Evidence map›Paper›PMID 33999106›Full record

ArticleJAMA pediatrics2021

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy: International Clinical Practice Guideline Based on Systematic Reviews.

Catherine Morgan, Linda Fetters, Lars Adde, Nadia Badawi, Ada Bancale, Roslyn N Boyd, Olena Chorna, Giovanni Cioni, Diane L Damiano, Johanna Darrah and 32 more

2 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 185 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
185citing papers in PubMed, 12 pooled it
42.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06737471 recruitingnot on this mapstarted 2024, after this paper: background citation

Italian Cp eArly REhabilitation (iCARE)

TypeobservationalSponsorIRCCS Eugenio MedeaRan2024 to 2026Enrolled96ConditionsCerebral PalsyArmsIntensive rehabilitation treatment, Extensive rehabilitation treatment
NCT07469514 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

CIRCLE-CP Study: Coaching, Learning, Empowerment in Cerebral Palsy - a 6-Week Integrated PT/OT Caregiver "Primer" Bootcamp for Infants Diagnosed With or at High Risk for Cerebral Palsy

TypeinterventionalSponsorUniversity of California, San FranciscoRan2026 to 2027Enrolled32ConditionsCerebral Palsy, Cerebral Palsy (CP), Cerebral Palsy Infantile, InfantArmsCaregiver knowledge, Physical therapy, Occupational Therapy
3 · Its place in the literature

Who cites it

185 citing papers in PubMed, 12 syntheses or guidelines pooled it, 409 citations in OpenAlex.

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  7. Neural Correlates of Mobility in Children with Cerebral Palsy: A Systematic Review.International journal of environmental research and public health · 2024
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125 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

42 authors at 20 institutions in 10 countries.

Catherine MorganCerebral Palsy Alliance Research Institute, Brain Mind Centre, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.
Linda FettersUniversity of Southern California, Los Angeles.
Lars AddeDepartment of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Nadia BadawiCerebral Palsy Alliance Research Institute, Brain Mind Centre, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.
Ada BancaleIRCCS Fondazione Stella Maris, Pisa, Italy.
Roslyn N BoydThe University of Queensland, St Lucia, Queensland, Australia.
Olena ChornaIRCCS Fondazione Stella Maris, Pisa, Italy.
Giovanni CioniIRCCS Fondazione Stella Maris, Pisa, Italy.
Diane L DamianoNational Institutes' of Health, Bethesda, Maryland.
Johanna DarrahFaculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
Linda S de VriesUniversity Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Stacey DusingUniversity of Southern California, Los Angeles.
Christa EinspielerDivision of Phoniatrics, Medical University of Graz, Austria.
Ann-Christin EliassonKarolinska Institutet, Stockholm, Sweden.
Donna FerrieroUniversity of California, San Francisco, San Francisco.
Darcy FehlingsHolland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
Hans ForssbergDepartment of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Andrew M GordonTeachers College, Columbia University, New York, New York.
Susan GreavesThe Royal Children's Hospital, Melbourne, Australia.
Andrea GuzzettaIRCCS Fondazione Stella Maris, Pisa, Italy.
Mijna Hadders-AlgraDepartment of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Regina HarbourneDuquesne University, Pittsburgh, Pennsylvania.
Petra KarlssonCerebral Palsy Alliance Research Institute, Brain Mind Centre, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.
Lena Krumlinde-SundholmKarolinska Institutet, Stockholm, Sweden.
Beatrice LatalUniversity Children's Hospital Zurich, Zurich, Switzerland.
Alison Loughran-FowldsGrace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Catherine MakThe University of Queensland, St Lucia, Queensland, Australia.
Nathalie MaitreNationwide Children's Hospital, The Ohio State University, Columbus.
Sarah McIntyreCerebral Palsy Alliance Research Institute, Brain Mind Centre, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.
Cristina MeiOrygen, Parkville, Victoria, Australia.
Angela MorganThe Royal Children's Hospital, Melbourne, Australia.
Angelina Kakooza-MwesigeMakerere University, Kampala, Uganda.
Domenico M RomeoPediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, Universitá Cattolica del Sacro Cuore, Rome, Italy.
Katherine SanchezMurdoch Children's Research Institute, Melbourne, Victoria, Australia.
Alicia SpittleMurdoch Children's Research Institute, Melbourne, Victoria, Australia.
Roberta ShepherdThe University of Sydney, Sydney, Australia.
Marelle ThorntonCerebral Palsy Alliance Research Institute, Brain Mind Centre, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.
Jane ValentinePerth Children's Hospital, Nedlands, Western Australia, Australia.
Roslyn WardCurtin University, Perth, Australia.
Koa WhittinghamThe University of Queensland, St Lucia, Queensland, Australia.
Alieh ZamanyEugene Child Development and Rehabilitation Center, Oregon Health and Science University, Eugene.
Iona NovakThe University of Sydney, Sydney, Australia.
University of Sydney · AUCerebral Palsy Alliance · AUFondazione Stella Maris · ITKarolinska Institutet · SEMurdoch Children's Research Institute · AUUniversity of Queensland · AUUniversity of Southern California · USChildren's Hospital at Westmead · AUColumbia University · USCurtin University · AUDuquesne University · USMakerere University · UGMedical University of Graz · ATNational Institutes of Health · USOregon Health & Science University · USOrygen · AUPerth Children's HospitalRoyal Children's Hospital · AUSt Olav's University Hospital · NOThe Ohio State University · US

Funding

Intramural NIH HHS Z99 CL999999
6 · The paper itself

Abstract

Importance: Cerebral palsy (CP) is the most common childhood physical disability. Early intervention for children younger than 2 years with or at risk of CP is critical. Now that an evidence-based guideline for early accurate diagnosis of CP exists, there is a need to summarize effective, CP-specific early intervention and conduct new trials that harness plasticity to improve function and increase participation. Our recommendations apply primarily to children at high risk of CP or with a diagnosis of CP, aged 0 to 2 years. Objective: To systematically review the best available evidence about CP-specific early interventions across 9 domains promoting motor function, cognitive skills, communication, eating and drinking, vision, sleep, managing muscle tone, musculoskeletal health, and parental support. Evidence Review: The literature was systematically searched for the best available evidence for intervention for children aged 0 to 2 years at high risk of or with CP. Databases included CINAHL, Cochrane, Embase, MEDLINE, PsycInfo, and Scopus. Systematic reviews and randomized clinical trials (RCTs) were appraised by A Measurement Tool to Assess Systematic Reviews (AMSTAR) or Cochrane Risk of Bias tools. Recommendations were formed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and reported according to the Appraisal of Guidelines, Research, and Evaluation (AGREE) II instrument. Findings: Sixteen systematic reviews and 27 RCTs met inclusion criteria. Quality varied. Three best-practice principles were supported for the 9 domains: (1) immediate referral for intervention after a diagnosis of high risk of CP, (2) building parental capacity for attachment, and (3) parental goal-setting at the commencement of intervention. Twenty-eight recommendations (24 for and 4 against) specific to the 9 domains are supported with key evidence: motor function (4 recommendations), cognitive skills (2), communication (7), eating and drinking (2), vision (4), sleep (7), tone (1), musculoskeletal health (2), and parent support (5). Conclusions and Relevance: When a child meets the criteria of high risk of CP, intervention should start as soon as possible. Parents want an early diagnosis and treatment and support implementation as soon as possible. Early intervention builds on a critical developmental time for plasticity of developing systems. Referrals for intervention across the 9 domains should be specific as per recommendations in this guideline.

Indexed as

Cerebral PalsyChild, PreschoolEarly DiagnosisEarly Intervention, EducationalHumansInfantInfant, NewbornParentsPractice Guidelines as Topic

Identifiers

PMID33999106
PMCPMC9677545
OpenAlexW3163644331

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.