Towards universal early screening for cerebral palsy: a roadmap for automated General Movements Assessment

Alicia J Spittle^{1

2

3}, Peter B Marschik^{4

5

6

7}, Lars Adde^{8

9}, Nadia Badawi¹⁰, Rachel Byrne¹¹, Arend F Bos¹², Alain Chatelin¹³, John Coughlan¹⁴, Francesca Fedeli¹⁵, Andrea Guzzetta^{16

17}, Edmond S L Ho¹⁸, Michelle J Johnson^{19

20}, Amanda Kwong^{1

2

3}, Alistair McEwan^{10

21}, Catherine Morgan¹⁰, Anderson Mughogho²², Deirdre M Murray^{23

24}, Silvia Orlandi^{25

26

27}, Colleen Peyton^{28

29}, Laura A Prosser^{19

20}, Anina Ritterband-Rosenbaum³⁰, Truyen Tran³¹, Dajie Zhang^{4

6}, Elyse Passmore^{32

33

34

35}

Affiliations

¹ Department of Physiotherapy, Melbourne School of Health Science, University of Melbourne, Melbourne, Australia.
² Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
³ Department of Physiotherapy, The Royal Women's Hospital, Melbourne, Australia.
⁴ Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, German Center for Mental Health (DZPG), Heidelberg University, Heidelberg, Germany.
⁵ Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, German Center for Child and Adolescent Health (DZKJ) and Leibniz ScienceCampus Primate Cognition, Göttingen, Germany.
⁶ Division of Phoniatrics, interdisciplinary Developmental Neuroscience (iDN), Medical University of Graz, Graz, Austria.
⁷ Center of Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women's and Children's Health, Child and Adolescent Psychiatry, Region Stockholm, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.
⁸ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
⁹ Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
¹⁰ Cerebral Palsy Alliance Research Institute, Brain Mind Centre, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia.
¹¹ Cerebral Palsy Foundation, New York, NY, USA.
¹² Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
¹³ Fondation Paralysie Cerebrale, Paris, France.
¹⁴ International Cerebral Palsy Society, Bath, United Kingdom.
¹⁵ Fight the Stroke Foundation, Milano, Italy.
¹⁶ Department of Clinical and Experimental Medicine University of Pisa, Italy.
¹⁷ Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy.
¹⁸ School of Computing Science, University of Glasgow, Scotland, United Kingdom.
¹⁹ Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
²⁰ Rehabilitation Robotics Lab, GRASP, University of Pennsylvania, Philadelphia, PA, USA.
²¹ School of Biomedical Engineering, University of Sydney, Australia.
²² Department of Rehabilitation Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi.
²³ Dept of Paediatrics and Child Health, University College Cork, Cork, Ireland.
²⁴ INFANT Maternal and Child Health Centre, University College Cork, Ireland.
²⁵ Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy.
²⁶ IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
²⁷ Health Sciences and Technologies, Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Italy.
²⁸ Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
²⁹ Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, USA.
³⁰ Elsass Foundation, Gentofte, Denmark.
³¹ Applied Artificial Intelligence Institute, Deakin University, Waurn Ponds, Australia.
³² Developmental Imaging Group, Murdoch Children's Research Institute, Melbourne, Australia.
³³ Gait Analysis Laboratory, Royal Children's Hospital, Melbourne, Australia.
³⁴ Department of Paediatrics, University of Melbourne, Melbourne, Australia.
³⁵ Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia.

PMID: 40735348
PMCID: PMC12304702
DOI: 10.1016/j.eclinm.2025.103379

Review

Towards universal early screening for cerebral palsy: a roadmap for automated General Movements Assessment

Alicia J Spittle et al. EClinicalMedicine. 2025.

. 2025 Jul 22:86:103379.

doi: 10.1016/j.eclinm.2025.103379. eCollection 2025 Aug.

Authors

Affiliations

¹ Department of Physiotherapy, Melbourne School of Health Science, University of Melbourne, Melbourne, Australia.
² Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
³ Department of Physiotherapy, The Royal Women's Hospital, Melbourne, Australia.
⁴ Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, German Center for Mental Health (DZPG), Heidelberg University, Heidelberg, Germany.
⁵ Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, German Center for Child and Adolescent Health (DZKJ) and Leibniz ScienceCampus Primate Cognition, Göttingen, Germany.
⁶ Division of Phoniatrics, interdisciplinary Developmental Neuroscience (iDN), Medical University of Graz, Graz, Austria.
⁷ Center of Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women's and Children's Health, Child and Adolescent Psychiatry, Region Stockholm, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.
⁸ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
⁹ Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
¹⁰ Cerebral Palsy Alliance Research Institute, Brain Mind Centre, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia.
¹¹ Cerebral Palsy Foundation, New York, NY, USA.
¹² Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
¹³ Fondation Paralysie Cerebrale, Paris, France.
¹⁴ International Cerebral Palsy Society, Bath, United Kingdom.
¹⁵ Fight the Stroke Foundation, Milano, Italy.
¹⁶ Department of Clinical and Experimental Medicine University of Pisa, Italy.
¹⁷ Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy.
¹⁸ School of Computing Science, University of Glasgow, Scotland, United Kingdom.
¹⁹ Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
²⁰ Rehabilitation Robotics Lab, GRASP, University of Pennsylvania, Philadelphia, PA, USA.
²¹ School of Biomedical Engineering, University of Sydney, Australia.
²² Department of Rehabilitation Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi.
²³ Dept of Paediatrics and Child Health, University College Cork, Cork, Ireland.
²⁴ INFANT Maternal and Child Health Centre, University College Cork, Ireland.
²⁵ Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy.
²⁶ IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
²⁷ Health Sciences and Technologies, Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Italy.
²⁸ Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
²⁹ Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, USA.
³⁰ Elsass Foundation, Gentofte, Denmark.
³¹ Applied Artificial Intelligence Institute, Deakin University, Waurn Ponds, Australia.
³² Developmental Imaging Group, Murdoch Children's Research Institute, Melbourne, Australia.
³³ Gait Analysis Laboratory, Royal Children's Hospital, Melbourne, Australia.
³⁴ Department of Paediatrics, University of Melbourne, Melbourne, Australia.
³⁵ Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia.

PMID: 40735348
PMCID: PMC12304702
DOI: 10.1016/j.eclinm.2025.103379

Abstract

Cerebral palsy (CP) is the most common lifelong physical disability, affecting millions globally. Early detection and intervention are crucial for improving outcomes, yet many children are diagnosed late. The General Movements Assessment (GMA) is a highly accurate clinical tool for detecting infants at high probability of CP, but access to health professionals trained in the GMA limits its use. Artificial intelligence (AI) has the potential to automate the GMA, increasing accessibility worldwide. We established an interdisciplinary, international consortium for the purpose of developing a roadmap for the ongoing development and implementation of an AI-enabled GMA system for universal CP screening worldwide. The consortium included clinicians (children neurologists, paediatricians, neonatologists, allied health), researchers, engineers, computer scientists, legal experts, and individuals with lived experience, from around the globe (across Africa, Australia, Europe, and North America). The roadmap identifies the following steps and key requirements within: (1) development of standards for AI validation; (2) development of AI-GMA from large and diverse validation sets; (3) development of software tools and clinical pathways; (4) regulatory requisites; and (5) implementation. With the roadmap, AI-enabled screening for CP incorporating state-of-the-art technology can be made possible. Future work will require international collaboration to allow for scaling of data sets, refining automated solutions and translation into practice.

Funding: Cerebral Palsy Foundation, Cerebral Palsy Alliance, European Union Born to Get There, the National Health and Medical Research Council.

Keywords: Artificial intelligence; Cerebral palsy; Early detection; General movements; Machine learning.

PubMed Disclaimer

Conflict of interest statement

AJS, PBM, AB, AG, CM, and CP are all members of the General Movements Trust. Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital, Trondheim University Hospital, may benefit financially from a commercialization of the In-Motion AI-tools through existing intellectual properties which may include LA. All other authors declare no competing interests.

Figures

**Fig. 1**
**Automated GMA-Taskforce process**.

**Fig. 2**
**Road Map to Universal Screening of CP using AI-GMA**.

**Fig. 3**
**Recommendation for recording GMA for AI**.

**Fig. 4**
**Possible workflow for AI-GMA**.

See this image and copyright information in PMC

References

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1. McIntyre S., Goldsmith S., Webb A., et al. Global prevalence of cerebral palsy: a systematic analysis. Dev Med Child Neurol. 2022;64(12):1494–1506. - PMC - PubMed
1. Morgan C., Fetters L., Adde L., et al. Early intervention for children aged 0 to 2 years with or at high risk of cerebral palsy: international clinical practice guideline based on systematic reviews. JAMA Pediatr. 2021;175(8):846–858. - PMC - PubMed
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Towards universal early screening for cerebral palsy: a roadmap for automated General Movements Assessment

Affiliations

Towards universal early screening for cerebral palsy: a roadmap for automated General Movements Assessment

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

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