- Do I need a referral to come to your clinic?
- What is the earliest a child with CP can be diagnosed?
- What observations of my child should make me suspicious that he or she may not be developing normally?
- What did I do wrong to have a child with cerebral palsy?
- Is cerebral palsy curable?
- If cerebral palsy is not progressive, how come my child seems to have gotten worse as she gets older?
- Why do my child’s bones seem to be twisting as she gets older?
- Do you see adults with CP?
- I am an adult with CP and have had a sudden loss of function. Is this because of my CP?
- I have not seen a doctor about my CP in years, but I notice it I harder for me to get around. Should I be concerned?
- What kind of insurance do you accept?
- Do you accept MediCal?
Q: Do I need a referral to come to your clinic?
Patients with a managed care (HMO) insurance, including MediCal HMO or California Children’s Services (CCS), need to obtain an authorization before an initial appointment can be made. The authorization should to be made out to “UCLA Orthopaedics” . Since we are an orthopaedic clinic, all initial consultations must include authorization for us to take x-rays if recommended by our physicians. If you or your provider has questions regarding this requirement, please contact our office. While we gladly accept referrals from primary care physicians or specialists, all non-managed care patients may make an initial appointment without a referral. (top)
Q: What is the earliest a child with CP can be diagnosed?
A definite or suspect diagnosis is often possible in infancy. For some children with mild cerebral palsy, a definitive diagnosis may not be made until eighteen to 24 months. (top)
- excessive irritability, especially with arching of the back or neck
- over or under reactivity to environmental stimulation
- difficulty with feeding or swallowing or choking when fed
- delay in achieving head control, rolling, sitting, crawling or walking
- performance of developmental milestones beyond the upper limit of normal time frames (top)
Q: What did I do wrong to have a child with cerebral palsy?
In most instances, it is very difficult to determine the exact cause of cerebral palsy. For many children, injury or damage to the brain may occur weeks before birth and is beyond the parents’ control. With the exception of exposure to alcohol, drugs or smoking during pregnancy, it is rare that any event or action on the part of the mother caused the child to have cerebral palsy. (top)
Q: Is cerebral palsy curable?
No. Cerebral palsy is not curable. That does not mean, however, that children with cerebral palsy cannot grow up to be functional, independent members of the community. The best long-term results are related to beginning therapy as early as the diagnosis is made. Therapy may include physical, occupational and speech therapy. Treatment interventions are designed to maximize function and allow for the child to interact with family, friends and community. (top)
Q: If cerebral palsy is not progressive, how come my child seems to have gotten worse as she gets older?
By its definition, cerebral palsy is not progressive, which means that the injury to the brain does not get worse over time. The symptoms of cerebral palsy may, however, appear to change as the child matures. This is because of the abnormal signals in the brain that cause the spasticity. As a child grows, the bones grow as well. A spastic muscle may not stretch and grow at the same rate as the normal bone. This results in the muscle getting tighter as the child grows, and joints that once seemed loose now appear tighter. (top)
Q: Why do my child’s bones seem to be twisting as she gets older?
Bones grow in response to the force of the muscles pulling on them. The injury to the brain impairs the brain’s ability to control muscle activity. This may result in an imbalance of muscle activity, with some muscles being more spastic and exerting more of a force the one that moves in the opposite direction. This may result in changes in the bone as it grows. Common bony deformities in cerebral palsy are turning in of the hips or knees. (top)
Q: Do you see adults with CP?
Cerebral palsy is a lifelong condition and the Center for Cerebral Palsy clinic is a lifespan clinic. We see people with cerebral palsy regardless of their age. As of May 2011, however, the State of California has changed its coverage of seniors and people with disabilities who have MediCal as their sole insurance. Please refer to the FAQ “Do you accept MediCal?” for more information. (top)
Q: I am an adult with CP and have had a sudden loss of function. Is this because of my CP?
Cerebral palsy is a non-progressive disorder of the brain. While it is well-known that adults with cerebral palsy may experience the signs and symptoms of aging earlier than the unaffected population, a rapid change in muscle strength, sensation or overall function is not a sign of CP and should be evaluated by a physician. (top)
Q: I have not seen a doctor about my CP in years, but I notice it I harder for me to get around. Should I be concerned?
Recent research and our clinical experience have shown that adults with CP exhibit many of the signs and symptoms of aging sooner than their unaffected contemporaries. It is not uncommon for someone who was able to walk without equipment to choose to use a cane or a wheelchair for long distances when they are older. Depending upon the person and the degree of their impairment, these slow changes may begin in their 20s or 30s. Some of these problems may be respond to an individualized exercise program that strengthens muscles, increases cardiorespiratory endurance or increases muscle flexibility. The Center for Cerebral Palsy’s inter-disciplinary team can evaluate you and determine if your problems are amenable to therapy or other intervention to improve your quality of life. (top)
Q: What kind of insurance do you accept?
The Center for Cerebral Palsy accepts most insurance carriers, however, if your insurance requires you to have an authorization to come to UCLA (e.g. you have an HMO) you must obtain an authorization before making an appointment. If you have any questions regarding your referral, please call (424) 259-6593. To avoid problems on the day of your appointment, we must have a copy of your authorization and your insurance card before scheduling an appointment. Please fax, or have your physician or insurance company fax a copy of the authorization to (424) 259-6560 before calling for an appointment. (top)
Q: Do you accept MediCal?
As a part of the MediCal expansion of the Affordable Care Act, seniors and adults with disabilities who have MediCal as their only insurance have been transitioned to a MediCal managed care (HMO) plan. UCLA has a contract with some of the MediCal HMOs; however, the Center for Cerebral Palsy does not maintain a list of these contracts, as the frequently change. If you would like to be seen in our clinic and are a member of a MediCal HMO, you may contact your medical group or ask your provider for a referral. Some adults with cerebral palsy may be seen at Rancho Los Amigos National Rehabilitation Center’s new Adults with Developmental Disabilities Clinic. For more information about the program at Rancho, call (562) 401-7143 or visit their website at www.rancho.org and click on “Healthy Way LA Health Coverage Program”.
We will continue to make appointments for current UCLA patients who have straight MediCal (not in an HMO). For specific questions regarding an appointment for a patient with MediCal, please contact the clinic appointment line at (424) 259-6593.
For children between the ages of three and twenty-one who have cerebral palsy and MediCal for their only insurance, California Children’s Services (CCS) is the primary insurer. These patients must obtain an authorization from their CCS Medical Therapy Unit (MTU) before making an appointment to the Center. According to California rules governing the use of CCS, we cannot accept MediCal as a substitute for a CCS authorization.
For further information on California Children’s Services, contact them at their website http://www.dhcs.ca.gov/services/ccs/Pages/default.aspx (top)