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What Are the Key Early Clinical Signs of Cerebral Palsy?

Maria Baldino, OTD, MS, OTR/L, BCP, Lindsay Moore, PT, DPT, PCS

December 1, 2025

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Question

What are the key early clinical signs of cerebral palsy?

Answer

Pediatric therapists play a crucial role in identifying clinical red flags for CP, particularly in children without a history of NICU care. These warning signs, often highlighted during therapy sessions, include persistent asymmetries or early hand preferences before 12 months, abnormal tone (such as stiffness or tightness), and delays in achieving milestones, such as head control or sitting. Once these signs are identified, therapists have the responsibility to initiate a prompt referral to specialists. An ideal referral pathway should include neurology or a physiatrist for official diagnosis, and may also involve a high-risk infant follow-up clinic.

 

This Ask the Expert is an edited excerpt from the course, Early Detection Of Cerebral Palsy: Best Practices And The Role Of Therapy Providers, presented by Maria Baldino, OTD, MS, OTR/L, BCP, Lindsay Moore, PT, DPT, PCS.

maria baldino

Maria Baldino, OTD, MS, OTR/L, BCP

Maria Baldino is an assistant professor in the occupational therapy department at the University of Minnesota and a Board Certified Pediatric Occupational Therapist with over a decade of experience across various pediatric settings. Her practice has focused on outpatient care, NICU follow-up clinics and other specialty clinics, and acute and critical care settings. She is certified in the Prechtl General Movement Assessment and the Hammersmith Infant Neurological Examination, and her current research explores the experiences of parents and caregivers navigating early detection and diagnosis of cerebral palsy. She continues to practice in pediatric acute care.
lindsay moore

Lindsay Moore, PT, DPT, PCS

Lindsay Moore is a Board-Certified Clinical Specialist in Pediatric Physical Therapy with over a decade of experience in medical outpatient care. She practices at Phoenix Children’s and is a pediatric lecturer at Creighton University’s Phoenix campus. Lindsay has led the development of a high-risk infant follow-up program that integrates evidence-based practice into clinical systems to improve early identification and care coordination. She also leads the Arizona Cerebral Palsy Early Surveillance Task Force, advancing statewide collaboration in early detection and intervention. Her professional interests include early detection and diagnosis of neurodevelopmental conditions, timely seating and mobility interventions, and best practices in equipment prescription. She is passionate about building community partnerships and translating research into sustainable, equitable models of care for children and families.

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