Equitable access to cerebral palsy assessments and diagnosis through an early detection Hub: a feasibility study

BACKGROUND: Cerebral palsy (CP) can be diagnosed in infants with identifiable risk factors before 5 months corrected age. However, many barriers prevent equitable access to assessments and diagnosis. This study evaluated whether international best practice recommendations for early CP detection could be equitably implemented, regardless of place of residence or ethnicity, while maintaining fidelity to the recommendations. Demand, age of diagnosis and acceptability were also evaluated. METHODS: A prospective feasibility study was conducted of infants (and their families) admitted to a tertiary Neonatal Intensive Care Unit (2023-2024). An early CP detection pathway was delivered through a regional, multidisciplinary Hub providing flexible access to assessments and support for families and health professionals. RESULTS: Neuroimaging, Prechtl's General Movement Assessments (GMA), and Hammersmith Infant Neurological Examination (HINE) were completed for 74% and 75% of the local and regional infants (p = 0.97), and 64% and 82% for Māori and non-Māori infants (p = 0.09). Demand was high (93%) for families enrolling in the study to access early assessments. High-risk of CP/ CP was diagnosed at a mean age of 4.3 months (SD 1.0). CONCLUSION: Providing early CP detection assessments for high-risk infants, independent of ethnicity or region of residence, appears feasible using the Hub model of care, supporting earlier diagnosis of CP. IMPACT: Partnering with families and clinicians in health care design and delivery improves access to early diagnostic assessments, communication and information sharing with families and between service providers. Demand for early CP assessments and diagnosis is high among families, with a Hub model of care well-received. It is feasible to implement international best evidence for early CP detection, independent of place of residence or ethnicity, and reduce the age of CP diagnosis.