700 Section - Cerebral Palsy Surveillance Capacity: What Registry Infrastructure Reveals About Early Childhood Systems

This study examined international variation in cerebral palsy (CP) surveillance capacity by mapping registry infrastructure across high-income countries and assessing whether patterns coincide with early childhood system characteristics, reflecting shared governance priorities. Objectives were to describe registry scope and reporting practices in Nordic and Westminster governance families, determine which key surveillance variables are reported, and assess whether comprehensive registry infrastructure aligns with strong OECD childhood well-being indicators as a marker of systemic investment in early childhood.

Design:

A scoping review was conducted across Denmark, Norway, Sweden, Finland, Iceland, Australia, Canada, and the United Kingdom using published sources from 2000 to 2024, CP-North, ACPR, SCPE, and registry websites. All sources were publicly available. Extracted variables included scope, diagnostic age reporting, functional outcome standardization, data accessibility, and cross-national collaboration. OECD indicators included early childhood education enrollment, child health access scores, and family policy supports. Registry comprehensiveness was assessed descriptively across these dimensions.

Results:

Registry patterns aligned with governance structures. Nordic countries with strong OECD early childhood performance demonstrated nationally integrated registries, standardized functional outcome reporting, and collaborative data sharing through CP-North. Westminster countries with more variable OECD early childhood performance demonstrated fragmented systems: provincial registries in Canada, state-based structures in Australia, and regional programs in the United Kingdom. Diagnostic age, essential for monitoring early identification, was systematically tracked only in Denmark (median 11-13 months). These patterns suggest registry capacity and early childhood system investment reflect shared policy priorities rather than causal relationships.

Conclusion: CP registry infrastructure mirrors broader early childhood system integration, with both reflecting shared governance priorities. Countries investing in early childhood also build comprehensive surveillance capacity. Widespread absence of diagnostic-age reporting limits international monitoring of early identification efforts. Findings support development of consensus-based registry standards and validated quality metrics, positioning surveillance infrastructure as an upstream indicator of system investment in early childhood.