. 2021 Apr 9;11(4):e041695.

doi: 10.1136/bmjopen-2020-041695.

Early Moves: a protocol for a population-based prospective cohort study to establish general movements as an early biomarker of cognitive impairment in infants

Catherine Elliott^{1

2}, Caroline Alexander¹, Alison Salt³, Alicia J Spittle⁴, Roslyn N Boyd⁵, Nadia Badawi^{6

7

8}, Catherine Morgan^{6

8}, Desiree Silva⁹, Elizabeth Geelhoed⁹, Robert S Ware¹⁰, Alishum Ali¹, Anne McKenzie⁹, David Bloom¹¹, Mary Sharp⁹, Roslyn Ward^{1

12}, Samudragupta Bora^{5

13}, Susan Prescott⁹, Susan Woolfenden¹⁴, Vuong Le¹⁵, Sue-Anne Davidson³, Ashleigh Thornton^{3

16}, Amy Finlay-Jones^{1

2}, Lynn Jensen¹, Natasha Amery¹; Early Moves Clinical Working Group; Jane Valentine¹⁷

Collaborators, Affiliations

Collaborators

Early Moves Clinical Working Group:
Jane Valentine, Alison Salt, Desiree Silva, Caroline Alexander, Natasha Amery, Arlette Coenen, Rose Morie, Jennifer Moore, Madeleine OConnor, Ravisha Srinivasjois, Jason Tan, Brad Jongeling, Elayne Downie, Ruth Last, Mary Sharp, John Wray, Sue-Anne Davidson, Ashleigh Thornton

Affiliations

¹ Curtin University, Perth, Western Australia, Australia.
² Telethon Kids Institute, Nedlands, West Australia, Australia.
³ Perth Children's Hospital, Perth, Western Australia, Australia.
⁴ University of Melbourne, Melbourne, Victoria, Australia.
⁵ The University of Queensland, Brisbane, Queensland, Australia.
⁶ Cerebral Palsy Alliance Research Institute, Sydney, New South Wales, Australia.
⁷ Grace Centre for Newborn Intestive Care, The Childrens Hospital at Westmead, Sydney, New South Wales, Australia.
⁸ University of Sydney, Sydney, New South Wales, Australia.
⁹ University of Western Australia, Perth, Western Australia, Australia.
¹⁰ Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
¹¹ Harvard University, Cambridge, Massachusetts, USA.
¹² University of Notre Dame, Perth, WA, Australia.
¹³ Mothers, Babies and Women's Health Program, Mater Research Institute, Brisbane, Queensland, Australia.
¹⁴ University of New South Wales, Kensington, New South Wales, Australia.
¹⁵ Deakin University, Geelong, Victoria, Australia.
¹⁶ University of Western Australia, Perth, Western Autralian, Australia.
¹⁷ Perth Children's Hospital, Perth, Western Australia, Australia jane.valentine@health.wa.gov.au.

PMID: 33837094
PMCID: PMC8043010
DOI: 10.1136/bmjopen-2020-041695

Early Moves: a protocol for a population-based prospective cohort study to establish general movements as an early biomarker of cognitive impairment in infants

Catherine Elliott et al. BMJ Open. 2021.

. 2021 Apr 9;11(4):e041695.

doi: 10.1136/bmjopen-2020-041695.

Authors

Collaborators

Early Moves Clinical Working Group:
Jane Valentine, Alison Salt, Desiree Silva, Caroline Alexander, Natasha Amery, Arlette Coenen, Rose Morie, Jennifer Moore, Madeleine OConnor, Ravisha Srinivasjois, Jason Tan, Brad Jongeling, Elayne Downie, Ruth Last, Mary Sharp, John Wray, Sue-Anne Davidson, Ashleigh Thornton

Affiliations

¹ Curtin University, Perth, Western Australia, Australia.
² Telethon Kids Institute, Nedlands, West Australia, Australia.
³ Perth Children's Hospital, Perth, Western Australia, Australia.
⁴ University of Melbourne, Melbourne, Victoria, Australia.
⁵ The University of Queensland, Brisbane, Queensland, Australia.
⁶ Cerebral Palsy Alliance Research Institute, Sydney, New South Wales, Australia.
⁷ Grace Centre for Newborn Intestive Care, The Childrens Hospital at Westmead, Sydney, New South Wales, Australia.
⁸ University of Sydney, Sydney, New South Wales, Australia.
⁹ University of Western Australia, Perth, Western Australia, Australia.
¹⁰ Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
¹¹ Harvard University, Cambridge, Massachusetts, USA.
¹² University of Notre Dame, Perth, WA, Australia.
¹³ Mothers, Babies and Women's Health Program, Mater Research Institute, Brisbane, Queensland, Australia.
¹⁴ University of New South Wales, Kensington, New South Wales, Australia.
¹⁵ Deakin University, Geelong, Victoria, Australia.
¹⁶ University of Western Australia, Perth, Western Autralian, Australia.
¹⁷ Perth Children's Hospital, Perth, Western Australia, Australia jane.valentine@health.wa.gov.au.

PMID: 33837094
PMCID: PMC8043010
DOI: 10.1136/bmjopen-2020-041695

Abstract

Introduction: The current diagnostic pathways for cognitive impairment rarely identify babies at risk before 2 years of age. Very early detection and timely targeted intervention has potential to improve outcomes for these children and support them to reach their full life potential. Early Moves aims to identify early biomarkers, including general movements (GMs), for babies at risk of cognitive impairment, allowing early intervention within critical developmental windows to enable these children to have the best possible start to life.

Method and analysis: Early Moves is a double-masked prospective cohort study that will recruit 3000 term and preterm babies from a secondary care setting. Early Moves will determine the diagnostic value of abnormal GMs (at writhing and fidgety age) for mild, moderate and severe cognitive delay at 2 years measured by the Bayley-4. Parents will use the Baby Moves smartphone application to video their babies' GMs. Trained GMs assessors will be masked to any risk factors and assessors of the primary outcome will be masked to the GMs result. Automated scoring of GMs will be developed through applying machine-based learning to the data and the predictive value for an abnormal GM will be investigated. Screening algorithms for identification of children at risk of cognitive impairment, using the GM assessment (GMA), and routinely collected social and environmental profile data will be developed to allow more accurate prediction of cognitive outcome at 2 years. A cost evaluation for GMA implementation in preparation for national implementation will be undertaken including exploring the relationship between cognitive status and healthcare utilisation, medical costs, health-related quality of life and caregiver burden.

Ethics and dissemination: Ethics approval has been granted by the Medical Research Ethics Committee of Joondalup Health Services and the Health Service Human Research Ethics Committee (1902) of Curtin University (HRE2019-0739).

Trial registration number: ACTRN12619001422112.

Keywords: community child health; developmental neurology & neurodisability; paediatrics.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Study assessment timeline. EI, early intervention; GMs, general movements; GMA, GM assessment; GMOS, GM Optimality Score; MOS, Motor Optimality Score.

See this image and copyright information in PMC

References

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1. Commonwealth of Australia . Australian early development census national report 2018. Canberra ACT: Department of Education and Training, 2019.
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1. Williams PTJA, Martin JH. Motor cortex activity organizes the developing rubrospinal system. J Neurosci 2015;35:13363–74. 10.1523/JNEUROSCI.1719-15.2015 - DOI - PMC - PubMed

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Early Moves: a protocol for a population-based prospective cohort study to establish general movements as an early biomarker of cognitive impairment in infants

Collaborators

Affiliations

Early Moves: a protocol for a population-based prospective cohort study to establish general movements as an early biomarker of cognitive impairment in infants

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

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MeSH terms

Substances

Associated data

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Full Text Sources

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