HOUSE MEMORIAL 118

53rd legislature - STATE OF NEW MEXICO - second session, 2018

INTRODUCED BY

Elizabeth "Liz" Thomson and Deborah A. Armstrong

 

 

 

 

 

A MEMORIAL

RECOGNIZING THE IMPORTANCE OF THE EARLY DETECTION OF HIGH RISK FOR AND DIAGNOSIS OF CEREBRAL PALSY IN CHILDREN; REQUESTING THE CHANCELLOR FOR HEALTH SCIENCES AT THE UNIVERSITY OF NEW MEXICO TO RECONVENE THE CURRENT EARLY IDENTIFICATION OF RISK FOR CEREBRAL PALSY TASK FORCE TO CONTINUE DURING THE 2018 INTERIM ITS WORK IN IDENTIFYING BEST PRACTICES IN CEREBRAL PALSY RISK IDENTIFICATION, DIAGNOSIS AND INTERVENTIONS, IN CREATING A PLAN OF CARE THAT MEETS INTERNATIONAL PRACTICE STANDARDS AND IN IDENTIFYING HEALTH COVERAGE GUIDELINES FOR ACCESS TO APPROPRIATE AND TIMELY CEREBRAL PALSY CARE.

 

     WHEREAS, cerebral palsy is the most common physical disability in childhood, with a prevalence of two and one-tenth cases per thousand in high-income countries; and

     WHEREAS, cerebral palsy is a group of permanent disorders of the development of movement and posture, causing limitations in function that are attributed to nonprogressive disturbances that occur in the developing fetal or infant brain; and

     WHEREAS, cerebral palsy is a clinical diagnosis based on a combination of clinical and neurological signs; and

     WHEREAS, currently, diagnosis of cerebral palsy typically occurs in children between the ages of twelve and twenty-four months; and

     WHEREAS, previously, twelve to twenty-four months of age was regarded as the latent or silent period where cerebral palsy could not be identified accurately in children; and

     WHEREAS, experts now consider the concept of the "silent period" outdated, because cerebral palsy or "high risk of cerebral palsy" can be accurately predicted with ninety to ninety-five percent certainty in children before the age of six months, using valid gross motor tests; and

     WHEREAS, a highly experienced clinical team should conduct and interpret the standardized assessments and then communicate the news compassionately to the family, if the child demonstrates an abnormal quality of movement, reduced frequency of movement or the child's motor skills are below what is expected for the child's age; and

     WHEREAS, eighty-six percent of parents of children with cerebral palsy suspect it before the clinical diagnosis is made; and

     WHEREAS, parents and caregivers dissatisfied with a prolonged diagnostic process are more likely to experience depression and lasting anger; and

     WHEREAS, parents and caregivers acknowledge that, while receiving a diagnosis is always difficult, they prefer to know earlier rather than later so that they can assist in their child's development; and

     WHEREAS, when a child is perceived to be at risk of cerebral palsy, the child should be referred for cerebral- palsy-specific early intervention with regular medical, neurological and developmental monitoring from the child's pediatrician or neurologist; and

     WHEREAS, early detection allows improved access to early intervention and efficient use of resources and, therefore, the clinical diagnosis of cerebral palsy or high risk of cerebral palsy should always be followed by a referral of a child to cerebral-palsy-specific intervention and the provision of emotional support to the child's parents or caregivers; and

     WHEREAS, children with cerebral palsy require an early diagnosis because motor and cognitive gains are greater from diagnostic-specific early intervention; and

     WHEREAS, the motor tracts in the brain are primarily formed in the first year of life, so by diagnosing cerebral palsy in children between twelve months and two years of age, this critical period of brain development in the first months of life, when targeted interventions could have the most impact, would be missed; and

     WHEREAS, worldwide, the early detection of high risk for cerebral palsy and use of targeted, timely, research-based, effective interventions are becoming the standard of care to optimize neuroplasticity in young children, prevent complications and enhance parent and caregiver well-being; and

     WHEREAS, since February 2017, representatives of the university of New Mexico health sciences center and the center for development and disability have convened a task force, called the "early identification of risk for cerebral palsy task force", consisting of physicians, including representatives from the subspecialties of pediatrics, neonatology and pediatric neurology; representatives from the fields of nursing, physical therapy, occupational therapy and social work; representatives of health care facilities; representatives of the human services department; and parents and others, who have been meeting monthly to gather research and take steps to implement the international clinical practice guidelines in New Mexico; and

     WHEREAS, the early identification of risk for cerebral palsy task force intends to continue meeting to devise a plan of care for providing children diagnosed with cerebral palsy with interventions that meet international clinical practice guidelines for cerebral palsy; and

     WHEREAS, the early identification of risk for cerebral palsy task force seeks as well to ensure that health coverage provides adequate access to appropriate and timely risk identification, diagnosis and intervention services related to cerebral palsy;

     NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the importance of early detection of high risk for cerebral palsy in children be recognized; and

     BE IT FURTHER RESOLVED that the chancellor for health sciences at the university of New Mexico be requested to reconvene the current early identification of risk for cerebral palsy task force to continue its work during the 2018 interim and invite to participate in the task force the current membership, consisting of representatives from the university of New Mexico health sciences center and the center for development and disability; physicians, including representatives from the subspecialties of pediatrics, neonatology and pediatric neurology; representatives from the fields of nursing, physical therapy, occupational therapy and social work; representatives of health care facilities; representatives of the human services department; and parents; and

     BE IT FURTHER RESOLVED that the chancellor for health sciences at the university of New Mexico be requested to invite as new members of the task force representatives from the interagency benefits advisory committee and private health insurance plans to identify health coverage guidelines that will provide appropriate and timely access to risk identification, diagnosis and intervention services relating to cerebral palsy; and

     BE IT FURTHER RESOLVED that health care professionals, parents and caregivers of young children be encouraged to have young children evaluated for risk of cerebral palsy and, for those children at high risk, seek a diagnosis before the age of six months and begin appropriate intervention; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the governor, the chancellor for health sciences at the university of New Mexico, the executive and clinical director of the center for development and disability of the university of New Mexico school of medicine, the secretary of human services, the secretary of general services, the director of the public school insurance authority, the superintendent for Albuquerque public schools, the executive director of the retiree health care authority and the cerebral palsy parent association of New Mexico.

- 6 -