Children born prematurely, those who endured birth trauma, and those who underwent a neonatal stroke are susceptible to developing Cerebral Palsy (CP). The timely diagnosis of CP in a child and the prompt initiation of early intervention can mitigate the neurodevelopmental impact associated with CP.
Neuroplasticity and the Importance of Early Intervention
The effectiveness and urgency of early intervention, ideally commencing shortly after birth, stem from the concept of neuroplasticity. Neuroplasticity refers to the brain's capacity to grow and acquire new skills. The period from birth to around 3 years old represents the peak plasticity of the brain. While neuroplasticity remains heightened between ages 3 and 5, it diminishes significantly after the age of 5. Initiating early intervention therapy during the early years of a child's life maximizes the brain's potential to develop new neuromotor connections and strengthen existing ones. This approach offers the child the best opportunity to acquire the skills necessary for thriving in life and reaching their full potential.
Identification of At-Risk Infants
If your baby is a premature birth and has spent time in the Neonatal Intensive Care Unit (NICU), suffered birth traumas such as skull fractures, birth asphyxia, caput succedaneum, extracranial hemorrhages, or is suspected to have experienced a perinatal stroke, they are at risk for Cerebral Palsy.
For premature babies, the risk of CP varies based on their degree of prematurity. Infants born at 26 weeks gestation or less face a 20% risk, those born between 27 to 32 weeks have a 12% risk, and those born at 33 to 36 weeks have a 1% chance of developing CP.
What is the General Movement Assessment (GMA)?
The most precise method for predicting a Cerebral Palsy diagnosis in infants is the General Movement Assessment (GMA), surpassing the accuracy of a cranial MRI (Seesahai et al., 2021). This unintrusive assessment can be conducted shortly after birth, or thereafter, and involves capturing and analyzing video footage of the infant. The GMA identifies absent or abnormal general movements, and depending on the type of abnormality detected, it can be highly indicative of Cerebral Palsy. This assessment is applicable for infants up to the age of 4 months (adjusted). If your child is over 4 months of age, the pediatric physiotherapists at the Canadian Centre for Development are able to provide guidance on other Neonatal Developmental Assessments that can be conducted in GMA's place. Three other assessments that we provide at the Canadian Centre for Development are the Hammersmith Neonatal Assessment (up to 20 weeks of age), Hammersmith Infant Assessment (up to 24 months of age), and the Alberta Infant Motor Scale (AIMS) Assessment (up to 40 weeks of age).
Who is Qualified to Perform a General Movement Assessment (GMA)?
A General Movement Assessment (GMA) is generally administered by a pediatric physiotherapist with specialized training and certification in conducting the GMA. At the Canadian Centre for Development, our pediatric physiotherapist, Svenje Duffield, possesses the necessary expertise to conduct General Movement Assessments for families with children at risk for Cerebral Palsy.