Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation Study
Cerebral palsy (CP) diagnosis is historically late, at between 12 and 24 months. We aimed to determine diagnosis age, fidelity to recommended tests and acceptability to parents and referrers of an early diagnosis clinic to implement a recent evidence-based clinical guideline for the early diagnosis...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-08-01
|
| Series: | Brain Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3425/11/8/1074 |
| _version_ | 1797524496558587904 |
|---|---|
| author | Anna te Velde Esther Tantsis Iona Novak Nadia Badawi Jane Berry Prue Golland Johanna Korkalainen Robyn McMurdo Ronda Shehata Catherine Morgan |
| author_facet | Anna te Velde Esther Tantsis Iona Novak Nadia Badawi Jane Berry Prue Golland Johanna Korkalainen Robyn McMurdo Ronda Shehata Catherine Morgan |
| author_sort | Anna te Velde |
| collection | DOAJ |
| description | Cerebral palsy (CP) diagnosis is historically late, at between 12 and 24 months. We aimed to determine diagnosis age, fidelity to recommended tests and acceptability to parents and referrers of an early diagnosis clinic to implement a recent evidence-based clinical guideline for the early diagnosis of CP. A prospective observational case series of infants <12 months with detectable risks for CP attending our clinic was completed with data analysed cross-sectionally. Infants had a high risk of CP diagnosis at a mean age of 4.4 (standard deviation [SD] 2.3) months and CP diagnosis at 8.5 [4.1] months. Of the 109 infants seen, 57% had a diagnosis of CP or high risk of CP, showing high specificity to our inclusion criteria. Parent and referrer acceptability of the clinic was high. Paediatricians had the highest rate of referral (39%) followed by allied health (31%), primary carer (14%) and other health workers (16%). Fidelity to the guideline was also high. All infants referred <5 mths had the General Movements Assessment (GMA) and all except one had the Hammersmith Infant Neurological Examination (HINE) administered. <i>N</i> = 92 (84%) of infants seen had neuroimaging, including <i>n</i> = 53 (49%) who had magnetic resonance imaging (MRI), showing recommended tests are feasible. Referral to CP-specific interventions was at 4.7 [3.0] months, sometimes before referral to clinic. Clinicians can be confident CP can be diagnosed well under 12 months using recommended tools. This clinic model is acceptable to parents and referrers and supports access to CP-specific early interventions when they are likely to be most effective. |
| first_indexed | 2024-03-10T08:58:14Z |
| format | Article |
| id | doaj.art-31e868bff33e4b4b935de7cbf7f63602 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T08:58:14Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-31e868bff33e4b4b935de7cbf7f636022023-11-22T06:59:42ZengMDPI AGBrain Sciences2076-34252021-08-01118107410.3390/brainsci11081074Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation StudyAnna te Velde0Esther Tantsis1Iona Novak2Nadia Badawi3Jane Berry4Prue Golland5Johanna Korkalainen6Robyn McMurdo7Ronda Shehata8Catherine Morgan9Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaTJ Nelson Department of Neurology and Neurosurgery, Children’s Hospital Westmead, Westmead, NSW 2145, AustraliaCerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaCerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaCerebral Palsy Alliance, Allambie Heights, NSW 2100, AustraliaCerebral Palsy Alliance, Allambie Heights, NSW 2100, AustraliaCerebral Palsy Alliance, Allambie Heights, NSW 2100, AustraliaCerebral Palsy Alliance, Allambie Heights, NSW 2100, AustraliaCerebral Palsy Alliance, Allambie Heights, NSW 2100, AustraliaCerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaCerebral palsy (CP) diagnosis is historically late, at between 12 and 24 months. We aimed to determine diagnosis age, fidelity to recommended tests and acceptability to parents and referrers of an early diagnosis clinic to implement a recent evidence-based clinical guideline for the early diagnosis of CP. A prospective observational case series of infants <12 months with detectable risks for CP attending our clinic was completed with data analysed cross-sectionally. Infants had a high risk of CP diagnosis at a mean age of 4.4 (standard deviation [SD] 2.3) months and CP diagnosis at 8.5 [4.1] months. Of the 109 infants seen, 57% had a diagnosis of CP or high risk of CP, showing high specificity to our inclusion criteria. Parent and referrer acceptability of the clinic was high. Paediatricians had the highest rate of referral (39%) followed by allied health (31%), primary carer (14%) and other health workers (16%). Fidelity to the guideline was also high. All infants referred <5 mths had the General Movements Assessment (GMA) and all except one had the Hammersmith Infant Neurological Examination (HINE) administered. <i>N</i> = 92 (84%) of infants seen had neuroimaging, including <i>n</i> = 53 (49%) who had magnetic resonance imaging (MRI), showing recommended tests are feasible. Referral to CP-specific interventions was at 4.7 [3.0] months, sometimes before referral to clinic. Clinicians can be confident CP can be diagnosed well under 12 months using recommended tools. This clinic model is acceptable to parents and referrers and supports access to CP-specific early interventions when they are likely to be most effective.https://www.mdpi.com/2076-3425/11/8/1074cerebral palsyearly diagnosisimplementation scienceknowledge translationinfantearly intervention |
| spellingShingle | Anna te Velde Esther Tantsis Iona Novak Nadia Badawi Jane Berry Prue Golland Johanna Korkalainen Robyn McMurdo Ronda Shehata Catherine Morgan Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation Study Brain Sciences cerebral palsy early diagnosis implementation science knowledge translation infant early intervention |
| title | Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation Study |
| title_full | Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation Study |
| title_fullStr | Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation Study |
| title_full_unstemmed | Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation Study |
| title_short | Age of Diagnosis, Fidelity and Acceptability of an Early Diagnosis Clinic for Cerebral Palsy: A Single Site Implementation Study |
| title_sort | age of diagnosis fidelity and acceptability of an early diagnosis clinic for cerebral palsy a single site implementation study |
| topic | cerebral palsy early diagnosis implementation science knowledge translation infant early intervention |
| url | https://www.mdpi.com/2076-3425/11/8/1074 |
| work_keys_str_mv | AT annatevelde ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT esthertantsis ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT ionanovak ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT nadiabadawi ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT janeberry ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT pruegolland ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT johannakorkalainen ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT robynmcmurdo ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT rondashehata ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy AT catherinemorgan ageofdiagnosisfidelityandacceptabilityofanearlydiagnosisclinicforcerebralpalsyasinglesiteimplementationstudy |