[PS15-2C-2] Early Detection and Diagnosis of infants at “High-risk of Cerebral Palsy and Cerebral Palsy”: International Recommendations
Cerebral palsy is the most common physical disability in childhood and is typically diagnosed between 12-24 months of age. Advances in neuroscience have identified strategies for accelerating early detection of “high-risk infants” (e.g. Preterm, neonatal encephalopathy, neonatal stroke, congenital abnormalities, intrauterine growth restriction, multiples, neonatal intensive care graduates), to enable timely access to diagnostic-specific early intervention. IMPACT for CP, an international, multidisciplinary research network, unanimously agreed to develop an international clinical practice guideline on early detection. The guideline states that: “Cerebral palsy or high-risk of cerebral palsy can be detected accurately and early using standardized tools. High quality evidence indicates that for infants less than 5-months corrected age, with identifiable high-risk for CP, early detection using a combination of the General Movements assessment and MRI at near term age is over 95% accurate and is therefore strongly recommended. High quality evidence indicates that for infants older than 5-months corrected age, with high-risk for cerebral palsy, early detection using a combination of the Hammersmith Infant Neurological Evaluation (HINE) and early MRI is over 90% accurate and is therefore strongly recommended. The accuracy of these techniques in infants without discernable risks or lower-risks for cerebral palsy (e.g. healthy term born infants, with no apparent pregnancy and neonatal risks) are not yet known but are conditionally recommended based on best-available evidence. Early detection of high-risk of CP, followed by CP-specific early intervention is strongly recommended and should be the standard of care to optimize infant neuroplasticity, prevent complications and enhance parent well-being. Implementation at both practice and policy levels is recommended. This invited presentation will present the evidence base behind the development of the guidelines, and present implementation plans currently being applied for Australian contexts.