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. 2024 Oct;66(10):1361-1368.
doi: 10.1111/dmcn.15901. Epub 2024 Mar 24.

Predictive value of the General Movements Assessment and Standardized Infant NeuroDevelopmental Assessment in infants at high risk of neurodevelopmental disorders

Mijna Hadders-Algra  1 , Uta Tacke  2 , Joachim Pietz  3 , André Rupp  4 , Heike Philippi  5
Affiliations
Free article

Predictive value of the General Movements Assessment and Standardized Infant NeuroDevelopmental Assessment in infants at high risk of neurodevelopmental disorders

Mijna Hadders-Algra et al. Dev Med Child Neurol. 2024 Oct.
Free article

Abstract

Aim: To compare the predictive values of the General Movements Assessment (GMA) and the Standardized Infant NeuroDevelopmental Assessment (SINDA) neurological scale for atypical neurodevelopmental outcome in 3-month-old at-risk infants.

Method: A total of 109 infants (gestational age 30 weeks; range: 24-41; 52 males) attending a non-academic outpatient clinic were assessed with the GMA and the SINDA at 3 (2-4) months corrected age. The GMA pays attention to the complexity of general movements and presence of fidgety movements. Atypical neurodevelopmental outcome at 24 months corrected age (and older) implied cerebral palsy (CP) or a Bayley Mental Development Index or Bayley Psychomotor Development Index lower than 70.

Results: At 24 months corrected (and older) age, 16 children had an atypical outcome, including 14 children with CP. Regarding markedly reduced general movement complexity in combination with absent or sporadic fidgety movements, the GMA predicted an atypical outcome with specificity, positive, and negative predictive values greater than 0.900, and sensitivity of 0.687 (95% confidence interval [CI] = 0.460-0.915). SINDA predicted an atypical outcome with sensitivity, specificity, and negative predictive value greater than 0.900 and a positive predictive value of 0.652 (95% CI = 0.457-0.847). Regarding absent fidgety movements only or markedly reduced general movement complexity, the GMA predicted the outcome less well than both general movement criteria.

Interpretation: The SINDA and GMA both predict neurodevelopmental outcome well, but SINDA is easier to learn than the GMA; being a non-video-based assessment, it allows caregiver feedback during the consultation whereas the GMA usually does not.

What this paper adds: The General Movements Assessment (GMA) and Standardized Infant NeuroDevelopmental Assessment (SINDA) neurological scale predict atypical neurodevelopmental outcome equally well. The GMA and SINDA neurological scale predict CP and atypical neurodevelopmental outcome well. The GMA works best to predict neurodevelopmental outcome when based on both general movement complexity and fidgety movements.

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References

REFERENCES

    1. Prechtl HF. Qualitative changes of spontaneous movements in fetus and preterm infant are a marker of neurological dysfunction. Early Hum Dev. 1990; 23: 151–8. https://doi.org/10.1016/0378‐3782(90)90011‐7.
    1. Einspieler C, Prechtl HFR, Bos AF, Ferrari F, Cioni G. Prechtl's Method on the qualitative assessment of General Movements in preterm, term and young infants. London: Mac Keith Press, 2008.
    1. Hadders‐Algra M. Neural substrate and clinical significance of general movements: an update. Dev Med Child Neurol. 2018; 60: 39–46. https://doi.org/10.1111/dmcn.13540.
    1. Bosanquet M, Copeland L, Ware R, Boyd R. A systematic review of tests to predict cerebral palsy in young children. Dev Med Child Neurol. 2013; 55: 418–26. https://doi.org/10.1111/dmcn.12140.
    1. Novak I, Morgan C, Adde L, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017; 171: 897–907. https://doi.org/10.1001/jamapediatrics.2017.1689.

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