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Introduction
Skills and Expertise
Current institution
Publications
Publications (54)
Aim:
To determine the relationship between the Test of Infant Motor Performance (TIMP) at 3 months and cognitive, language, and motor outcomes on the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 2 years of age in high-risk infants born preterm.
Method:
One hundred and six infants (47 females, 59 males) born at e...
Infants who have graduated from a neonatal intensive care unit require close follow-up because they have a greater chance of experiencing later motor and cognitive difficulties; however, these difficulties are often challenging to identify at an early age. The General Movement Assessment is a low-cost and highly reliable tool that can indicate abno...
Importance
There is an urgent need to assess neurodevelopment in Zika virus (ZIKV)–exposed infants.
Objectives
To perform general movement assessment (GMA) at 9 to 20 weeks’ postterm age and to evaluate whether the findings are associated with neurodevelopmental outcomes at age 12 months in infants prenatally exposed to acute maternal illness with...
Background and purpose:
Very preterm infants (birth weight, <1500 g) are at increased risk of cognitive and motor impairment, including cerebral palsy. These adverse neurodevelopmental outcomes are associated with white matter abnormalities on MR imaging at term-equivalent age. Cerebral palsy has been predicted by analysis of spontaneous movements...
Background:
Cerebral Magnetic Resonance Imaging, the General Movement Assessment, and the Test of Infant Motor Performance are all tools that can predict neurodevelopmental outcome in preterm infants. However, how these tests relate to each other is unclear.
Aims:
To examine the relationship between cerebral Magnetic Resonance Imaging measured a...
Objectives:
To characterize early developmental trajectories of selective motor control (SMC) in very preterm infants and examine associations with later cerebral palsy (CP) diagnosis and gross motor function.
Methods:
Very preterm infants (<32 weeks gestation) were recorded every 2 to 4 weeks until 5 months post term age (PTA). SMC was scored from...
Background/Objectives: Cerebral palsy (CP), often caused by early brain injury such as perinatal stroke or hemorrhage, is the most common lifelong motor disability. Early identification of at-risk infants and timely access to rehabilitation interventions are essential for improving long-term outcomes. The General Movements Assessment (GMA), perform...
Background:
Children exposed antenatally to Zika virus (ZIKV) during the 2015-2016 epidemic are now in school; little is known about their neurodevelopment at this age. The objective was to evaluate neurodevelopment of ZIKV-exposed Colombian children compared to non-exposed controls at ages 5-6.
Methods:
In total, 48 normocephalic children with...
Background: The increasing clinical use of combining structural MRI (sMRI) with General Movements Assessment (GMA) or Hammersmith Infant Neurological Exam (HINE) before five months corrected age (CA) for early diagnosis of cerebral palsy (CP) lacks sufficient prognostic data for children with CP, especially those with Gross Motor Function Classific...
OBJECTIVE: The development and clinical application of EEG devices equipped with seizure-detection algorithms using artifi cial intelligence in Neonatal Intensive Care Units has grown. Although some of these algorithms, trained using term seizure data, have reported sensitivities of approximately 0.5, their adaptability to seizures observed in pret...
Neurodevelopmental outcomes for preschool-age children in the United States with in utero Zika virus (ZIKV) exposure have not yet been reported. We performed a case-control study to assess whether children exposed in utero to ZIKV have abnormal neurodevelopment at age 4–5 years compared to unexposed controls. Thirteen ZIKV-exposed cases that did no...
Aim
To assess the predictive capabilities of the Baby Observational Selective Control AppRaisal (BabyOSCAR) tool, administered at 3 months corrected age, in determining spastic cerebral palsy (CP) outcome, functional abilities, and body topography at 2 years of age or later.
Method
Independent joint motions were measured at age 10 to 16 weeks from...
Aim
To investigate the construct validity of the Baby Observational Selective Control AppRaisal (BabyOSCAR), an assessment of independent joint motion in infants with cerebral palsy (CP).
Method
BabyOSCAR was scored for 75 infants (45 with CP and 30 without CP). Rasch analysis was used in combination with classical test theory to assess areas of s...
Aim
To describe the development of an observational measure of spontaneous independent joint motion in infants with spastic cerebral palsy (CP), the Baby Observational Selective Control AppRaisal (BabyOSCAR), and to test its convergent validity and reliability.
Method
A retrospective sample of 75 infants (45 with spastic CP and 30 without CP) at 3...
Background: The general movement optimality score (GMOS) quantifies the details of general movements (GMs). We recently conducted psychometric analyses of the GMOS and developed a revised scoresheet. Consequently, the GMOS-Revised (GMOS-R) instrument necessitated validation using new percentile ranks. This study aimed to provide these percentile ra...
Since 2016, international research groups have focused on assessing outcomes of children with in utero Zika virus (ZIKV) exposure. While the more severe outcomes of congenital Zika syndrome (CZS) occur in up to 10% of children with antenatal exposure, early findings among ZIKV-exposed children without CZS ages 0-5 years suggest that they may also h...
The long-term neurodevelopmental effects of antenatal Zika virus (ZIKV) exposure in children without congenital Zika syndrome (CZS) remain unclear, as few children have been examined to the age of school entry level. A total of 51 Colombian children with antenatal ZIKV exposure without CZS and 70 unexposed controls were evaluated at 4–5 years of ag...
Introduction
Developmental disabilities and neuromotor delay adversely affect long-term neuromuscular function and quality of life. Current evidence suggests that early therapeutic intervention reduces the severity of motor delay by harnessing neuroplastic potential during infancy. To date, most early therapeutic intervention trials are of limited...
Purpose:
To evaluate the General Movement Assessment (GMA) with the Motor Optimality Score-Revised (MOS-R) as a neurodevelopmental marker in infants with retinopathy of prematurity (ROP).
Methods:
Infants screened prospectively for ROP were evaluated at 3 months' post-term age using a smartphone application to complete the GMA and MOS-R. Results...
Background:
Children with in utero Zika virus (ZIKV) exposure without congenital Zika syndrome (CZS) are at risk for abnormal neurodevelopment. Preschool-age outcomes for children with antenatal ZIKV exposure have not yet been established.
Methods:
Children with in utero ZIKV exposure and non-exposed controls had neurodevelopmental evaluations a...
Background
The Motor Optimality Score-Revised (MOS-R) is a detailed scoring of the General Movement Assessment (GMA), measuring the spontaneous behaviors of infants. Infants born moderate-late preterm are not traditionally followed in high-risk clinics, but have increased risk of neurodevelopmental disability.
Aims
Compare MOS-R at 3 months correc...
Importance:
Early identification of cerebral palsy (CP) is important for early intervention, yet expert-based assessments do not permit widespread use, and conventional machine learning alternatives lack validity.
Objective:
To develop and assess the external validity of a novel deep learning-based method to predict CP based on videos of infants...
Purpose:
Perinatal brain injury is a primary cause of cerebral palsy, a condition resulting in lifelong motor impairment. Infancy is an important period of motor system development, including development of the corticospinal tract (CST), the primary pathway for cortical movement control. The interaction between perinatal stroke recovery, CST organ...
Numerous conditions and circumstances place infants at risk for poor neuromotor health, yet many are unable to receive treatment until a definitive diagnosis is made, sometimes several years later. In this integrative perspective, we describe an extensive team science effort to develop a transdiagnostic approach to neuromotor health interventions d...
Background and Objective
Children with a history of acute provoked neonatal seizures are at high risk for disability, often requiring developmental services. The COVID-19 pandemic has led to widespread changes in how healthcare is delivered. Our objective was to determine the magnitude of service interruption of services among children born between...
The COVID-19 pandemic occurred during planned neurodevelopmental follow-up of Colombian children with antenatal Zika-virus exposure. The objective of the study was to leverage the institution's telemedicine infrastructure to support international clinical child outcome research. In a prospective cohort study of child neurodevelopment (NCT04398901),...
Objective
To describe the inter-observer reliability of the General Movement Assessment (GMA) among a sample of infants at high-risk of cerebral palsy (CP) among raters with various levels of experience
Methods
Video assessments of 150 high-risk infants at 10-15 weeks corrected age were rated by three Prechtl GMA-certified observers with varied ex...
The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) is a 50-item, criterion-specified questionnaire that assesses a child’s adaptive skills in everyday context and can be used in high-risk follow-up settings to identify risk for adverse neurodevelopmental outcome. Our aim was to validate the WIDEA-FS by comparin...
Objective
To evaluate the prevalence and associations between structural MRI (sMRI) injury/abnormality at term equivalent age and absent fidgety General Movements Assessment (GMA) and abnormal Hammersmith Infant Neurological Examination (HINE) scores among very preterm infants at 3-4 months corrected age.
Study design
This prospective cohort study...
Aim
To determine the concurrent validity of the Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA‐FS), a criterion‐specified questionnaire that assesses a child's adaptive skills in everyday contexts, and the Bayley Infant and Toddler Scales of Development, Third Edition (Bayley‐III).
Method
In a prospective cohort s...
Preterm infants born before 32 weeks gestation have increased risks for neurodevelopmental impairment at two years of age. How brain function differs between preterm infants with normal or impaired development is unknown. However, abnormal spontaneous motor behavior at 12-15 weeks post-term age is associated with neurodevelopmental impairment. We i...
Importance
The number of children who were born to mothers with Zika virus (ZIKV) infection during pregnancy but who did not have apparent disability at birth is large, warranting the study of the risk for neurodevelopmental impairment in this population without congenital Zika syndrome (CZS).
Objective
To investigate whether infants without CZS b...
Background:
Early identification of cerebral palsy (CP) during infancy will provide opportunities for early therapies and treatments. The aim of the present study was to present a novel machine-learning model, the Computer-based Infant Movement Assessment (CIMA) model, for clinically feasible early CP prediction based on infant video recordings....
Background:
Early prediction of cerebral palsy (CP) using the General Movement Assessment (GMA) during the fidgety movements (FM) period has been recommended as standard of care in high-risk infants. The aim of this study was to determine the accuracy of GMA, alone or in combination with neonatal imaging, in predicting cerebral palsy (CP).
Method...
Background
Congenital Zika syndrome (CZS) is seen in 5–12% of newborns from Zika virus (ZIKV)-infected pregnancies and includes severe neurologic abnormalities. However, the majority of ZIKV-exposed newborns do not have CZS. The risk for neurodevelopmental impairment for infants without CZS following in utero ZIKV is not well known. The objective w...
Background and purpose:
Contracture and toe-walking in children due to vascular anomaly of the calf musculature is rarely described and there is limited evidence regarding treatment. The purpose of this case is to describe the novel use of serial casting, combining the knee and ankle, to reduce contracture in a child with hemangioma of the calf....
The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3– 5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may p...
Diagnosis of cerebral palsy (CP) after perinatal stroke is often delayed beyond infancy, a period of rapid neuromotor development with heightened potential for rehabilitation. This study sought to assess whether the presence or absence of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) could be an early biomarker...
Background and objective:
To evaluate neurodevelopmental outcomes among infants treated for retinopathy of prematurity (ROP) at the authors' institution.
Patients and methods:
Before-and-after retrospective chart reviews identified 40 infants treated with laser and 46 treated with primary intravitreal bevacizumab (IVB). Primary outcomes were dea...
Background:
Perinatal brain injuries often impact the corticospinal system, leading to motor impairment and cerebral palsy (CP). While transcranial magnetic stimulation (TMS) has been widely used to study corticospinal connectivity in adults and older children, similar studies of young infants are limited.
Objectives:
The objective was to establ...
eAppendix. Supplemental Appendix
A 67-year-old woman presented 3 weeks following left total hip arthroplasty (THA) and received 12 physical therapy sessions over 2 months. One week after returning to work, the patient experienced severe left buttock pain and was diagnosed with degenerative L5-S1 spondylolisthesis and foraminal stenosis, for which she subsequently underwent L5-S1 l...
Introducing dynamic magnetic resonance imaging (MRI) broke new ground in visualising human fetal behaviour.1 We use this method for detailed analyses of complex and coordinated fetal motor patterns, to study spontaneous motor activity, and for functional assessments of the young nervous system.2 While analysing a fetus at 27 weeks of gestation duri...
