Predictive value of the General Movements Assessment and Standardized Infant NeuroDevelopmental Assessment in infants at high risk of neurodevelopmental disorders

Abstract

Predicting neurodevelopmental disorders, such as cerebral palsy and intellectual disability, during infancy is not easy. Literature indicates that the General Movements Assessment (GMA) gives the best prediction. It can be used in infants up to the age of 5 months corrected age and is based on a video-recording of the infant's spontaneous movements. It requires substantial assessor training. A relatively recently developed instrument is the Standardized Infant NeuroDevelopmental Assessment (SINDA) for infants aged 6 weeks to 12 months corrected age. SINDA has three scales: neurological, developmental, and socio-emotional. SINDA is not video-dependent.

We compared how well GMA and SINDA's neurological scale predict neurodevelopmental disorders in 109 high-risk infants (mostly born very preterm). Abnormal general movements (like reduced variety in movement and lack of specific ‘fidgety’ movements) and low SINDA scores (below 22 out of 28) were used as markers for neurodevelopmental issues. These infants were tracked until at least 2 years old to identify outcomes like cerebral palsy or low developmental scores.

Both GMA and SINDA accurately predicted atypical outcomes, with minor differences in the profile of the predictive values. However, SINDA is easier to learn and doesn't rely on video, which allows caregivers to be more involved during assessments.

Learning that SINDA and the GMA both predict neurodevelopmental outcome well may be relevant, as SINDA is easier to learn than the GMA. Moreover, the non-video-based SINDA allows caregiver feedback during the consultation and the GMA usually does not.