A systematic review of tests to predict cerebral palsy in young children
Open accessAbstract
Aim: This systematic review evaluates the accuracy of predictive assessments and investigations used to assist in the diagnosis of cerebral palsy (CP) in preschool‐age children (<5y). Method: Six databases were searched for studies that included a diagnosis of CP validated after 2 years of age. The validity of the studies meeting the criteria was evaluated using the Standards for Reporting Diagnostic Accuracy criteria. Where possible, results were pooled and a meta‐analysis was undertaken. Results: Nineteen out of 351 studies met the full inclusion criteria, including studies of general movements assessment (GMA), cranial ultrasound, brain magnetic resonance imaging (MRI), and neurological examination. All studies assessed high‐risk populations including preterm (gestational range 23–41wks) and low‐birthweight infants (range 500–4350g). Summary estimates of sensitivity and specificity of GMA were 98% (95% confidence interval [CI] 74–100%) and 91% (95% CI 83–93%) respectively; of cranial ultrasound 74% (95% CI 63–83%) and 92% (95% CI 81–96%) respectively; and of neurological examination 88% (95% CI 55–97%) and 87% (95% CI 57–97%) respectively. MRI performed at term corrected age (in preterm infants) appeared to be a strong predictor of CP, with sensitivity ranging in individual studies from 86 to 100% and specificity ranging from 89 to 97% There was inadequate evidence for the use of other predictive tools. Summary: This review found that the assessment with the best evidence and strength for predictive accuracy is the GMA. MRI has a good predictive value when performed at term‐corrected age. Cranial ultrasound is as specific as MRI and has the advantage of being readily available at the bedside. Studies to date have focused on high‐risk infants. The accuracy of these tests in low‐risk infants remains unclear and requires further research.
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New international clinical practice guidelines aim to shift detection of infants at high risk of CP earlier, to 12 to 24 weeks corrected age, which is significantly earlier than previous diagnosis windows in Australia at 19 months.
“New international clinical practice guidelines exist for identifying infants at high risk of cerebral palsy (CP) earlier: between 12 to 24 weeks corrected age, significantly earlier than previous diagnosis windows in Australia at 19 months.”
From Early Parenting Acceptance and Commitment Therapy ‘Early PACT’ for parents of infants with cerebral palsy: a study protocol of a randomised controlled trial (2020) · cites this paper as [3]
The Clinical implications section says that tools can help predict cerebral palsy in high-risk infants and enable early intervention. The paper does not report new international clinical practice guidelines, a 12–24-week corrected-age detection window, or a previous Australian diagnosis window of 19 months (pages unavailable in our copy). (LLM, conf=0.82)
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Self-citation
- Authors
- Bosanquet, M., Copeland, L., Ware, R., & Boyd, R.
- Affiliations
- The University of Queensland (AU)
- Children's Health Queensland Hospital and Health Service (AU)
- Corresponding author
- Bosanquet, Margot
- Venue
- Developmental Medicine & Child Neurology
- Publisher
- Wiley
- Published
- 2013-04-11
- Volume
- 55
- Issue
- 5
- Pages
- 418-426
- ISSN
- 0012-1622 (ISSN-L)
- 1469-8749
- OpenAlex
- W2010394425
- Cited by
- 518
- References
- 66
- Citations by year
- 2026: 26 · 2025: 42 · 2024: 63 · 2023: 41 · 2022: 52 · 2021: 57 · 2020: 54 · 2019: 28 · 2018: 41 · 2017: 33 · 2016: 40 · 2015: 23 · 2014: 14 · 2013: 4
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Developmental Medicine & Child Neurology (publishedVersion)
- PubMed (publishedVersion)
- eSpace (Curtin University) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Funders
- Children's Medical Research
- Children's Hospital Foundation
- Royal Children's Hospital Foundation
- National Health and Medical Research Council (473840)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Keywords
- cerebral palsy, early diagnosis, prediction accuracy, General Movements Assessment, cranial ultrasound, brain MRI, neurological examination, preterm infants, low birth weight, sensitivity and specificity
- MeSH terms
- Cerebral Palsy, Female, Humans, Infant, Newborn, Magnetic Resonance Imaging, Male, Movement, Neurologic Examination, Predictive Value of Tests, Databases, Factual
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