Doctors classify cerebral palsy in three overlapping ways: by the kind of movement problem present, by which parts of the body are affected, and by how severely function is limited.
Most people encounter the movement-based classification first, because it drives the most meaningful differences in day-to-day life.
The NIH's National Institute of Neurological Disorders and Stroke describes cerebral palsy broadly as a group of neurological disorders caused by damage to or abnormal development of the brain during the fetal or infant stage, with effects that are permanent but not worsening over time.
Roughly 1 in 345 children in the United States is diagnosed with cerebral palsy, according to CDC surveillance data.
A neurologist might say a child has "spastic diplegic cerebral palsy, GMFCS Level II" and each part of that phrase carries meaning that parents deserve to understand fully.
The type of cerebral palsy a child has determines what challenges they will face, what therapies make sense, and in some cases, what questions need to be asked about how the injury occurred.
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What Is Spastic Cerebral Palsy?
Spastic cerebral palsy is by far the most common type, accounting for approximately 70 to 80 percent of all cerebral palsy cases, according to CDC epidemiological data.
The defining feature of spastic CP is increased muscle tone, meaning the muscles are stiff and resistant to movement. This stiffness produces movements that appear jerky or awkward and can limit range of motion significantly over time.
The underlying cause is damage to the motor cortex or the corticospinal tracts, the nerve pathways that carry movement signals from the brain down to the muscles.
When those pathways are disrupted, the muscles lose the regulatory signals that would otherwise allow them to relax and contract smoothly.
Common signs of spastic cerebral palsy include:
- Stiff, tight muscles that resist stretching
- Jerky or scissor-like movement patterns
- Exaggerated reflexes
- Joints that are difficult to bend or extend fully
- Muscle weakness alongside the stiffness
- Difficulty with fine motor tasks like gripping or writing
If you've observed any of these signs in your child, our detailed overview of warning signs that a child's cerebral palsy may be due to medical negligence can help you understand what to watch for and when to take action.
Spastic CP is further divided based on which limbs are affected:
| Subtype | Limbs Affected | Common Features |
| Spastic Hemiplegia | One side of the body (arm and leg on the same side) | Intelligence often typical; possible speech or learning delays |
| Spastic Diplegia | Primarily both legs; arms mildly involved | Many individuals can walk with braces or walkers |
| Spastic Quadriplegia | All four limbs, often trunk and face | Most severe form; frequently accompanied by intellectual disability and seizures |
Spastic quadriplegia is considered the most severe presentation.
Children with this form often cannot walk, may have significant difficulty speaking, and frequently experience co-occurring epilepsy.
It is also the form most closely associated with acute oxygen deprivation during birth, known clinically as hypoxic-ischemic encephalopathy.
What Is Dyskinetic Cerebral Palsy?
Dyskinetic cerebral palsy is characterized by involuntary, uncontrolled movements that the person cannot stop or predict. These movements fall into two main patterns: slow, writhing motions called athetosis, and rapid, jerky movements called chorea.
Some individuals experience dystonia, which involves sustained abnormal postures caused by simultaneous contraction of opposing muscle groups.
It is associated with damage to the basal ganglia, a cluster of structures deep in the brain that normally coordinate smooth, purposeful movement.
Signs of dyskinetic cerebral palsy include:
- Slow, writhing movements of the hands, arms, feet, or legs (athetosis)
- Rapid, jerky, unpredictable movements (chorea)
- Sustained abnormal postures or twisting (dystonia)
- Facial grimacing and involuntary facial expressions
- Drooling caused by poor oral muscle control
- Difficulty with speech due to uncontrolled movement of the mouth and tongue
- Significant challenges sitting upright or maintaining any stable posture
One important and often overlooked reality of dyskinetic CP is that intellectual ability is frequently intact. The involuntary movements, facial grimacing, drooling, and speech difficulties can cause people to underestimate a person's cognitive capacity significantly.
Many individuals with dyskinetic CP communicate through augmentative technology precisely because their motor impairments mask otherwise typical thinking and comprehension.
Birth asphyxia, where the brain is deprived of adequate oxygen during or around delivery, is a well-documented cause of dyskinetic CP.
Research published in Developmental Medicine and Child Neurology notes that intrapartum hypoxic events are more strongly associated with dyskinetic presentations than with spastic ones.
What Is Ataxic Cerebral Palsy?
Ataxic cerebral palsy primarily affects balance, coordination, and depth perception. The word ataxia comes from the Greek for "lack of order," and that captures the experience well.
Ataxic CP is linked to damage in the cerebellum, the region of the brain at the back of the skull that coordinates timing and precision in movement. The cerebellum does not initiate movement but calibrates it, so when cerebellar function is disrupted, the result is movements that are technically possible but poorly controlled.
Signs of ataxic cerebral palsy include:
- Wide-based, unsteady gait that can resemble walking as if on an unstable surface
- Difficulty with depth perception and judging distances accurately
- Tremor that appears during intentional movements, like reaching for a cup
- Poor coordination on fine motor tasks such as writing, buttoning clothes, or using utensils
- Difficulty with tasks that require precise timing, like catching a ball
Children with ataxic CP often have relatively preserved muscle strength and no spasticity. Their challenges are more about executing accurate, timed movements than about fighting stiff muscles.
This distinction matters for treatment, because therapies that reduce muscle tone in spastic CP may not be appropriate or helpful for ataxic presentations.
What Is Mixed Cerebral Palsy?
Mixed cerebral palsy is diagnosed when a person shows significant features of more than one movement type. The most common combination is spastic and dyskinetic features together, which occurs when brain injury affects both the motor cortex and the basal ganglia simultaneously. Some individuals show spastic and ataxic features, or all three types to varying degrees.
CDC surveillance data categorizes mixed CP among cases that do not fit cleanly into a single movement type. The "mixed" label is not a catch-all for uncertainty.
It reflects real neurological complexity, where multiple brain regions sustained damage and the clinical picture reflects all of them.
Signs that a child may have mixed cerebral palsy include:
- Stiff muscles in some limbs combined with involuntary movement in others
- Presentation that does not respond predictably to treatments designed for a single type
- Evaluations by multiple specialists that highlight different predominant features at different times
- A clinical record that notes features of both spastic and dyskinetic or ataxic CP
A child with spastic-dyskinetic mixed CP might benefit from some interventions used for spastic presentations and others used for dyskinetic ones, and finding the right combination requires close collaboration with a pediatric neurologist and rehabilitation team.
How Doctors Describe Which Parts of the Body Are Affected
Beyond movement type, cerebral palsy is also described by distribution, meaning which limbs are involved. These terms appear frequently in medical records and legal documents:
- Hemiplegia involves one side of the body, typically one arm and one leg on the same side. According to the Cerebral Palsy Alliance Research Foundation, roughly 40 percent of people with CP have hemiplegia in clinical datasets.
- Diplegia involves primarily both legs, with the arms mildly or minimally affected. Spastic diplegia is the most common presentation of spastic CP overall.
- Quadriplegia involves all four limbs and often the trunk, face, and oral muscles. This is usually the most severe functional presentation.
- Triplegia involves three limbs, most often both legs and one arm.
- Monoplegia involves a single limb, which is rare.
These distribution terms are combined with movement type in clinical language. A medical record might describe "spastic diplegic cerebral palsy" or "dyskinetic quadriplegic cerebral palsy."
Reading these combinations accurately helps families understand the full scope of what a child is living with and what to expect from evaluations, IEP meetings, and medical appointments.
What Is the GMFCS and Why Does It Matter?
The Gross Motor Function Classification System (GMFCS) is a five-level standardized scale that classifies children with cerebral palsy based on their ability to move independently, particularly sitting, standing, and walking. It was developed to give clinicians, therapists, and families a consistent language for describing functional ability across a lifespan.
| GMFCS Level | What It Describes |
| Level I | Walks without limitations; may have minor challenges with balance or speed |
| Level II | Walks in most settings; limitations outdoors, on uneven terrain, or when carrying objects |
| Level III | Walks with a hand-held mobility device; uses a wheelchair for long distances |
| Level IV | Self-mobility is limited; uses a wheelchair in most settings; may operate a power chair |
| Level V | Severely limited head and trunk control; transported in a manual wheelchair or uses powered mobility |
The GMFCS matters because two children can share the same movement type and have very different functional levels.
One child with spastic quadriplegia at Level III might attend school independently with supports, while another at Level V requires full-time personal care.
Does the Type of Cerebral Palsy Tell You What Caused It?
The American College of Obstetricians and Gynecologists (ACOG), in collaboration with an international task force, has published clinical criteria for when an acute intrapartum event, meaning something that happened during labor and delivery, can be considered sufficient to have caused cerebral palsy. Those criteria include:
- Severe metabolic acidosis in the newborn at or shortly after birth
- Early moderate-to-severe neonatal encephalopathy (brain dysfunction in the newborn period)
- The presence of spastic quadriplegic or dyskinetic CP specifically
- Exclusion of other identifiable causes
Exclusion of other identifiable causes
Reviews published in Neoreviews note that many cerebral palsy cases arise from events before labor begins, including prematurity, prenatal infections, stroke in utero, and genetic factors, and that obstetric interventions have not meaningfully reduced the overall rate of CP over time. If you're unsure whether your child's diagnosis meets the threshold for a legal claim, our guide on whether you have a cerebral palsy birth injury case walks through the key questions families ask.
What Rights and Supports Are Available for Children with Cerebral Palsy in New York
Under the Individuals with Disabilities Education Act (IDEA) and its federal regulations at 34 C.F.R. Part 300, New York's State Education Department requires that eligible children receive special education and related services.
This includes physical therapy, occupational therapy, and speech-language therapy when necessary for a child to access their education. CP consistently qualifies under IDEA as either an orthopedic impairment or other health impairment depending on the child's presentation.
New York implements IDEA through Parts 200 and 201 of the Commissioner's Regulations, which govern evaluation, Individualized Education Programs (IEPs), and placement decisions. The ADA and Section 504 of the Rehabilitation Act provide additional protections against discrimination in school, employment, and public accommodations.
For supports beyond the school system, the New York State Office for People With Developmental Disabilities (OPWDD) administers services including service coordination, community habilitation, residential options, and family supports for eligible individuals.
Medicaid Home and Community-Based Services (HCBS) waivers, including the OPWDD waiver and the Care at Home program, fund services like personal care, respite, and therapies that allow people with CP to live in community settings.
Financial supports available to New York families include:
- SSI (Supplemental Security Income) for qualifying children based on disability severity and family income, administered through the Social Security Administration
- SSDI (Social Security Disability Insurance) for qualifying adults with CP based on work history
- NY ABLE, a state-sponsored tax-advantaged savings program for individuals whose disability began before age 26, which allows saving for disability-related expenses without affecting SSI eligibility up to specified limits
Some Types of Cerebral Palsy May Be Linked to Medical Negligence
Spastic quadriplegia and dyskinetic cerebral palsy can sometimes be associated with oxygen deprivation or complications during labor and delivery. Speak with an experienced New York birth injury attorney if you have questions about hospital or doctor negligence.
Summing It Up
Cerebral palsy is a diagnosis that comes in significantly different forms, and understanding those differences matters practically for treatment, education, long-term planning, and in some cases, understanding whether negligence played a role.
Spastic CP is the most common type, affecting roughly 70 to 80 percent of those diagnosed, with spastic quadriplegia being the most severe. Dyskinetic and ataxic types are less common but carry their own distinct challenges.
Mixed presentations reflect real neurological complexity and often require the most individualized approach to care.
If your child was diagnosed with cerebral palsy and you have questions about whether a medical provider may have contributed to that outcome, the birth injury attorneys at Porter Law Group can help you evaluate what happened. You can also read about a recovery secured for a child diagnosed with profound cerebral palsy due to medical malpractice to understand what these cases can look like in practice.
There are strict deadlines that apply to these cases in New York, so the sooner those questions are asked, the better.
Frequently Asked Questions About Types of Cerebral Palsy
What are the four main types of cerebral palsy?
The four main types are spastic, dyskinetic, ataxic, and mixed cerebral palsy, classified by the predominant movement disorder present. Spastic CP involves stiff muscles and jerky movements, dyskinetic CP involves involuntary uncontrolled movements, ataxic CP affects balance and coordination, and mixed CP involves features of more than one type..
What is the most common type of cerebral palsy?
Spastic cerebral palsy is the most common type, affecting approximately 70 to 80 percent of people with a CP diagnosis, according to CDC epidemiological surveillance data. Within spastic CP, spastic diplegia and spastic hemiplegia are the most frequently seen presentations. Spastic quadriplegia, which affects all four limbs, is less common but tends to involve the most severe functional limitations, including frequent co-occurring intellectual disability and epilepsy.
Can cerebral palsy get worse over time?
Cerebral palsy itself is non-progressive, meaning the underlying brain injury does not worsen over time. However, the physical effects of CP can become more challenging as a person grows, particularly without proper management. Muscle stiffness in spastic CP can lead to joint contractures, scoliosis, and chronic pain if not addressed through ongoing therapy, orthotics, or surgery. So while the neurological condition is stable, its physical consequences require active management throughout a person's life.
What is the difference between spastic diplegia and spastic quadriplegia?
Spastic diplegia primarily affects both legs, with the arms either mildly involved or functionally unaffected. Many people with spastic diplegia walk independently or with mobility aids. Spastic quadriplegia affects all four limbs as well as the trunk, face, and oral muscles, and is generally the most severe form of spastic CP. People with spastic quadriplegia typically cannot walk and often have significant co-occurring conditions including intellectual disability and epilepsy..
Can cerebral palsy be caused by medical negligence during birth?
Some cases of cerebral palsy are associated with preventable events during labor and delivery, including failure to respond to fetal distress, delayed emergency C-section, or mismanagement of oxygen deprivation. ACOG has published criteria identifying the specific CP types most linked to intrapartum injury, primarily spastic quadriplegia and dyskinetic CP.
How long does a family have to file a cerebral palsy lawsuit in New York?
Under CPLR § 208, the statute of limitations for a minor child's personal injury or medical malpractice claim is tolled, meaning paused, until the child's 18th birthday. This gives a child diagnosed with cerebral palsy due to medical malpractice until their 21st birthday to file a lawsuit (18 plus the standard 2.5-year medical malpractice period under CPLR § 214-a).
What is the GMFCS and how is it used?
The Gross Motor Function Classification System (GMFCS) is a five-level scale used by clinicians to describe how independently a child with cerebral palsy can move, particularly in terms of sitting, standing, and walking. Level I represents the fewest limitations and Level V represents the most severe, where the child has very limited ability to control head and trunk movement. The GMFCS is used in treatment planning, educational accommodation decisions, and predicting long-term mobility outcomes.
Does the type of cerebral palsy affect what services a child qualifies for in New York?
Generally, no. Eligibility for services under IDEA, OPWDD, and Medicaid HCBS waivers in New York is based on whether a qualifying disability exists and how it affects functioning, not on which specific movement type of CP a child has. A child with mild spastic hemiplegia and a child with dyskinetic quadriplegia both have cerebral palsy and both may qualify for services, though the intensity and type of services will differ substantially.
