Related Experiment Video
Updated: Mar 25, 2026
Quantified Assessment of Infant's Gross Motor Abilities Using a Multisensor Wearable
Published on: May 17, 2024
Predictive value of general movements' quality in low-risk infants for minor neurological dysfunction and behavioural
Anne N Bennema1, Pamela Schendelaar1, Jorien Seggers1
1Division Developmental Neurology,Department of Paediatrics,University Medical Center Groningen,University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands.
Insights
General movement (GM) assessment in low-risk infants has limited predictive value for minor neurological dysfunction and behavioral issues. While specific abnormal GMs showed some associations, their low sensitivity limits clinical utility for early detection in this population.
Area of Science:
- Neurodevelopmental Pediatrics
- Early Childhood Development
- Movement Assessment
Background:
- General movement (GM) assessment is established for predicting cerebral palsy in high-risk infants.
- Its predictive value in low-risk populations for minor neurological dysfunction (MND) and behavioral problems is less understood.
Purpose of the Study:
- To evaluate the predictive accuracy of early infancy GM quality for complex MND and behavioral issues at preschool age.
- To determine the clinical utility of GM assessment in a low-risk cohort.
Main Methods:
- Prospective cohort study of 216 infants from a Groningen Assisted Reproductive Techniques (ART) cohort.
- GM quality assessed at 2 weeks and 3 months.
- Minor neurological dysfunction (MND) evaluated at 18 months and 4 years using the Hempel examination; behavioral problems assessed via Child Behavior Checklist at 4 years.
Main Results:
- Definitely abnormal (DA) GMs at 2 weeks predicted complex MND and atypical total and internalizing problem scores at 4 years (p<0.05).
- Positive predictive value of DA GMs at 2 weeks was low (13%-60%), but specificity and negative predictive value were high (92%-99%).
- DA GMs at 3 months were too infrequent for prediction; mildly abnormal (MA) GMs showed no association with outcomes.
Conclusions:
- GM quality alone has limited clinical value for predicting complex MND and behavioral problems in low-risk children.
- The low sensitivity of abnormal GMs restricts their use as a sole screening tool in this population.
Background:
General movement (GM) assessment is a well-established tool to predict cerebral palsy in high-risk infants. Little is known on the predictive value of GM assessment in low-risk populations.
Aims:
To assess the predictive value of GM quality in early infancy for the development of the clinically relevant form of minor neurological dysfunction (complex MND) and behavioral problems at preschool age.
Study Design:
Prospective cohort study.
Subjects:
A total of 216 members of the prospective Groningen Assisted Reproductive Techniques (ART) cohort study were included in this study. ART did not affect neurodevelopmental outcome of these relatively low-risk infants born to subfertile parents.
Outcome Measures:
GM quality was determined at 2 weeks and 3 months. At 18 months and 4 years, the Hempel neurological examination was used to assess MND. At 4 years, parents completed the Child Behavior Checklist; this resulted in the total problem score (TPS), internalizing problem score (IPS), and externalizing problem score (EPS). Predictive values of definitely (DA) and mildly (MA) abnormal GMs were calculated.
Results:
DA GMs at 2 weeks were associated with complex MND at 18 months and atypical TPS and IPS at 4 years (all p<0.05). Sensitivity and positive predictive value of DA GMs at 2 weeks were rather low (13%-60%); specificity and negative predictive value were excellent (92%-99%). DA GMs at 3 months occurred too infrequently to calculate prediction. MA GMs were not associated with outcome.
Conclusions:
GM quality as a single predictor for complex MND and behavioral problems at preschool age has limited clinical value in children at low risk for developmental disorders.
