LAUSR

Research Objectives To investigate the relationship between community, age of cerebral palsy (CP) diagnosis, and gross motor function in children with CP. Design Retrospective, cohort study. Setting A single, pediatric hospital (2010-2020). Participants N=88 children with CP (N=29 rural, N=30 urban, and N=29 suburban), 0-18 years old (6.7±5.0 years old,55.7% male), all severity levels (N=38 Gross Motor Function Classification System (GMFCS) I, N=12 II, N=9 III, N=17 IV, N=12 V). Interventions Data were sourced from electronic medical records (EMR). Multiple linear regression models were used to evaluate relationships between community, age at CP diagnosis, and gross motor function for children with CP (α=0.03, Bonferroni adjustment). Main Outcome Measures All data was collected via EMR. Gross motor function was measured by Gross Motor Function Measure (GMFM-66). Results Age and community were significant predictors of age of CP diagnosis (respectively:F=100.2,p= Conclusions These results suggest (1) age of CP diagnosis has decreased in the past 10 years, and (2) children from rural Appalachia and urban communities are diagnosed with CP between 1-1.7 years later than children from suburban communities. Early diagnosis for CP is critical, as neuroplasticity is greatest within the first 2 years of life, maximizing potential for motor change. Our study found that age of CP diagnosis has decreased over the past 10 years. This is most likely related to the implementation of international guidelines for detection and diagnosis for CP established in 2017. The results from our study also suggest the child's community may impact age of diagnosis. Future work should investigate factors that contribute to this difference, such as access to care, health equity, and health literacy in rural Appalachia and urban communities. Author(s) Disclosures The authors have no conflicts of interest to disclose. This work was partially funded by the Foundation for Physical Therapy Research PODS II Award to Rachel Bican.