Sîan A Williams1,2, Anna Mackey3, Alexandra Sorhage3, Malcolm Battin4, Nichola Wilson2,5, Alicia Spittle6, N Susan Stott2,4. 1. School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia. 2. Department of Surgery, University of Auckland, Auckland, New Zealand. 3. New Zealand Cerebral Palsy Register, Starship Child Health, Auckland, New Zealand. 4. Neonatal Intensive Care, Starship Child Health, Auckland, New Zealand. 5. Department of Paediatric Orthopaedics, Starship Child Health, Auckland District Health Board, Auckland, New Zealand. 6. Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.
Abstract
AIM: A diagnosis of cerebral palsy (CP) can, and should, be made as early as possible. This work describes current clinical practice around the awareness and use of diagnostic tools for the detection of CP in New Zealand (NZ). METHODS: A purpose-developed survey distributed electronically to NZ clinicians working with young children with or at risk of CP. RESULTS: A total of 159 clinicians (including paediatricians, physiotherapists and occupational therapists) participated in this cross-sectional study. Ninety-six percent were aware that a diagnosis of CP can be made by 12 months of age, with high levels of awareness of the use of magnetic resonance imaging (94%), Prechtl's qualitative assessment of general movements (GMs) (70%) and Hammersmith Infant Neurological Examination (HINE) (77%). Only 40% were aware of the HINE optimality scoring. Fifty-four clinicians provided a diagnosis of CP as part of their role: 48% never used the GMs or HINE to assess children <1 year, and 57% never used the HINE for children between 1 and 2 years. Clinicians not providing a diagnosis within their professional role (n = 104) also indicated infrequent use of assessment tools with 74% and 54% never using the GM's or HINE (respectively) in their assessment of children at risk of CP. Barriers to use included lack of time and funding, lack of clear pathways and management support. CONCLUSION: Despite high awareness, current use of international best practice tools in NZ clinical practice appears low. Multiple barriers are reported to the use of these tools, which need to be addressed to improve the timeliness of diagnosis.
AIM: A diagnosis of cerebral palsy (CP) can, and should, be made as early as possible. This work describes current clinical practice around the awareness and use of diagnostic tools for the detection of CP in New Zealand (NZ). METHODS: A purpose-developed survey distributed electronically to NZ clinicians working with young children with or at risk of CP. RESULTS: A total of 159 clinicians (including paediatricians, physiotherapists and occupational therapists) participated in this cross-sectional study. Ninety-six percent were aware that a diagnosis of CP can be made by 12 months of age, with high levels of awareness of the use of magnetic resonance imaging (94%), Prechtl's qualitative assessment of general movements (GMs) (70%) and Hammersmith Infant Neurological Examination (HINE) (77%). Only 40% were aware of the HINE optimality scoring. Fifty-four clinicians provided a diagnosis of CP as part of their role: 48% never used the GMs or HINE to assess children <1 year, and 57% never used the HINE for children between 1 and 2 years. Clinicians not providing a diagnosis within their professional role (n = 104) also indicated infrequent use of assessment tools with 74% and 54% never using the GM's or HINE (respectively) in their assessment of children at risk of CP. Barriers to use included lack of time and funding, lack of clear pathways and management support. CONCLUSION: Despite high awareness, current use of international best practice tools in NZ clinical practice appears low. Multiple barriers are reported to the use of these tools, which need to be addressed to improve the timeliness of diagnosis.
Authors: Malcolm R Battin; Sîan A Williams; Anna Mackey; Woroud Alzaher; Alexandra Sorhage; N Susan Stott Journal: J Clin Med Date: 2022-03-28 Impact factor: 4.241
Authors: Sîan A Williams; Woroud Alzaher; Anna Mackey; Amy Hogan; Malcolm Battin; Alexandra Sorhage; N Susan Stott Journal: J Clin Med Date: 2021-03-31 Impact factor: 4.241