The screening Hand Assessment for Infants: Feasibility, validity, and reliability based on parents' recordings

Area of Science:

• Pediatric Neurology
• Developmental Pediatrics
• Rehabilitation Medicine

Background:

• Early identification of unilateral cerebral palsy (CP) is crucial for timely intervention.
• Traditional assessments require in-person clinical visits, posing accessibility challenges.
• Remote assessment tools are needed to facilitate early screening in infants at risk.

Purpose of the Study:

• To evaluate the concurrent validity and interrater reliability of a remote screening Hand Assessment for Infants (s-HAI) administered by parents.
• To assess the feasibility of parents using a smartphone app for s-HAI recordings.
• To determine the utility of the s-HAI for early identification of unilateral CP in infants.

Main Methods:

• Observational study involving 30 infants (3.5-12 months) at risk of unilateral CP.
• Parents administered and recorded the s-HAI using a smartphone app.
• Remote s-HAI results were compared with in-clinic Hand Assessment for Infants (HAI) using Spearman's rank correlation.
• Interrater reliability was assessed using the intraclass correlation coefficient.

Main Results:

• Parents found the remote s-HAI feasible and recorded sessions with good quality.
• A strong correlation (r_s = 0.86) was observed between the s-HAI and the six-item HAI.
• Excellent interrater reliability was demonstrated for both affected (0.96) and non-affected (0.95) hands.

Conclusions:

• The remote s-HAI is a valid and reliable tool for assessing infants at risk of unilateral CP.
• Parent-administered remote s-HAI via smartphone app is feasible and effective.
• The s-HAI facilitates early identification of unilateral CP, improving access to timely interventions.