Early onset (and later onset/delayed puberty) is not uncommon with children who have a diagnosis of CP. I was so surprised to hear this since none of our doctors/specialists mentioned it as something to look out for before us bringing some concerns to our pediatrician. When there is a brain injury or disturbance in early neurological development (leading to a CP diagnosis) it’s not always clear what areas of development will be affected that are controlled by neurological function; the endocrine system is one possibility. It is the endocrine system that regulates puberty and determines when it will be begin. There are different kinds of early onset puberty and the one I am referring to here is central precocious puberty or CPP. This is a type that can be treated with medication that mimics the hormones that normally put the breaks on puberty. Aside from social, emotional/behavioral and practical consequences that may be associated with early puberty, the child’s growth plates can fuse early causing growth to be stunted. It is my understanding that consequences of this have not been well studied (if at all) in CP. 

If you have concerns about your child’s development that relate to early (or late onset of puberty) be open with your pediatrician. If you aren’t comfortable having that conversation in front of your child contact the office and provide the nurse with the information prior to the visit or ask to speak with your child’s doctor directly. Your pediatrician can guide you and determine whether a referral to an endocrinologist (hormone specialist) is warranted. They may order blood tests to see where the hormone levels are and your child may also be sent to have an X-ray to determine his/her bone age which tells the doctor how far along the bones are in development and if they are advanced beyond the child’s chronological age.

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