For generations, cerebral palsy was explained almost entirely by what happened around the time of birth — especially a lack of oxygen. New research using whole-genome sequencing is showing the picture is more complex, and that genetics plays a larger role than once believed.
While many cases can still be linked to medical mistakes during birth, this new research matters for families. Understanding why a child has cerebral palsy can sharpen diagnosis, improve genetic counseling, and help care teams choose the therapies best suited to each child.
“This opportunity for precision medicine is of utmost importance to accurately diagnose etiology across all children.”
— Dr. Darcy Fehlings, study co-author
What the new genomic research found
In a seven-year study of 327 children with cerebral palsy — led by scientists at SickKids, the Research Institute of the McGill University Health Centre, and Holland Bloorview Kids Rehabilitation Hospital, and published in Nature Genetics in 2024 — whole-genome sequencing identified a genetic or likely-genetic cause in 11.3% of children. A further 17.7% carried “variants of uncertain significance” that may prove relevant with more research.
Larger international studies point the same way. Reporting on a major 2024 analysis described genetic factors underlying roughly a quarter of cases in some populations — suggesting that, in some children, birth complications may be a consequence of an underlying genetic difference rather than the root cause.
Genetics and birth events are not either/or
It is easy to read this research as “cerebral palsy is genetic after all,” but that overstates it. For most children, cerebral palsy still has no single, identifiable cause, and known risk factors — premature birth, low birth weight, infection during pregnancy, and lack of oxygen around the time of delivery — remain very real.
What the genomic studies add is a more layered picture. In some children, an underlying genetic difference may make the developing brain more vulnerable, so that a difficult birth becomes the visible event rather than the original cause. In others, genetics plays little or no role. Cerebral palsy is best understood as an umbrella term for a brain difference that can be reached by many different paths — and genomics is simply helping researchers map a few more of those paths.
What genomic testing actually involves
Genomic testing usually starts with a simple blood or saliva sample. A laboratory then reads part or all of a child’s DNA — exome sequencing looks at the protein-coding regions where many disease-related changes cluster, while whole-genome sequencing reads nearly the entire genetic code and can catch differences the exome misses. The results are compared against large databases of known variants.
One result families should understand in advance is the “variant of uncertain significance” — a genetic change that the lab can see but cannot yet confirm as harmless or harmful. These findings are common and can feel unsettling, but they are not a diagnosis; they are flagged for re-evaluation as science learns more. A genetic counselor can help interpret what any result does, and does not, mean for your child.
Why it matters for families
A genetic explanation does not change a child’s strengths or the value of therapy, but it can change care. As the researchers note, identifying a cause supports more accurate diagnosis, better family counseling, and treatment tailored to the individual child — the goal of “precision medicine.” It can also end a long diagnostic search and connect families with others who share the same condition. Learn how CP is identified on our diagnosis and causes pages.
For a small number of children, a specific genetic finding may even point toward a targeted therapy or a clearer prognosis, and it can clarify whether other family members carry the same variant. For many, the practical impact is simpler but still meaningful: answers. After years of wondering “why,” a name for the condition can bring a measure of peace and a clearer path forward.
Will my other children have cerebral palsy?
This is one of the first questions parents ask after hearing the word “genetic,” and the honest answer is: usually not, but it depends. Many of the genetic changes linked to cerebral palsy arise newly in the child (so-called de novo variants) and are not carried by either parent, which means the chance of a sibling being affected is low. Other variants can be inherited, and a few carry a higher recurrence risk.
This is exactly the kind of question a genetic counselor exists to answer. Rather than guessing from general statistics, a counselor can look at your child’s specific result and your family history to give you a realistic, personalized picture — including what it might mean for future pregnancies. For most families, that conversation replaces a vague fear with concrete, reassuring information.
Questions to discuss with your care team
Genomic testing is a personal decision with emotional as well as medical dimensions. Families often find it helpful to ask: Is genetic testing likely to change my child’s care or monitoring? What kinds of results are possible, including uncertain ones? Who will help us interpret the findings? And how might the results affect other family members or future pregnancies? A genetic counselor is specifically trained to walk through these questions with you.
The bottom line for families
The new genomics does not rewrite what matters most day to day. Whatever the cause, the things that help a child with cerebral palsy thrive — early intervention, consistent therapy, supportive equipment, good medical care, and a loving, engaged family — remain the same. Genetic research is widening the map of why cerebral palsy happens, and for some families that knowledge brings answers, better-tailored care, and connection to others. But a diagnosis has never defined a child’s potential, and these discoveries do not change that.
Genetic testing is not yet routine for every child with cerebral palsy, and a genetic finding does not mean the condition is simply “inherited” or that siblings will be affected. Whether genomic testing is appropriate is a decision to make with your child’s medical team and, often, a genetic counselor.
This article is for general education and is not medical advice. Discuss diagnosis and testing options with your child’s healthcare team.
Sources
- SickKids. “Genetic causes of cerebral palsy uncovered through whole-genome sequencing.” Study published in Nature Genetics, 2024. sickkids.ca
- ScienceDaily. “Genetics, not lack of oxygen, causes cerebral palsy in quarter of cases.” 2024. sciencedaily.com
- “Potential clinical applications of advanced genomic analysis in cerebral palsy.” eBioMedicine, 2024. thelancet.com
