Cerebral palsy (CP) is diagnosed in childhood. The need for knowledgeable medical care does not end when pediatric care ends. Recent research about childhood identification provides an opportunity to examine what is known about children with CP. It also points to what remains unanswered about their care as adults.
New data from the Centers for Disease Control and Prevention (CDC) show how often CP is being identified in young children. The findings suggest that some children may be receiving a diagnosis earlier than children did several years ago.
Earlier identification can give families access to medical care, therapy, early intervention, education supports, and other services sooner. It also raises a question that becomes more important as those children grow older: whether the same level of attention follows them into adulthood.
Researchers reviewed health and education records for children living in selected communities across the United States (U.S.). The surveillance sites were in Georgia, Minnesota, Missouri, Tennessee, and Utah. The CDC has tracked CP for decades and recently resumed broader surveillance through an existing network that monitors developmental disabilities.
The study examined how often CP was identified and when it was documented. Researchers also reviewed the subtypes reported and how children functioned in the participating communities. The estimates describe those five communities and are not national prevalence estimates.
In 2022, CP was identified in an estimated 2.2 per 1,000 4-year-olds and 2.4 per 1,000 8-year-olds. At both ages, the figure was slightly more than two children in every 1,000. Children born in 2018 were also more likely to have CP documented by age four than children born in 2014. This suggests that children in the younger group may have been identified sooner, which could allow services and support to begin earlier.
Researchers cautioned that the difference may reflect improvements in identification rather than an actual increase in the number of children with CP (Patrick et al., 2026). The finding adds useful information about when care may begin. It does not answer whether appropriate care remains available as those children grow older and their needs change.
The study also reported differences in CP prevalence and mobility among racial groups within the communities studied. Among 8-year-olds, CP prevalence was higher among Black children than among White children. A lower proportion of Black 8-year-olds with CP walked independently. These findings describe disparities within the population, but they do not explain the factors contributing to them. Overall, spastic CP was the most common subtype. Among all 8-year-olds with CP, 58.4 percent walked independently (Patrick et al., 2026).
CP does not affect everyone in the same way. One person may walk independently, while another uses a mobility device or needs assistance. The type and level of support can also vary. Medical care and rehabilitation must reflect the needs of the individual rather than a single view of the disability (Centers for Disease Control and Prevention, 2026).
Prevalence data show how many children are identified with CP. The numbers may differ depending on when children are diagnosed and which populations are studied. These findings are important, but CP does not end with childhood. Health needs can continue to change throughout adulthood. Population estimates help define the size of the population. They do not show whether adults with CP can find appropriate care when they need it at 30, 45, or 60.
Adult health needs can be very different from those that led to a diagnosis in childhood. The underlying brain injury is nonprogressive, but its effects on the body can change. Tasks that were once manageable may become more difficult. Pain, fatigue, or changes in movement can affect function in new ways. Aging can bring concerns involving the joints, bones, and overall physical health. Illness, injury, or surgery may create additional limitations and new rehabilitation needs.
Adults with CP can also develop medical conditions that are unrelated to the disability. Other conditions may interact with CP in ways that are not always easy to separate. These conditions may include nerve injuries, arthritis, spinal conditions, tendon injuries, and other neurological or orthopedic problems. When a person’s function changes, it should be evaluated rather than assumed to be part of CP.
The disability can affect how symptoms appear and how the person moves. It can also shape how a clinician interprets an examination. CP may influence which treatments are appropriate and what recovery requires. Even when CP is relevant, other possible causes of the new problem still need to be considered.
Clinicians also need to understand how CP may affect the assessment and treatment of another medical issue. The issue itself may not be caused by the disability. Even so, CP may influence decisions about surgery, rehabilitation, mobility, pain management, or recovery. Clinicians need to consider the current problem along with the person’s existing disability.
Finding that expertise can become more difficult after pediatric care ends. Providers and services available in childhood do not always have a clear counterpart in the adult health system. What was once a coordinated group of specialists can become a search for individual providers with the right experience.
Clinicians have described the need for stronger adult-focused systems. Many people leave pediatric care without an equivalent group of providers who understand CP across the lifespan (Clark et al., 2024). Children with CP may receive care from a range of specialists. Neurologists may evaluate changes in muscle tone, movement, coordination, or other concerns involving the nervous system.
Physical medicine and rehabilitation physicians, also called physiatrists, focus on function and mobility. They also consider the effects of disability on the body. Orthopedic specialists address problems involving bones, joints, muscles, and movement. Physical therapists work on mobility, strength, balance, and movement. Occupational therapists focus on the skills needed for everyday activities. Other specialists may be involved depending on the child’s needs.
Adult care is often less coordinated, even though the need for specialized care continues well beyond the transition from pediatrics. A 2025 University of Colorado study examined 280 adults with cerebral palsy who continued to receive rehabilitation care through a pediatric health system. More than half, 53.8 percent, had at least one equipment prescription, and 57.9 percent were receiving at least one form of therapy.
Across the group, patients had received care from more than 30 types of specialists, reflecting the range of medical and rehabilitation needs that can continue into adulthood. Yet documented transition efforts appeared in only 7.7 percent of rehabilitation visits (Sarmiento et al., 2025). The findings point to a persistent gap: adults may continue to need substantial specialty care even when there is little documented planning for how that care will continue outside the pediatric system
Research also shows how rehabilitation changes in adulthood. The reasons adults use therapy and rehabilitation services are not necessarily the same as they were in childhood. Therapy may help maintain function or address pain and changes in mobility. It may also support the use of equipment or respond to a new decline or medical problem. Equipment needs may change as a person’s abilities, priorities, and circumstances change.
A separate study examined how rehabilitation needs change across adulthood. Adults described the continuing importance of access to therapy. They also reported changes in equipment needs and rehabilitation goals as their health and circumstances changed. Rehabilitation does not become unnecessary after pediatric care ends. Its purpose may change as adults require different equipment, treatment, or support (Sarmiento et al., 2026).
Access to rehabilitation is only one element of effective care. The treatment plan also has to reflect the person’s existing function and physical needs. Muscle tone, balance, established ways of moving, and the use of mobility devices may influence recovery after surgery. Recovery can also place added demands on other parts of the body that are already compensating.
A standard rehabilitation plan may not account for those factors. Before treatment begins, the clinician needs a clear picture of how the person functioned before the new problem occurred. The clinician can then identify what has changed. The plan should address what needs to be restored or adapted and which approach is most appropriate for recovery.
Long-term care also needs to address health risks that may become more significant with age. A 2026 review found a higher burden of osteoarthritis, osteoporosis, and fractures among adults with CP than among adults without CP. The certainty of the evidence ranged from low to moderate. The review also found limited evidence about how musculoskeletal conditions should be monitored and managed over time (Ryan et al., 2026).
These conditions affect the muscles, bones, joints, and other structures involved in movement. Adults with cerebral palsy may develop osteoarthritis or hip degeneration. Tendon injuries and problems related to overuse may also occur, particularly after years of compensating for altered movement. Despite these risks, clinicians still have limited evidence to guide screening, monitoring, and treatment.
Work to strengthen that guidance is underway. In 2023, the Cerebral Palsy Foundation launched an international initiative to develop preventive health care guidelines for adults with CP, with the goal of supporting primary care. The guidelines address pain; musculoskeletal and neurological health; cardiometabolic and respiratory health; mental health; gastrointestinal health; and other concerns that may require attention throughout adulthood (Cerebral Palsy Foundation, n.d.).
Preventive care is meant to identify risks and address concerns before they become more serious. Routine screenings matter, but they are only one part of it. Prevention also depends on recognizing changes early and deciding when closer monitoring is needed. It also means knowing when a concern requires further evaluation or specialty care. Those decisions can determine how quickly a problem is identified and whether treatment begins before the condition progresses or becomes harder to manage.
For adults with CP, the quality of care becomes especially important when health or function changes. A primary-care clinician may need to recognize when a specialist should become involved. A surgeon may need to consider how CP could affect recovery. A therapist may need to adjust rehabilitation to the person’s existing mobility and function.
New concerns may involve pain, but pain is not an inevitable part of CP. Changes may instead appear as increased stiffness or changes in muscle tone. A person may also experience reduced movement or greater difficulty completing familiar activities. Pain and spasticity can occur together, but they are not the same problem. Each may require a different evaluation and treatment. These changes need to be assessed rather than accepted as an expected part of the disability.
Treatment should reflect the person’s current needs. It should also account for aging and recovery from illness or surgery. Changes in mobility or function may require the treatment plan to be adjusted over time. When those elements are missing, treatment may be delayed. The result may be additional loss of function or greater difficulty finding a clinician with the right experience.
The 2026 CDC study is valuable because reliable prevalence data remain necessary. Earlier diagnosis can improve access to services during childhood. Surveillance can also identify differences across populations that warrant further study. The data cannot show whether adults can find appropriate specialists or obtain useful rehabilitation. They also cannot show whether a change in health or function receives a timely evaluation.
A child diagnosed with cerebral palsy at age four will eventually become an adult. The diagnosis may remain the same at 24, 44, or 64, but medical needs can change. New mobility problems may call for evaluation by a physical medicine and rehabilitation physician. Recovery after surgery may involve occupational or physical therapy. Pain, changes in movement, or other musculoskeletal concerns may require orthopedic evaluation. Primary care also remains important in recognizing changes that may need specialty assessment.
Surveillance data can show how often cerebral palsy is identified in childhood and reveal patterns in diagnosis. Far less information is available about what happens later. For adults with CP, important questions remain: whether appropriate specialists are available, whether rehabilitation can be obtained after surgery or injury, and whether changes in strength, mobility, pain, or function are evaluated by clinicians with experience treating adults with CP.
Earlier diagnosis can improve access to services during childhood, but it does not address the medical and rehabilitation needs that continue into adulthood. Those needs may change with age, new health conditions, surgery, injury, or changes in function. Access to adult specialty care, rehabilitation, and treatment, however, remains much harder to measure than childhood prevalence.
Knowing how many children are identified with CP is important. Prevalence data establish the size of the population and can reveal patterns in diagnosis and childhood outcomes. Such data cannot show whether appropriate care remains available as children with CP become adults.
Significant gaps remain in adult care, rehabilitation, transition planning, and long-term clinical guidance. These gaps affect whether adults with CP can find clinicians with appropriate expertise, obtain rehabilitation when needed, and receive timely evaluation when health or function changes. The same gaps also shape whether treatment reflects the realities of aging with CP.
A prevalence estimate can describe the population. It cannot show whether the health care system is prepared to meet the needs of that population 20, 40, or 60 years later. Childhood surveillance can document who is identified with CP. What remains much less clear is what kind of care is available after childhood ends.
As childhood identification improves, a larger question remains: whether knowledgeable adult care will keep pace or become increasingly difficult to find. Earlier diagnosis may connect a child with specialists, rehabilitation, and other services.
Years later, when health or function changes, will that same person still be able to find a clinician who understands cerebral palsy, recognizes what has changed, and knows how to respond?
Author’s Note
The views expressed in this article are those of the author and are not intended to represent any organization associated with the author. The author is not affiliated with the Centers for Disease Control and Prevention, the Cerebral Palsy Foundation, or the researchers and institutions cited.
This article is provided for informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. Readers should consult a qualified health care professional about individual medical concerns and review the original sources for complete study findings.
References
- Centers for Disease Control and Prevention. (2026, June 12). About cerebral palsy. https://www.cdc.gov/cerebral-palsy/about/index.html
- Cerebral Palsy Foundation. (n.d.). Adult health care. https://www.cerebralpalsyfoundation.org/adult-healthcare/
- Clark, J., Sarmiento, C., Sanders, J., Wang, L., Fetsko, L., & Akamagwuna, U. (2024). Navigating the complex care landscape: Addressing challenges and advancing adult care frameworks for individuals with cerebral palsy. Health Care Transitions, 2, Article 100051. https://doi.org/10.1016/j.hctj.2024.100051
- Patrick, M. E., Shaw, K. A., Claridy, M., et al. (2026). Prevalence of cerebral palsy among children aged 4 and 8 years in 5 US communities in 2022. Pediatrics Open Science, 2(2), 1-9. https://doi.org/10.1542/pedsos.2026-001428
- Ryan, J. M., Burke, J., Byrne, R., Capellari, E., Marciniak, C. M., Sofiany, M., Jalal, R., Peterson, M. D., Gorter, J. W., Whaley, A. H., & Imms, C. (2026). Musculoskeletal health among adults with cerebral palsy: A systematic review. Developmental Medicine & Child Neurology. Advance online publication. https://doi.org/10.1111/dmcn.70317
- Sarmiento, C. A., Glaros, C., Wyrwa, J. M., Gianetti, E., Bremel, M., Silveira, L., Borchert, D., Brenner, L. A., & Dorsey Holliman, B. (2025). Rehabilitation needs and healthcare utilization of adults with cerebral palsy: A mixed methods study. Journal of Pediatric Rehabilitation Medicine, 18(4), 268-281. https://doi.org/10.1177/18758894251391901
- Sarmiento, C. A., Petranovich, C. L. K., Moran, N., Glaros, C., et al. (2026). Evolving rehabilitation needs across the lifespan: A mixed methods study with adults with cerebral palsy. Disability and Rehabilitation, 48(5), 1391-1406. https://doi.org/10.1080/09638288.2025.2561860
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