Malvern
When can a paediatric physio help?
Neurodevelopmental assessment for infants
We offer comprehensive neurodevelopmental assessments for infants, including Prechtl's General Movements assessment and the Hammersmith Infant Neurological Examination (HINE) at our Yarraville and Malvern clinics.
Infant neurodevelopmental assessments can be used to screen babies for conditions affecting their movement and gross motor development, for example, Cerebral Palsy. A neurodevelopmental assessment may be recommended if your baby has known risk factors for a neurological condition, for example, prematurity, low birth weight, multiple births (twins/triplets/quadruplets), infection during pregnancy (e.g., CMV/Rubella/Influenza), admission to the Neonatal Intensive Care Unit (NICU), severe untreated jaundice and/or a known brain injury, e.g., Periventricular Leukomalacia (PVL) and Hypoxic Ischaemic Encephalopathy (HIE), Intraventricular Hemorrhage (IVH). A full list of risk factors can be found on the Cerebral Palsy Alliance website. Sometimes a neurodevelopmental assessment may be recommended when a baby doesn’t have known risk factors, but presents with a gross motor delay with concerns about muscle tone or other neurological signs.
Neurodevelopmental assessments are non-invasive and usually tolerated well by babies. Your Physiotherapist will move your baby into different positions to observe their movement and postures. Muscle tone is assessed by moving the baby’s arms and legs to feel the amount of resistance to passive movement. Sometimes video footage of the babies’ movement is used to analyse movement patterns in greater detail after the appointment has taken place or in a team of trained paediatric Physiotherapists & Paediatricians.
Neurodevelopmental assessments are very valuable in the early identification of developmental delays or potential neurological issues. Early identification of problems affecting movement enables early intervention, earlier access to funding, and more support for families.
Prechtl's General Movements Assessment (GMA)
Prechtl’s General Movements Assessment is used for babies from birth to 16 weeks corrected age. The assessment is completed by analysing a 3-minute video of the babies’ spontaneous movement while laying on their back when they are settled and undistracted. When atypical movements or ‘absent fidgety movements’ are identified, further investigation and follow-up care will be recommended. The video footage is usually reviewed by >1 practitioner to ensure scoring accuracy and often repeated at different stages between birth and 16 weeks corrected age.
Prechtl's General Movements Assessment is considered an essential tool in early diagnosis & intervention process, allowing for timely and targeted support to optimize the neurodevelopmental outcomes of infants.
Hammersmith Infant Neurological Examination
The Hammersmith Infant Neurological Assessment (HINE) can be used for babies from 2 - 24 months of age and takes around 30 minutes to complete. During the assessment, your Physiotherapist will assess your babies’ movements and postures in various positions. Your Physiotherapist will gently move your babies’ arms and legs to assess their muscle tone (the amount of resistance to passive movement). Reflexes and reactions are assessed by gently tapping on tendons in the babies’ arms and legs with a reflex hammer and observing the babies’ movement responses when held in different positions. Cranial nerve function is assessed by observing the baby’s response to visual and auditory input.
The assessment is non-invasive and gentle, with breaks for a cuddle as needed! If your baby’s score suggests a possible neurological condition, the assessment will be repeated in a few months’ time and further investigation and follow up care is recommended.
The Hammersmith Infant Neurological Examination serves as an important tool in the early identification and monitoring of neurological issues in infants, allowing for prompt and targeted interventions to support optimal neurodevelopment.
Early Diagnosis & Intervention
The results from neurodevelopmental assessments such as the Hammersmith Infant Neurological Examination (HINE) and Prechtl’s General Movements Assessment (GMs) are used in combination with the babies’ birth history and MRI results to inform diagnosis.
In the past, babies were not usually diagnosed with cerebral palsy until after 1 year of age, however neurodevelopmental assessments mean that babies can be diagnosed with Cerebral Palsy or ‘at high risk of Cerebral Palsy’ as early as 3 months of age. When babies are diagnosed early, they are able to start receiving therapy earlier. Given the large amount of brain development that takes place in the first years of life, early intervention leads to much better long-term outcomes. Early diagnosis also enables families to access funding to pay for therapy and equipment and to be connected with support to promote whole family wellbeing. Results from neurodevelopmental assessments can be used to support applications for NDIS funding for early intervention.
More information can be found in the Early Assessment and Diagnosis of Cerebral Palsy Guide for Parents published by the Cerebral Palsy Alliance.