Cerebral palsy surveillance OSCE — clinic visit and family counselling

Station objectives

1. Run a domain-based CP surveillance assessment. [18]
2. State GMFCS and relevant functional scales. [3]
3. Counsel hip surveillance without pain as a prerequisite. [8] [10]
4. Set goal-directed therapy and tone plans with evidence language. [13]
5. Close loops with owners and dates. [18]

Candidate brief

You are the doctor in a paediatric neurodisability clinic. Station A is 12 minutes with parent and child. Station B is 8 minutes focused on counselling and system planning. [18]

Station A — Surveillance review

Setup: Seven-year-old, bilateral spastic CP, GMFCS IV, uses seating system. Parent reports longer meal times and night waking. Last hip film 18 months ago (result not in the file). No clear therapy goals documented. [3] [10]

Expected actions:

• Confirm the child is stable for outpatient review; convert if red flags. [18]
• Elicit parent agenda and pain/sleep/feed/chest symptoms. [18]
• State motor type, topography and GMFCS; consider EDACS given meal-time concerns. [3]
• Examine hips, spine, skin, tone pattern and respiratory effort without diagnostic overshadowing. [8]
• Identify overdue hip surveillance and incomplete records. [10]
• Avoid diagnosing “behaviour” without pain and constipation screen.

Station B — Counselling and plan

Setup: Parent asks why X-rays are needed if there is no pain, and whether “more Botox” will fix everything. [8] [13]

Expected counselling points:

• Hips can migrate without early pain; GMFCS IV needs structured surveillance. [8] [10]
• Radiograph is for prevention and timing of orthopaedic review, not punishment. [10]
• Botulinum toxin is goal-focused and focal; whole-body tone needs broader plan. [13]
• Prefer activity-based therapy goals the family can name. [13]
• Write one plan: hip film date, orthopaedic trigger, feeding review, sleep/pain work-up, therapy goals, medical-home owner. [18]

Marking domains

• Clinical assessment structure and red-flag safety [18]
• Functional classification accuracy [3]
• Hip surveillance rationale [8] [10]
• Evidence-aware therapy/tone counselling [13]
• Family-centred closed-loop planning [18]
• Communication clarity and teach-back [18]