What is CPIP?

CPIP (Cerebral Palsy Integrated Pathway) is a regular review programme for children and young people who have cerebral palsy, or where cerebral palsy is suspected.

The aim of CPIP is to keep a close eye on how your child’s muscles, joints and movement are developing as they grow. By checking this regularly, we can spot small changes early and offer support at the right time — often before problems become harder to manage.

Some children and young people with similar movement difficulties may also be offered a CPIP assessment, as many families find that having a planned annual review is helpful and reassuring.

Why is CPIP important?

Cerebral palsy can affect how a child’s body grows and moves over time. As children get older, this can sometimes lead to:

  • Muscles becoming tighter or stiffer
  • Changes in how the hip joints are positioned
  • Changes in walking or mobility
  • Pain or discomfort
  • Difficulties taking part in everyday activities

These changes do not always happen suddenly, and without regular checks they may go unnoticed until they are more difficult to treat. Attending CPIP assessments helps us to:

  • Spot changes early
  • Plan support or treatment before problems worsen
  • Reduce the risk of avoidable complications
  • Support long-term comfort, movement and participation

 

What happens at a CPIP assessment?

A CPIP assessment is a structured physiotherapy review that uses the same measurements each time, so we can clearly see how things are changing over the years.

During the assessment your child’s muscles and joints are gently moved through their usual range and muscle length and tone are measured a goniometer (an angle measure like a protractor). Results are recorded using a traffic-light system (green, amber and red), which helps us quickly see whether things are stable or changing and provides an early warning system.

When assessments are repeated, they build up a clear picture of your child’s physical development and help guide future decisions about care.

 

How often are CPIP assessments done?

From 2 to 6 years of age: every 6 months

From 6 to 16 years of age: once a year

 

What should we expect on the day?

The assessment is usually carried out by two trained therapists or assistants and normally takes around one hour to complete. Wearing shorts and comfortable, loose fitting clothes is beneficial.

The assessment should not be painful. Some children may find stretching a little uncomfortable, but the assessment can be paused at any time and your child can move, wriggle or take breaks as needed.

Parents and carers are invited to stay with their child throughout.

 

Hip X-rays as part of CPIP

Monitoring the hip joints is an important part of CPIP, as children with cerebral palsy can be at risk of changes in hip position as they grow.

For this reason, hip X-rays are carried out at certain ages:

Around 2 years of age (with the first CPIP assessment)

Children who are more mildly affected will have another X-ray at around 6 years

Children who are more severely affected will have annual X-rays until age 8, then every other year

All children are invited for a final X-ray at age 16

Research shows that having hip X-rays at the right times helps us identify problems early and allows us to take steps to reduce the risk of pain or dislocation later on.

 

Does CPIP make a difference?

Yes. Similar programmes used in other countries, including Sweden, have shown very positive results. Children taking part experienced:

Fewer hip dislocations

Fewer muscle contractures and spinal problems

Fewer major orthopaedic operations

Better coordination between healthcare professionals involved in their care

 

These findings support the value of regular monitoring and early action.

 

Your child’s information and participation

Information from CPIP assessments is stored securely within the NHS in a database.

Sometimes, anonymised information (with all personal details removed) is used for research. This helps improve understanding of cerebral palsy and the long-term impact of different treatments. No individual child or family can ever be identified from this data.

By attending CPIP assessments, families are helping not only their own child but also contributing to better care for children with cerebral palsy in the future.

 

Why attending the assessment matters

Even if your child seems comfortable and things appear to be going well, CPIP assessments are important. They provide reassurance when everything is stable and allow early action if changes begin.

Regular attendance helps ensure your child receives the right support, at the right time, as they grow.

If you have any worries about attending, or need adjustments to make the appointment easier, please contact your physiotherapy team — we are happy to help and answer any questions or concerns.