Telehealth Hammersmith Infant Neurological Examination and early diagnosis of cerebral palsy

Cerebral palsy (CP) affects movement and muscle control in young children, and early diagnosis is important because it allows children to engage in therapies sooner. One tool used to help identify CP early is the Hammersmith Infant Neurological Examination (HINE), a structured exam that evaluates an infant's movements, posture, and reflexes. Traditionally, this exam is done in person, but many families face challenges traveling to specialty clinics. In this study, we looked at whether the HINE can be performed effectively using telehealth (video visits) compared to in-person visits. We studied 650 infants at higher risk for CP who were followed in a neonatal follow-up program. About one-third of these infants had at least one HINE exam completed by telehealth. We found that HINE scores were strongly linked to later diagnosis of CP at 3, 6, 9, and 12 months of age, whether the exam was done in person or by telehealth. The ability of the test to correctly identify children with and without CP was similar between the two approaches. These findings suggest that telehealth can be a reliable way to perform this important neurological exam. Telehealth may help families who live far from specialty centers or have difficulty traveling access earlier evaluation and care. However, telehealth exams still depend on caregiver participation, technology access, and may not fully replace in-person visits when findings are unclear.