Understanding Cerebral Palsy Classification levels
Aug 8, 2018
Understanding Cerebral Palsy Classification levels

Children with cerebral palsy may be classified as Diplegic, Hemiplegic, Quadriplegic, Dyskinetic, Ataxic or a mixture of these depending on the presentation of their symptoms.

This classification system is useful for determining overarching areas of deficit, but can leave much to be desired when identifying a kiddos level of functional capacity or severity of disability.

While these traditional markers continue to be the primary method of classification used in the medical field, there is an additional system that can provide a more robust picture of the kiddo as a whole.

The Gross Motor Function Classification System (GMFCS) uses 5 levels to classify a child’s individual motor abilities through an analysis of functional mobility or more simply, how they get from place to place.

5 Levels of Cerebral Palsy

<Level 1>
Level 1 includes children who have no restraints when walking. They can ambulate freely without instability. Typically children in this level do not wear any assistive devices.

<Level 2>
Level 2 includes children who can walk without assistance but may have some difficulty at times. Typically these kiddos cannot jump or balance on one foot, may fall frequently and/or need to hold onto railings when walking up stairs or over curbs.

<Level 3>
Level 3 includes children who need to use an assistive device to walk upright. These kiddos can walk in certain environments for reduced distances by self directing the use of devices such as revere walkers or forearm crutches. For longer distances children in level 3 will used wheeled mobility and can often self propel their chair.

<Level 4>
Level 4 includes children who require external assistance in order to get around. They may use a wheelchair or a walker with significant help and support to compensate for lack of speed and/or stability. The child on the right is using a device called a Gait trainer, which provides trunk support for those who are unable to fully support themselves using a typical walker..

<Level 5>
Level 5 includes children who require the assistance of a guardian for all movements. These kiddos often cannot support their head and trunk while seated and may utilize wheelchair positioning devices such as head rests and lateral supports.

Sometimes, the distinctions between different levels can be unclear. Kiddos can have varying abilities, depending on the day. The best way to determine which level is the best fit is to think of how the child gets around most of the time, not just their best performance. Also, although GMFCS levels may seem to focus on lower body function, understand that many of these assistive devices require the use of arms and hands as well.

Seek the advice of your medical or therapy team if you are not sure what GMFCS level applies to your child or if a treatment plan is recommended to maximize their day-to-day function.

Further Reading
Fun Outdoor Activities for Your Child With Cerebral Palsy
Indoor Sensory Activities for Your Child With Cerebral Palsy
Cerebral Palsy Research Network


Movement and Strength of Children with Cerebral Palsy
Cerebral Palsy Rehab
Movement and Strength of Children with Cerebral Palsy
It can be confusing to determine what type and frequency of strength training activity would be helpful for children with cerebral palsy. Follow these tips to set up an effective program.
Stroke Therapy and Exercise: Move Early and Often to Increase Function
Stroke Therapy and Exercise: Move Early and Often to Increase Function
Move early for your stroke therapy and often to increase function. Learn about effective stroke exercises with Smart Glove and Smart Board packages.
How to regain hand grasp and function
How to regain hand grasp and function
The ability to do these simple tasks reduces dependency on others, improves potential for employment and enhances quality of life.
Using the Neofect Smart Glove to Maximize Constraint-Induced Movement Therapy
Constraint Induced Movement Therapy (CIMT) is used to treat people with Hemiplegia by constraining or restricting movement of the non-affected hand to force a person to use their affected hand.
Hemiplegia vs. HemiparesisHemiplegia vs. Hemiparesis
Hemiplegia and hemiparesis could seem very similar because they sometimes have the same underlying symptoms. However, they have different meanings.
What  does  a  drop  foot  brace  do?
Foot drop
What Does A Foot Drop Brace Do?
Are you contemplating to buy a drop foot brace? Here is the check list you need to consider before buying one.