At a glance
Evidence table
Everything on this site in one view. Read it by row: a therapy is rarely at the same level for every condition, and the gap between the best row and the worst is usually where families get into difficulty.
Established care
Either a medicines regulator has licensed it for this use, or clinical practice guidelines recommend it on the strength of controlled trials. This is the standard everything else on the scale is measured against — and for most children, the treatments at this level are the ones that will actually change their day.
In clinical trials
Randomised or controlled trials in children are under way or completed, but the result is not yet settled enough for routine care. Taking part in a registered trial is reasonable; paying for it as an established treatment is not.
Early research only
Evidence is limited to laboratory work, animal studies, small uncontrolled series or single case reports. These can justify further research. They cannot tell you whether your child will benefit.
Not supported by evidence
Claims have outrun the data, or the available studies found no benefit. This does not always mean the idea is wrong — it means nobody has shown it works.
Layer one
Established care
Early detection and early intervention
| Condition | Evidence | Note |
|---|---|---|
| Cerebral palsy — detection before 5 months | Established care | International clinical practice guidance supports combining the General Movements Assessment, a structured neurological examination and MRI to identify or strongly suspect cerebral palsy in early infancy. |
| Cerebral palsy — intervention after early detection | Established care | Guideline-backed. The recommended approach is infant-led, task-specific practice with the family, started as soon as risk is identified rather than waiting for a confirmed diagnosis. |
| Preterm and high-risk infants generally | Established care | Structured developmental follow-up is standard care in most health systems, and is how most early diagnoses are made. |
Goal-directed, task-specific training
| Condition | Evidence | Note |
|---|---|---|
| Cerebral palsy — motor function | Established care | The most consistently supported approach in cerebral palsy guidance across age groups. |
| Acquired brain injury | Established care | Same principle, same support. |
| Genetic and neuromuscular conditions | In clinical trials | Widely applied and biologically sensible; formal trial evidence is thinner in rarer conditions. |
Constraint-induced therapy and bimanual training
| Condition | Evidence | Note |
|---|---|---|
| Unilateral cerebral palsy — hand function | Established care | Strong randomised evidence for both approaches. Guideline-recommended. |
| Bilateral cerebral palsy | In clinical trials | Bimanual approaches are used; constraint has less rationale when both hands are affected. |
| Acquired hemiplegia | Established care | Same principle, applied after stroke or injury. |
Physiotherapy and strength training
| Condition | Evidence | Note |
|---|---|---|
| Cerebral palsy — gross motor function | Established care | Function-focused physiotherapy is standard, guideline-supported care. |
| Strength and fitness | Established care | Progressive resistance training improves strength. Translation into walking function is less consistent. |
| Passive stretching to prevent contracture | Early research only | Long-held belief, weak evidence. Stretching alone has not been shown to prevent contracture. |
Occupational therapy
| Condition | Evidence | Note |
|---|---|---|
| Cerebral palsy and motor disability | Established care | Goal-directed occupational therapy is guideline-supported. |
| Autism — daily function and participation | Established care | Supported where goals are functional. Sensory-integration approaches as a treatment for core autism features are a separate and weaker claim. |
| Developmental coordination difficulties | Established care | Task-oriented approaches have good support. |
Speech, language and communication
| Condition | Evidence | Note |
|---|---|---|
| Augmentative and alternative communication (AAC) | Established care | Well supported. Evidence indicates AAC does not inhibit speech development and is often associated with gains in speech. |
| Speech and language therapy in cerebral palsy | Established care | Standard care, including for eating and drinking safety. |
| Language intervention in autism | Established care | Naturalistic developmental behavioural approaches have the strongest support. |
| Oral-motor exercises to improve speech | Early research only | Non-speech oral exercises have not been shown to improve speech sound production. |
Spasticity and tone management
| Condition | Evidence | Note |
|---|---|---|
| Focal spasticity — botulinum toxin | Established care | Licensed and guideline-supported for focal spasticity in children, as part of an integrated programme with therapy. |
| Generalised spasticity — intrathecal baclofen | Established care | Established for selected children with severe generalised spasticity, in specialist centres. |
| Selective dorsal rhizotomy | Established care | Established for carefully selected children, most often ambulant children with spastic diplegia. Selection is the whole question. |
| Oral antispasticity medication | In clinical trials | Widely used; evidence for functional benefit in children is modest and side effects limit dose. |
| Serial casting and orthoses | Established care | Supported for specific goals such as improving ankle range or foot position in walking. |
Technology-assisted rehabilitation
| Condition | Evidence | Note |
|---|---|---|
| Robotic gait training / treadmill with body-weight support | In clinical trials | Can deliver high repetition. Evidence of advantage over equally intensive conventional training is not established. |
| Functional electrical stimulation | In clinical trials | Used for foot drop and to assist grasp; benefit reported, best evidence when combined with active practice. |
| Virtual reality and active video games | In clinical trials | Improves engagement and can increase practice volume. Effects on function are modest. |
| Exoskeletons for home use | Early research only | Marketed ahead of the evidence in children. |
Named physiotherapy approaches
| Condition | Evidence | Note |
|---|---|---|
| Bobath / neurodevelopmental treatment (NDT) | In clinical trials | The most widely taught approach in the world. Reviews have not shown it superior to goal-directed, activity-based therapy, and several guidelines have moved away from recommending it as the default. |
| MEDEK / Cuevas MEDEK Exercises | Early research only | Provocative, gravity-based handling to elicit postural responses. Enthusiastic parent reports, very little controlled evidence. |
| MAES therapy | Early research only | A newer approach emphasising the child's own problem-solving. Coherent reasoning; published controlled trials are essentially absent. |
| Anat Baniel Method / NeuroMovement | Early research only | Derived from Feldenkrais, built on gentle movement and attention. No controlled paediatric trial evidence of functional benefit. |
| Vojta therapy | Early research only | Reflex locomotion through pressure at defined points. Long history in central Europe, limited controlled evidence, and distress during sessions is a recognised concern. |
| Conductive education (Pető) | In clinical trials | An education-based, group, whole-day model. Studied more than most; results broadly comparable to other intensive programmes rather than superior. |
| Patterning (Doman–Delacato) | Not supported by evidence | Repeatedly rejected. Paediatric bodies have advised against it for decades on grounds of absent evidence and heavy family burden. |
Sensory therapies
| Condition | Evidence | Note |
|---|---|---|
| Ayres Sensory Integration (manualised) — participation goals in autism | In clinical trials | Randomised trials exist, using fidelity measures and individualised goal outcomes. Results are promising for functional goals; evidence is not strong enough to call it established. |
| ASI for core autism features or academic skills | Early research only | A different and weaker claim than improving participation in a specific child. |
| Weighted vests and blankets for attention or behaviour | Not supported by evidence | Studied repeatedly; benefit for attention has not been demonstrated. Blankets may help some children settle at night, which is a comfort claim, not a therapy claim. |
| Auditory integration and listening programmes | Not supported by evidence | Reviewed multiple times without demonstrated benefit. |
| Brushing protocols, swings and sensory diets as stand-alone treatment | Early research only | Widely delivered, largely untested as discrete interventions. |
Vision and cerebral visual impairment
| Condition | Evidence | Note |
|---|---|---|
| Identifying CVI in children with cerebral palsy or brain injury | Established care | Standard of care. CVI is the leading cause of visual impairment in children in high-income countries, and it is substantially under-recognised in cerebral palsy. |
| Environmental and task adaptation for CVI | Established care | Reducing visual clutter, controlling contrast and lighting, allowing processing time — established practice and often the single most effective change. |
| Structured visual habilitation programmes | In clinical trials | Programmes to build visual behaviours are widely used; controlled evidence of benefit over adaptation alone is limited. |
| Correcting refractive error and treating ocular problems | Established care | Basic and frequently overlooked. A child can have CVI and need glasses. |
Layer two
Diagnosis-led treatment
Getting a precise diagnosis
| Condition | Evidence | Note |
|---|---|---|
| Developmental delay, intellectual disability, epilepsy of unknown cause | Established care | Exome or genome sequencing is recommended as a first-tier test in international guidance, with diagnostic yield that no amount of further imaging matches. |
| Cerebral palsy without a clear injury on MRI | Established care | A meaningful proportion of children labelled cerebral palsy have an underlying genetic condition. Where the history and MRI do not explain the picture, genetic testing is indicated. |
| Early-onset epileptic encephalopathy | Established care | Diagnosis frequently changes treatment directly — some genes make particular antiseizure medicines the right choice and others actively harmful. |
| Neuromuscular presentations | Established care | Newborn screening and early genetic diagnosis in spinal muscular atrophy exist precisely because treatment before symptoms changes the outcome. |
Gene-targeted treatments
| Condition | Evidence | Note |
|---|---|---|
| Spinal muscular atrophy | Established care | Several licensed treatments with different mechanisms: an intrathecal antisense oligonucleotide, a one-off AAV gene replacement, and an oral splicing modifier. This condition was reshaped within a decade. |
| CLN2 Batten disease | Established care | Enzyme replacement delivered into the brain's ventricles slows functional decline. |
| Metachromatic leukodystrophy | Established care | An ex vivo gene therapy using the child's own corrected stem cells, licensed in Europe for early stages, before symptoms are established. |
| AADC deficiency | Established care | A gene therapy delivered directly into the brain, licensed in Europe. |
| Duchenne muscular dystrophy | In clinical trials | Exon-skipping oligonucleotides and an AAV gene therapy are licensed in some jurisdictions under accelerated pathways; the size of the functional benefit remains debated. |
| Dravet syndrome, Angelman syndrome, other channelopathies | In clinical trials | Antisense approaches are in clinical trials. Not approved. This is where a registered trial is a reasonable thing to seek out. |
| Cerebral palsy from acquired injury | Not supported by evidence | There is no gene to target. Genetic treatments have no role where the cause is an injury rather than a gene. |
Layer three
Emerging and experimental
Stem cell therapy
| Condition | Evidence | Note |
|---|---|---|
| Blood and immune disorders | Established care | Cord blood transplantation is a licensed, decades-old treatment — this is where the word “approved” genuinely applies. |
| Cerebral palsy | In clinical trials | Randomised controlled trials have been run and more are under way. Where benefit is reported it is usually small and measured on motor scales, not a return to typical development. |
| Hypoxic-ischaemic encephalopathy (newborn) | In clinical trials | Early-phase trials, usually added to cooling. Feasibility and safety are the main findings so far. |
| Autism | Early research only | A well-conducted randomised trial of cord blood did not meet its main endpoint. A possible signal in a subgroup has not been confirmed in a separate trial. |
| Genetic epilepsies | Early research only | No controlled paediatric evidence. Biological reasoning only. |
Exosomes
| Condition | Evidence | Note |
|---|---|---|
| Any paediatric neurological condition | Early research only | Laboratory and animal work is substantial. Controlled trials in children are not. |
| Marketed “exosome” products | Not supported by evidence | EU law now allows these to be developed as biological medicines, but no product has yet completed that path: none is authorised anywhere. Preparations sold outside trials are not standardised, and regulators have warned about them after serious infections traced to unlicensed batches. |
Muse cells
| Condition | Evidence | Note |
|---|---|---|
| Newborn hypoxic-ischaemic encephalopathy | Early research only | Early-phase Japanese work exists. Numbers are small and the question being asked is safety, not benefit. |
| Cerebral palsy, autism | Not supported by evidence | No controlled paediatric trial data. Offers outside a trial are running ahead of the science. |
Photobiomodulation
| Condition | Evidence | Note |
|---|---|---|
| Autism | Early research only | Small randomised studies report behavioural improvements. Samples are modest, follow-up short, and devices differ. |
| Traumatic brain injury (mostly adults) | Early research only | The largest body of transcranial work, still early and mainly in adults. |
| Cerebral palsy, epilepsy | Not supported by evidence | No controlled paediatric evidence for seizure control or motor outcome. |
Magnetic stimulation
| Condition | Evidence | Note |
|---|---|---|
| Adolescent depression | Established care | Regulators in some countries have cleared repetitive TMS as an add-on treatment in older adolescents. Approval is specific to that indication, age range and device. |
| Autism | In clinical trials | Controlled studies exist and continue. Results are mixed and effects reported are modest; it is not established care. |
| Cerebral palsy / motor recovery | In clinical trials | Studied mainly as an add-on to intensive motor therapy rather than a treatment on its own. |
| Epilepsy | Early research only | Low-frequency protocols have been explored for focal epilepsy. Evidence is limited, and stimulation parameters matter for safety. |
Peptide preparations
| Condition | Evidence | Note |
|---|---|---|
| Adult ischaemic stroke (cerebrolysin) | In clinical trials | The most studied use, and genuinely contested. A Cochrane review concludes it probably does not reduce death; other meta-analyses report early neurological improvement. Adults, not children. |
| Children — developmental delay, cerebral palsy, autism | Early research only | Widely prescribed in parts of Eastern Europe, Russia, Türkiye and Asia. Controlled paediatric evidence is thin and mostly low quality. |
| “Peptide therapy” from wellness and anti-ageing clinics | Not supported by evidence | BPC-157, thymosin fragments, growth-hormone secretagogues and similar. Not licensed as medicines for children anywhere, no paediatric neurological evidence, and several appear on anti-doping lists. |
Medicinal mushrooms and nootropics
| Condition | Evidence | Note |
|---|---|---|
| Lion's mane for nerve growth — children | Early research only | Compounds in this fungus stimulate nerve growth factor in laboratory models. That is where the evidence stops; there are no paediatric neurological trials. |
| Citicoline | In clinical trials | The most studied compound in this group, mainly in adult stroke and cognitive decline, with mixed results. Paediatric neurological evidence is limited. |
| Piracetam and related racetams | Early research only | Long history, particularly in Europe. Evidence for benefit in children is weak and the drug is not licensed for these uses in most countries. |
| Psilocybin | Not supported by evidence | Adult psychiatric trials are serious science. There is no basis for use in children, and it is not a neurorehabilitation treatment. |
| General “brain support” supplement blends | Not supported by evidence | Multi-ingredient products marketed for focus, speech or development. No evidence, variable contents, and interactions with antiseizure medicines are rarely considered. |
Cannabidiol and cannabis-based products
| Condition | Evidence | Note |
|---|---|---|
| Dravet syndrome | Established care | Purified cannabidiol is licensed as an add-on antiseizure medicine. In the pivotal trial the median monthly convulsive seizure frequency fell by about 39% on cannabidiol against about 13% on placebo — a real effect, and a partial one. |
| Lennox-Gastaut syndrome | Established care | Licensed on the same basis, with randomised trials showing a reduction in drop seizures. In the European licence it is approved as an add-on to clobazam; the United States licence does not tie it to clobazam. |
| Tuberous sclerosis complex | Established care | Added to the licence after a randomised trial in TSC-associated seizures — the FDA in 2020, the European Commission in 2021. |
| Other drug-resistant epilepsies | In clinical trials | Used off-label with open-label and registry data behind it. Some children respond; this is a weaker evidence base than the three licensed syndromes and should be framed as a trial of treatment, with a stopping rule. |
| Autism | Early research only | Randomised trials of CBD-rich extracts have been run, including a crossover trial in Israel. Results are mixed and the main outcomes have generally not been met. Not established care. |
| Spasticity in cerebral palsy | Early research only | Most of the spasticity evidence is from nabiximols in adults with multiple sclerosis. Paediatric cerebral palsy data are thin. |
| Shop-bought CBD oils for any neurological condition | Not supported by evidence | These are food supplements, not medicines. Independent analyses repeatedly find the amount of cannabidiol differing from the label, and sometimes detectable THC. A dose you cannot verify is a dose you cannot evaluate. |
How to use this honestly
A row marked “early research only” is not a verdict that the treatment is useless. It is a statement that nobody can yet tell you whether it will help your child — which is exactly the information a family needs before spending money and hope on it.