Neurodevelopmental Clinical Observations in Children with Cerebral Palsy

Neuro-Sensory Developmental Unit, Kasturba Medical College, Mangaluru

(Please Circle the appropriate one or refer below mentioned guidelines)

A. Automatic Reactions During ROLLING (Choose One Only)

1. No Log- Roll- Trunk Flaccid 5. Segmentally Rolls but cannot stop Roll, even at the
2. Log-Rolls Upper Body edge (Body Righting)
3. Log-Rolls using arching and Limb Retraction 6. Can Stop Segmental Roll at any point in Space
(Neck Righting) (Equilibrium Reactions)
4. Log-Rolls safely with Neck, Shoulder and Hip
Flexion (Neck Righting)
B. Upper Limb Strategies C. Lower Limb Strategies
1. Scapula: Abducted/Downward/Upward/ 8. Flexion Synergy
Adducted/Winging Hip- Abduction; Flexion; External Rotation; Knee-
2. Arms: Internally Rotated with Elbow Flexion/ Flexion to 90; Ankle- Dorsiflexion; Toes- Extension
Extension/Pronation/High Guard 9. Extension Synergy
3. Forearm: Pronated/Supinated Hip- Adduction; Extension; Internal Rotation; Knee-
4. Elbow: Flexed/Extended Extension; Ankle- Plantarflexion; Toes- Flexion/
5. Wrist: Flexed/Extended Extension
6. Hands: Fisted/Open
7. Thumb: Adducted/Abducted
D. Sits Symmetrically: On Floor or Bench E. Active Weight Shift in Sitting
1. Head: Midline; Erect; Down; Unstable 1. Lean Forward: Anterior/Neutral/Posterior Tilt in
2. Shoulder Height: Even; R > ? < L Pelvis
3. Pelvic Tilt: Anterior; Neutral; Posterior 2. Lean Sideways: To Right; To Left
4. Weight on Both Hips: Equal; R > ? < L 3. Active Trunk Rotation to Right
5. Hip Abduction: R > ? < L 4. Active Trunk Rotation to Left
F. Equilibrium in Sitting G. Protective Extension in Sitting
Left Right Left Right
------ Vertical Head Righting ------- ------ Vertical Head Righting -------
------ Trunk Elongation on Weight ------- ------ Lateral Trunk Flexion on Weight -------
Bearing Side Bearing Side
------ Rotation with /Posterior Tilt ------- ------ Rotation with /Anterior Tilt -------
----- Abduct Uphill Arm/Leg ------- ------ Extend Downhill Arm/Leg -------
Guidelines for Scoring: Yes- Child is able to Perform; No- Child is Not able to Perform; PA- Physical Assistance (Max/Mod/Min); ± - Partial
Performance; I- Independent; NT- Not Tested. Ref: Dutton R. Clinical Reasoning in Physical Disabilities. 1995.
Neurodevelopmental Clinical Observations for Gross Motor in Children with Cerebral Palsy
Neuro-Sensory Developmental Unit, Kasturba Medical College, Mangaluru