When a child is born with a birth injury, an accurate diagnosis is the first step towards getting the child the care he or she needs. Unfortunately, many medical conditions caused by birth injuries are frequently misdiagnosed.
An honest mistake, or an attempt to avoid liability?
In recent years, one particular misdiagnosis has become increasingly common: cerebral palsy misdiagnosed as autism.
What is cerebral palsy?
Cerebral palsy (CP) is a movement, muscle or posture disorder that develops as a result of damage to the developing brain, usually before, during or shortly after birth. Most commonly, CP causes impaired movement such as abnormal reflexes, "floppiness" or rigidity of the limbs, abnormal posture, difficulty walking and/or involuntary movements. CP can cause difficulty swallowing and focusing the eyes on objects, and many people with CP also have intellectual disabilities.
In addition, CP is associated with epilepsy, blindness and deafness.
What is autism?
Autism is a developmental disorder that causes difficulties with communication and social interaction, as well as restricted and repetitive behavior. Autism is associated with movement issues, such as poor muscle tone, poor motor planning and toe-walking. Many people with autism have difficulty speaking. Autism can also be associated with involuntary or "spastic" movements.
The cause of autism is not well understood but is generally believed to include some combination of genetic and environmental factors. The idea that vaccinations cause autism, while commonly believed, has been thoroughly debunked by numerous studies.
Why are cerebral palsy and autism commonly confused?
While cerebral palsy and autism are very different conditions, they have several key factors in common. They often become apparent at about the same time: symptoms of cerebral palsy usually become apparent within the first three years of life, and symptoms of autism are usually observed at age two to three. They also share a number of the same symptoms, including:
- Difficulty speaking
- Abnormal walking
- Poor muscle tone
- Awkward or involuntary movements
- Sensory symptoms, such as impaired vision or hearing
- Apparent intellectual disability
Because autism and the spectrum of related disorders, commonly called autism spectrum disorders or ASD, cover such a broad range, it is entirely possible for an autistic child to have symptoms that closely resemble cerebral palsy - and likewise, it is quite possible for a child with cerebral palsy to have symptoms that closely resemble classic autism or another condition on the autism spectrum.
Why is this misdiagnosis so common?
Diagnosis is not an exact science. Many medical conditions have similar symptoms that occur under similar circumstances, and doctors often mistake one condition for another. That is particularly true for autism because of the amount of attention paid in media and popular culture to this particular disorder. In the current environment, doctors may be more likely to over-diagnose autism - and parents may be more likely to believe them.
While mistakes certainly happen, there is another, potentially more problematic reason why hospitals and doctors may lean toward autism diagnoses rather than diagnosing cerebral palsy. Cerebral palsy is often the result of medical malpractice. Specifically, errors made by obstetricians and other medical professionals during labor and delivery can cause the baby's brain to become deprived of oxygen, leading to brain damage that causes cerebral palsy. Such an incident can expose the hospital to liability in a medical malpractice claim.
Meanwhile, the causes of autism are not well understood and generally cannot be linked to negligence. Thus, an autism diagnosis insulates the doctor and hospital from liability.
We are not accusing doctors of deliberately misdiagnosing children with cerebral palsy, but it is important to keep in mind the financial incentives that medical providers have when giving a diagnosis. If your child was diagnosed with autism and you suspect that the true diagnosis was cerebral palsy, you need to get a second medical opinion and talk to an attorney with experience handling birth injury cases. The consequences for your child's life could be massive.