Related Experiment Video
Updated: May 6, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early high risk of cerebral palsy classification is predictive of cerebral palsy at 2 years: an implementation cohort
Amanda Kl Kwong1,2,3, Abbey L Eeles4,2,3, Peter J Anderson2,5,6,7
1Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia amanda.kwong@unimelb.edu.au.
Insights
Early high risk of cerebral palsy (CP) classification accurately predicts CP by two years of age. This prediction uses neuroimaging and developmental assessments in infants born preterm or with risk factors.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Clinical Implementation Science
Background:
- Cerebral palsy (CP) is a leading cause of childhood motor disability.
- Early identification of infants at high risk for CP is crucial for timely intervention.
- International clinical guidelines aim to standardize CP risk assessment.
Purpose of the Study:
- To evaluate the predictive accuracy of an early high-risk classification for cerebral palsy (CP).
- To assess this classification within an implementation study of international CP guidelines.
- To determine CP diagnosis by 2 years' corrected age.
Main Methods:
- An implementation cohort study was conducted across eleven Australian neonatal intensive care units.
- 453 high-risk infants (born <28 weeks gestation or ≥28 weeks with risk factors) were included.
- Infants classified as high-risk CP based on neuroimaging, General Movements Assessment, and/or Hammersmith Infant Neurological Examination.
Main Results:
- 2-year outcomes were obtained for 95% of the cohort (425 infants).
- High-risk CP classification was identified in 25% of infants (105) at a mean age of 3.5 months.
- The classification showed 90% accuracy in predicting CP by 2 years, with 91% sensitivity and 90% specificity.
Conclusions:
- Early high-risk CP classification using a combination of assessments accurately predicts CP by two years of age.
- This predictive model supports the effective implementation of international CP guidelines.
- Timely identification facilitates earlier intervention for infants with cerebral palsy.
Objective:
To determine the predictive accuracy of an early high risk of cerebral palsy (CP) classification for CP diagnosed by 2 years' corrected age within an implementation study of international clinical CP guidelines.
Design:
Implementation cohort study.
Setting:
Eleven Australian neonatal intensive care units.
Patients:
453 infants born 2019-21 <28 weeks' gestation, or ≥28 weeks with other newborn-detectable risk factors for CP.
Interventions:
Implementation included providing professional development for clinicians, technology (smartphone app) and health network peer support. Infants were classified as high risk of CP if they had abnormal findings on at least two of the following three assessments: neonatal neuroimaging, General Movements Assessment at 3-4 months or Hammersmith Infant Neurological Examination.
Main Outcome Measures:
Baseline perinatal data and 2-year outcome data were collected from medical record review. Any parent-report of CP at the 2-year interview was confirmed by medical records and/or a paediatrician's report. We calculated predictive values for high risk of CP classification for confirmed CP at 2 years.
Results:
We obtained 2-year outcomes from 425 infants (95%). High risk of CP was classified in 105 (25%) of these infants at a mean age of 3.5 months (SD 2.5). This classification demonstrated 91% sensitivity (95% CI 82% to 96%), 90% specificity (95% CI 86% to 93%) and 90% accuracy (95% CI 87% to 93%) for predicting CP, with a mean age of diagnosis of 10.8 months (SD 6.3).
Conclusion:
Being classified as high risk of CP using a combination of neuroimaging, General Movements Assessment and/or Hammersmith Infant Neurological Examination can predict CP by 2 years of age with high accuracy.
More Related Videos
07:36Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
08:26Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
Published on: January 11, 2016
Related Concept Videos
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:25Secondary Spinal Cord Injury llI: Pathophysiology