Cerebral Palsy: From Diagnosis to Adult Life

Peter Rosenbaum and Lewis Rosenbloom. Cerebral Palsy: From Diagnosis to Adult Life. A Practical Guide from Mac Keith Press. London: Mac Keith Press; 2012 (210 pages) ISBN 978-1-908316-50-9.

The authors of this book—Peter Rosenbaum from Hamilton, Ontario, Canada and Peter Rosenbloom from Liverpool, England—do not need a special introduction. They are well-known, eminent professionals in the field, with decades of experience in teaching, research, and care for families and patients with cerebral palsy (CP). This book differs from many others published by Mac Keith Press in the series of Clinics in Developmental Medicine. Here, the authors' intention is to speak directly to families of children with cerebral palsy and focus on issues that challenge parents. The book is dedicated to parents, to adults with CP, and to the wide range of service provider colleagues.

The book is organized in four parts. Part 1 (Cerebral palsy—background and perspectives) includes five chapters discussing aspects of definition, epidemiology, causation, and “how people talk about and categorize CP.” A plea is made for the usefulness of retaining the concept of CP as a permanent disorder: a lifelong condition. Part 2 (Contextual factors and critical thinking) deals with evidence; the International Classification of Functioning, Disability and Health; and cerebral palsy and the family (with emphasis on telling “bad news,” impact on parental health and well-being, and family-centered service). Part 3 (Clinical perspectives in cerebral palsy) focuses on clinical recognition and diagnosis of CP, as well as principles of intervention, both conventional and alternative. This is a quite general discussion, not giving specific accounts on, for example, forms of physiotherapy or orthopaedic assessment. To be honest, I expected more practical hints than to learn “that the general health and well-being of children with CP need to be considered carefully.” The argument “that it is important that people who work with families of children with CP have experience and expertise” is a point well taken—but this applies to all fields of pediatric neurology and neurodisability. Part 4 (Outcomes in childhood and beyond) is, again, a very general discussion on outcome and transition. The reader may expect (as I did) hard numbers on outcome and perhaps some practical advice on the issue of transition. But we are informed that one has to consider “what people might mean by outcome” and are reminded that “the answers depend on the precision of the questions.”

If you are looking for a book on cerebral palsy with texts on practical and concrete medical assessments, differential diagnosis, neuroimaging and genetic aspects, and practical management hints on, for example, spasticity or feeding, you will not find what you might expect here. The series title on the lower part of the cover, “A practical guide from Mac Keith Press,” is perhaps equivocal. The text is narrative and includes a few tables, hardly any diagrams, and no photos or radiographic images. However, if you are looking for a general guide on the broad topic of CP, in particular how to address parents, how to perhaps improve service, how to communicate diagnostic information, and what practical and research questions need to be studied, this book will offer an impressive panorama, with an empathetic attitude that the child and the parents should be the focus of all efforts.