Health care services for adults with cerebral palsy.
BACKGROUND
Increasing numbers of young adults with cerebral palsy (CP) are transitioning to adult services from coordinated multidisciplinary paediatric hospital services. Limitations on provision of adult services include inadequate funding, lack of trained staff, and fragmented medical, surgical and allied health teams.


OBJECTIVE
This article summarises changes in treatments for children with CP over the past 2 decades and the implications for adult health care services. A multidisciplinary clinic for adults with CP at a tertiary adult teaching hospital in Sydney (New South Wales) is described.


CONCLUSIONS
Over the past 2 decades, interventions such as botulinum toxin-A, intrathecal baclofen infusion, gastrostomy feeding and single event multilevel orthopaedic surgery have improved the lives of children with CP. These interventions are generally delivered within multidisciplinary rehabilitation programs in paediatric hospitals. As the most recent cohorts of children move into adulthood, they, and their carers, have expectations of similarly structured services in the adult health care sector. The Children's Hospital at Westmead and Westmead Hospital, together with The Spastic Centre of New South Wales, recognised this need and developed a multidisciplinary consultative clinic for adults with CP.
Field
Barbara
B
Rehabilitation Medicine, Westmead Hospital, Sydney, New South Wales. bfield@med.usyd.edu.au
Scheinberg
Adam
A
Cruickshank
Adam
A
D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000188:drug therapy* / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy; D006233:Persons with Disabilities; D005260:Female; D005774:Gastrostomy; D006296:Health Services; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000627:therapeutic use; D009465:Neuromuscular Agents / Q000627:therapeutic use; D010348:Patient Care Team / Q000458:organization & administration*; D015397:Program Evaluation; D055815:Young Adult
D009125:Muscle Relaxants, Central; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; D001418:Baclofen