Predicting neurodevelopmental outcomes in Australian First Nations infants: The transdiagnostic utility of early screening tools
Bibliographic record
Abstract
Abstract Aim To determine the predictive relationship between evidence‐based screening tools and neurodevelopmental outcomes in Australian First Nations infants. Method This prospective cohort study invited First Nations families to participate in a culturally adapted early developmental screening programme. A total of 156 infants (55.1% male, mean gestational age = 33.6 weeks, SD = 4.6) were screened using the Prechtl's General Movements Assessment, with optimality scoring using the Motor Optimality Score‐Revised (MOS‐R) at 3 to 5 months and the Hammersmith Infant Neurological Examination (HINE) at 4 to 9 months. Participants completed ‘baby movement (BM) checks’ at two time points (BM1, 3–5 months corrected age; BM2, 4–9 months corrected age), with final movement and learning checks at 12 months corrected age. At 12 months corrected age, standardized motor, cognitive, and communication assessments, neurodisability‐specific symptomology, or a diagnosis made by a paediatrician classified infants as developing typically (‘on track’) or (1) with a high chance of or confirmed cerebral palsy (CP) or (2) non‐CP neurodevelopmental delay (NDD), including autism and fetal alcohol spectrum disorder (FASD). Predictive relationships were investigated using logistic regression and diagnostic statistics. Results At 12 months, 127 of 147 (86%) eligible infants ( n = 9 withdrawn or deceased) were classified as ‘on track’ ( n = 55, 43%), NDD ( n = 59, 47%), or CP ( n = 13, 10%). MOS‐R (≥ 14 weeks) and the HINE distinguished infants as ‘on track’, CP, or NDD. [Correction added on 1 November 2025 after first online publication: In the preceding sentence, “MOS‐R (≥ 14 weeks). The HINE distinguished infants…” has been updated to “MOS‐R (≥ 14 weeks) and the HINE distinguished infants…”.] Each 1‐point decrease on both tools increased the odds of NDD (OR MOS‐R = 1.40, 95% confidence interval [CI] = 1.00–1.96; OR HINE = 1.12, 95% CI = 1.05–1.21) and CP (OR MOS‐R = 1.47, 95% CI = 1.08–2.01; OR HINE = 1.41, 95% CI = 1.21–1.65,). The MOS‐R (cut‐off of less than 23) and HINE (moderate to severely reduced) were best for identifying any NDD and CP (MOS‐R: sensitivity = 84%, specificity = 38%; HINE: sensitivity = 64%, specificity = 63%). Combined trajectories across both tools were the strongest predictors of CP (sensitivity = 73%, specificity = 96%), autism (sensitivity = 59%, specificity = 95%), and FASD (sensitivity = 89%, specificity = 93%). Interpretation Evidence‐based screening tools demonstrate promising transdiagnostic prediction of ‘on‐track’ development and not only high chance of CP but also autism, FASD, and other NDDs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".