Background: Early intervention is considered best practice for children with Cerebral Palsy (CP); however, this can only be achieved if children are identified early. As little is known about current clinical practice in Sweden, we aimed to investigate whether children with CP in Uppsala County, Sweden, have equal access to timely physiotherapy. Furthermore, we describe their birth history and CP profile to learn more about typical features that might enable earlier identification.

Methods: We conducted a retrospective chart review study including children born in the county from 2010 to 2016, who received a CP diagnosis by December 2018. Entries by doctors and physiotherapists working at Uppsala University Children’s Hospital were reviewed.

Results: Thirty-eight children were included (21 girls). Twenty-two were term born. Age at first visit to physiotherapy varied greatly and depended on referral source (p<0.000) and number of risk factors for CP (p<0.000). Children considered at low risk for CP received therapy later. Severity of motor impairment (p=0.001) and number of risk factors (p=0.014) influenced age at referral to habilitation services. Twenty-eight children were ambulatory at 2 years of age. Unilateral (n=16) and bilateral (n=17) spastic CP was most common. Children referred from the child health services (CHS) had milder forms of CP.

Conclusion: Children with CP have unequal access to timely physiotherapy, and children referred from the CHS have the most delayed access. All professionals performing developmental surveillance should receive proper training and use evidence-based assessment methods when available to provide safe and equal care. Physiotherapy should be available prior to formal medical diagnosis.