Bridging the Gap in Early Cerebral Palsy Detection: Primary Care Providers' and Specialists' Perspectives on Implementing PROMPTs for Referral.
Annette Majnemer, Darcy Fehlings, Martina Alkot and 2 others
Canadian primary care providers and specialists described CP detection tools as practical when built into existing well-baby checklists, but identified diagnostic hesitancy before age 2 and rural access gaps as the main barriers to earlier referral.
Key findings
1Nine of 11 primary care providers wanted clearer guidance on when to refer to a paediatrician versus a subspecialist, and 7 of 11 found the EDIT-CP toolkit educational and practical for structuring well-baby assessments.
2A paediatric neurologist reported that diagnosis age for high-probability infants had decreased to 7 months, compared to 24 months in an earlier study, while community referrals still arrived as late as 2 years and 6 months.
3Both groups identified diagnostic hesitancy before age 2 as a persistent barrier, with specialists noting physicians remain reluctant to label CP even when clear signs are present, and primary care providers citing rural access limitations and long specialist wait times.
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What it does not show
Twenty providers is a small sample, and the themes reflect their views, not evidence that the PROMPTs tool changes referral timing or diagnosis age. Participants were drawn primarily from urban and tertiary settings; rural and remote perspectives are underrepresented despite being a stated focus. No First Nations, Inuit or Metis participants were included in this cycle. Voluntary recruitment likely attracted clinicians who already had an interest in early CP detection, which may inflate positive views of the tool. Caregiver perspectives were not collected, so the family experience of early detection and communication is absent. This is a qualitative study of perceptions and opinions. It does not measure whether the PROMPTs actually reduce diagnostic delay or improve outcomes.
Declared interests
Funded by the Kids Brain Health Network. The authors declare no conflicts of interest. ChatGPT (OpenAI) was used for language editing during manuscript preparation; the authors state they reviewed and edited all content and take full responsibility for the final manuscript.
The easy way to misread this
Do not read the positive themes about the PROMPTs as evidence the tool improves early detection. This is a qualitative study of 20 clinicians' perceptions and opinions, not a trial measuring whether referral timing or diagnosis age actually changed. The tool has not been tested in this paper.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →