio. She was awarded a Churchill Fellowship in 2015 to investigate evidence-based interventions for maximising gross motor outcomes in children with cerebral palsy. Prue is a member of the APA Disability national group.

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