The Musculoskeletal System in Children with Cerebral Palsy: A Philosophical Approach to Management

Do we need a paradigm shift in our approach to the assessment and management of the musculoskeletal system in children with cerebral palsy? This book encourages clinicians to reflect on how their thoughts and approaches are shaped by the clinical society. Using new perspectives and expertise, this book will inspire clinicians to rethink conventions about the child with cerebral palsy, consider how they communicate these new concepts to their fellow clinicians, and act to bring about positive changes in the management of children with cerebral palsy.

  • Provides a critical review of the current understanding and management of musculoskeletal deformity in children with cerebral palsy.
  • Transfers current understanding of muscle and bone physiology and function, from the realms of research into mainstream clinical thinking.
  • Advocates for an alternative clinical model of assessment and intervention, focusing on the experience of the child with cerebral palsy and their experience of the world.
  • Proposes the concept of the musculoskeletal system in the child with cerebral palsy as a linked system of interactive processes and subsystems, extending from individual molecules to the child and their environment.


A critical resource for clinicians and researchers involved in the care of children with cerebral palsy including Neurologists, Physical Therapists, Orthopaedic surgeons and Neurosurgeons, as well as researchers and clinicians in the philosophy of medicine.


Author podcast

In this podcast, authors Martin Gough and Adam Shortland discuss their upcoming publication with us, The Musculoskeletal System in Children with Cerebral Palsy: A Philosophical Approach to Management.

Early Detection and Early Intervention in Developmental Motor Disorders

Early-detection-and-early-intervention-in-developmental disorders

Critically ill infants in the newborn period are at high risk of developmental motor disorders. Mijna Hadders-Algra comprehensively addresses how best to detect which infants will be later diagnosed and how best to enact early intervention to improve their quality of life. Parts I & II provide an overview of the clinical picture and neurodevelopmental mechanisms. In Parts III & IV basic principles and features governing typical and atypical motor development are explained. Part V summarises assessment methods and Part VI discusses the methods and effectiveness of early intervention.

  • Provides practical clinical strategies to improve care of children with or at risk of developmental motor disorders (such as cerebral palsy or developmental co-ordination disorder).
  • Pays special attention to the family and environmental adaptations.
  • Video-clips illustrate typical and atypical movements.
  • Consistent use of the ICF as a framework.

From the Foreword

“The combination of theoretical and practical information with some really philosophical insights provide value for clinicians and for those wanting to teach and expand the evidence base in this area for the future.”

Anna Basu

Clinical Senior Lecturer and Honorary Consultant Paediatric Neurologist,

Population Health Sciences Institute, Newcastle upon Tyne, UK


This evidence-based practical guidance will be useful for health professionals working in the field of early detection and early intervention including paediatricians, developmental paediatricians, neonatologists, child neurologists, paediatric physiotherapists, occupational therapists, psychologists and educationalists.

Author Podcast

In this podcast, Anna Basu interviews Mijna Hadders-Algra about their newest publication, Early Detection and Early Intervention in Developmental Motor Disorders (March 2021).

The Cerebral Palsies: Epidemiology and Causal Pathways

This is a specialist reference on the most common physical disability – the cerebral palsies. It reviews published data on trends, presents thinking on causal pathways in the cerebral palsies suggesting means of prevention, and reviews management options. It is an essential guide to good epidemiological research into cerebral palsies and related areas.

Clinics in Developmental Medicine No.151

The Hemiplegia Handbook

Childhood hemiplegia affects up to one child in 1000. It is a condition affecting one side of the body caused by damage to the brain before, during or soon after birth (congenital hemiplegia) or later in childhood (acquired hemiplegia).

Until now there has been no book giving an overview of childhood hemiplegia for the people who are most affected by it – the children and young people themselves, and their parents, families, friends and teachers, as well as the professionals working with them on the management of their condition.

This highly accessible guide provides this overview, giving the background to how and why hemiplegia happens in children, outlining the different approaches to therapy, and setting out guidance on how to support the child or young adult with hemiplegia. It is practically orientated, answering many of the questions posed by families, carers and members of the interdisciplinary team involved with the children. It is invaluable both for parents and for medical and allied professionals.

  • Highly readable, practically orientated collaboration between a parent and a paediatrician
  • Accessible, straightforward explanations of nervous system development, what can go wrong, and the management options
  • Helpful overview of the practicalities of supporting the child or young adult with hemiplegia
  • Clearly outlines the different approaches to therapy
  • Valuable both for parents and carers and for the multidisciplinary team working with the child


Parents and carers; community health multidisciplinary teams; paediatricians (especially general and community); education professionals and social service interdisciplinary teams.

A Practical Guide from Mac Keith Press 

Typical and Atypical Motor Development

Sugden and Wade, leading authors in this area, comprehensively cover motor development and motor impairment, drawing on sources in medicine and health-related studies, motor learning and developmental psychology.

A theme that runs through the book is that movement outcomes are a complex transaction of child resources, the context in which movement takes place, and the manner in which tasks are presented.

The core themes of the book involve descriptions of motor development from conception through to emerging adulthood, explanations of motor development from differing theoretical, empirical, and experiential perspectives, and descriptions and explanations of atypical motor development when the resources of the child are limited in some way.


Occupational therapists, physiotherapists, paediatricians, teachers (physical education, early childhood development, elementary education), educational psychologists, kinesiology and sports scientists.

Clinics in Developmental Medicine

Neurophysiology and Neuropsychology of Motor Development

The central focus of this book is the development of skilled motor actions by children; commonplace but vital actions such as maintaining posture, walking, reaching and grasping, and manipulating objects and tools. It represents a state-of-the art report on motor development linking neurophysiological and neuropsychological approaches. Using examples from both normal and pathological development, contributions study pre and postnatal brain development and its relationship to movement, the importance of fetal movements, postural control in children, the neurobiology of locomotor development, neural mechanisms of grasping and typical patterns of behavioural change. New theoretical developments including adaptive model theory, dynamic systems theory, and the relationship between variability and stability in skill development are also critically reviewed.

Clinics in Developmental Medicine No. 143

Orthopaedic Management in Cerebral Palsy, 2nd Edition

Comprehensive review of current methods of management and evaluation of the motor disorders of cerebral palsy.

  • Features the whole range of orthopaedic surgical procedures with commentary on each
  • Reviews the current epidemiology in the subject, offering perspective on prevention
  • Provides tables of gross motor performance to assess the measure of effectiveness of physical therapy
  • Describes methods of management, including: assistive technology, selective posterior rootlet rhizotomy, Botulinum toxin intramuscular injections and intrathecal Baclofen.

Clinics in Developmental Medicine No. 173-4

Paediatric Orthotics

Orthoses are externally applied medical devices used to prevent or correct musculoskeletal deformities and improve physical functioning; these devices are typically custom made. This is one of very few books on the subject of orthotics published in recent years and the only book focusing solely on the orthotic management of children.

The first part of the book considers the principles that are fundamental to orthotic management, including a review of biomechanics, consideration of clinical assessment methods, and the materials and fabrication techniques used to make orthoses. The second part of the book comprises several condition-specific chapters that consider the appropariate orthotic management of the more common conditions in childhood in the context of multidisciplinary care. The chapters include neuromuscular conditions such as cerebral palsy, myelomeningocoele and muscular dystrophy; and also congenital deformities and conditions arising in childhood. One chapter considers orthotic intervention for idiopathic scoliosis and another considers the sometimes controversial issue of protective and corrective headwear. Whilst by no means exhaustive, Paediatric Orthotics provides both a basic grounding in the subject together with practical guidance to help clinical practice.

Paediatric Orthotics will be of use, not only to orthotists but also to physical and occupational therapists, paediatricians, paediatric orthopaedic surgeons and physiatrists. The book is also essential reading for all students and clinicians involved in the physical management of children with disabilities.

Clinics in Developmental Medicine No. 175

Physiotherapy and Occupational Therapy for People with Cerebral Palsy

Practical Guide

This book is a practical resource for physiotherapists and occupational therapists who support people with cerebral palsy, helping them to solve the problems with movement and other impairments that so often accompany cerebral palsy, so that they can be more active and better able to participate in roles such as study, work, recreation and relationships.

The first chapters provide the background to the clinical reasoning approach that informs the whole text, as well as an overview of therapeutic interventions.

The subsequent chapters present clinical situations that therapists will encounter in the course of their work with individuals with cerebral palsy across the lifespan.

Each chapter describes a case in detail, including the reasoning behind assessment and treatment choices, interventions and outcomes.

The themes emphasized throughout the book are the use of the clinical reasoning approach of the intervention process model, the International Classification of Functioning, Disability and Health as a framework to help therapists inform patient and family decision-making, family-centred approaches in developing and implementing therapeutic strategies, and multidisciplinary team work.

Postural Control

The complex nature of the postural control system makes it vulnerable to adverse conditions during early life, such as prenatally or perinatally acquired lesions of the brain or preterm birth. Children with disorders of the developing brain nearly always have dysfunctions in postural control. The postural control system of children with other neurodevelopmental disabilities such as myelomeningocele or muscle disease is also challenged: it has to find age-specific solutions for the postural problems posed by the disorder. These postural problems have serious consequences for the activities of daily life, as adequate postural control is a prerequisite for adequate motility. Until now, knowledge about the nature of postural problems in children has been scattered, and this has hampered the development of appropriate therapeutic management strategies. This book is a breakthrough in that it introduces the reader to the complexity of typical and atypical postural development and provides suggestions for the day-to-day management of postural problems in children with developmental disorders such as cerebral palsy, developmental coordination disorder, muscle disorder and myelomeningocoele. ‘This should be a “must read” for anyone whose occupation or interests are in the areas of motor development or rehabilitation.’ Diane Damiano

Clinics in Developmental Medicine No. 179