Predicting neurodevelopmental outcomes in Australian First Nations infants: The transdiagnostic utility of early screening tools.
Carly Luke, Katherine A Benfer, Leeann Mick-Ramsamy and 5 others
PMID 40999580WHAT IT FOUND
A combined trajectory of early movement scores (MOS-R) and neurological exams (HINE) predicted neurodevelopmental delays and autism at 12 months with 74% accuracy.
This transdiagnostic utility allows therapists to identify high-risk First Nations infants earlier, even before a formal diagnosis is confirmed.
Key findings
01A combined trajectory of a MOS-R score under 23 and a moderate-to-severely reduced HINE score predicted high chance of NDD or CP with 74% accuracy, 62% sensitivity, and 93% specificity.
02The HINE was the strongest overall predictor at 4 to 9 months corrected age, with a moderately to severely reduced score showing 72% accuracy and 85% positive predictive value for NDD or CP.
03Early screening tools demonstrated transdiagnostic utility, with a combined MOS-R and HINE trajectory showing 80% accuracy for predicting a high chance of autism and 92% for FASD.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The 12-month outcomes are accurate for predicting CP, but features for autism and FASD are less certain and require later follow-up. The SACS-R reported lower diagnostic accuracy for autism at 12 months compared to older ages, so autism outcomes should be interpreted cautiously. Only four of the ten developmental domains considered for FASD diagnosis were assessed, as the others are only assessable in older children. Some confidence intervals for odds ratios were wide due to the small number of cases for specific neurodevelopmental disabilities. The study excluded infants with major congenital or chromosomal abnormalities, so findings may not apply to this group.
Declared interests
The study was guided by the CONSIDER statement and involved active participation of First Nations communities. Funding and conflicts of interest declarations are not explicitly detailed in the provided text beyond the mention of the LEAP-CP protocol and ethics approvals.
The easy way to misread this
Do not interpret the high sensitivity of the MOS-R alone as a diagnostic tool. The MOS-R cut-off of <23 had low specificity (38%), meaning many infants flagged as at risk were actually 'on track'. The combined trajectory with the HINE is necessary to improve specificity and reduce false positives.
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