A comparison of the general movements assessment with traditional approaches to newborn and infant assessment: concurrent validity

Abstract

Background: Assessment of the quality of general movements (GMs) is an early clinical marker for prediction of cerebral palsy.

Aims: To explore how the General Movements Assessment (GMsA) relates to traditional newborn and infant measures currently in use.

Study design: A prospective cohort design was used to examine concurrent validity of the GMsA in Neonatal Intensive Care (NICU) survivors (n=100) at three age points: preterm (34 weeks gestational age GA), term (38-40 weeks GA), and post term (12 weeks adjusted age [AA]) with traditional assessments (see below). Correlation analysis was used to determine the strength of the associations between tests at each age point.

Subjects: Preterm infants born at <or=32 weeks gestational age and birth weight <1,500 g (n=108) were recruited sequentially from the NICU of a large teaching hospital and referral centre. Infants with diagnoses of metabolic disorders, cardiac, chromosomal, or congenital abnormalities were excluded.

Outcome measures: Test of Infant Motor Performance (TIMP), Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS), Alberta Infant Motor Scales (AIMS).

Results: A low-strength relationship (r=or<0.25) was found between the GMsA and the traditional tests which increased across age points (r=0.25-0.50). Relationships between the traditional tests over time was characterized by stronger associations (r=0.50-0.75).

Conclusions: Evidence of concurrent validity of the GMsA with traditional assessments was not found. These early findings support Prechtl's suggestion that GMs reflect a unique neurologic construct, different from traditional tests and reinforce the complementary perspective which the GMsA brings to neonatal assessment.