The Knowledge Translation of Early Cerebral Palsy (KiTE CP) Study: Implementing Screening Among a High-Risk Prospective Cohort of Australian Infants

Abstract

ObjectiveTo describe the implementation of the international guidelines for the early diagnosis of cerebral palsy (CP) and engagement in the screening process in an Australian cohort of infants with neonatal risk factors for CP. Study designProspective cohort study of infants with neonatal risk factors recruited at <6 months CA from 11 sites in the states of Victoria, New South Wales, and Queensland, Australia. First, we implemented a multi-modal knowledge translation strategy including barrier identification, technology integration and special interest groups. Screening was implemented as follows: infants with clinical indications for neuroimaging underwent magnetic resonance imaging and/or cranial ultrasound. The General Movements Assessment (GMA) was recorded clinically or using an app (Baby Moves). Infants with absent or abnormal fidgety movements on GMA videos were offered further assessment using the Hammersmith Infant Neurological Examination (HINE). Infants with atypical findings on 2/3 assessments met criteria for high risk of CP. ResultsOf the 597 infants (56% male) recruited, 95% (n=565) received neuroimaging, 90% (n=537) had scorable GMA videos (2% unscorable/8% no video), and 25% (n=149) HINE. Overall, 19% of the cohort (n=114/597) met criteria for high risk of CP, 57% (340/597) had at least two normal assessments (of neuroimaging, GMA or HINE), and 24% (n=143/597) had insufficient assessments. ConclusionsEarly CP screening was implemented across participating sites using a multi-modal knowledge translation strategy. Although the COVID-19 pandemic affected recruitment rates, there was high engagement in the screening process. Reasons for engagement in early screening from parents and clinicians warrant further contextualization and investigation.