Retrospective study of developmental deficits in children with known brachial plexus palsy

Birth brachial plexus palsy is thought to be due to traction on the roots of the brachial plexus during delivery. The incidence occurs in about 0.1% to 0. 25 % of live births. Much has been written about motor and sensory functional outcome of children with brachial plexus palsy. Little has been written about other developmental disabilities also found in children who have had brachial plexus palsy as a result of birth trauma. Objective: To determine if children who have a history of brachial plexus palsy at birth were at risk for developmental disabilities other than motor and sensory, particularly language impairment, learning disabilities and/or behavior problems. Methods: Chart review was conducted on all currently active Rehabilitation Unit charts at the Children's Evaluation and Rehabilitation Center. Twenty-five cases over the age of 2 years were included. Current ages of children ranged from 2 years 2 months to 16 years 8 months. All children had a diagnosis of brachial plexus palsy at birth. Information regarding developmental assessment with respect to language, learning and behavior was obtained. School placement and ancillary services were noted when available. Other concomitant medical problems were identified. Results: Twelve children (48%) had right sided brachial plexus palsy and 13 children (52%) had left sided palsy. Language problems were reported by professionals as a concern in 15 of 25 children (60%). Formal speech and language assessment was obtained in 11of 25 (44%) and all 11 children were given the diagnosis of language impairment. Eleven of 25 (44%) were recommended and/or receiving speech and language services. Of those diagnosed with a language impairment, 4 of 11 (36%) had a right sided brachial plexus palsy and 7of 11 (64%) had a left sided palsy. Learning problems were reported as concerns in 5 of 25 (25%) of children. Three children (12%) were known to be in special education programs. Behavior problems including attentional difficulties were reported in 9 of 25 (36%) of children. Conclusion: Children with a history of brachial plexus palsy at birth appear to be at risk for having one or more developmental disabilities marked by language, learning and behavior problems.