# Implementation of an innovative virtual selective screening program for early detection of cerebral palsy in British Columbia

## TL;DR

A virtual screening program in British Columbia improved early detection of cerebral palsy, reducing diagnosis age and increasing access for rural infants.

## Contribution

A province-wide virtual early motor screening pathway was implemented to enhance equitable access to early cerebral palsy detection.

## Key findings

- 622 out of 883 infants completed General Movements Assessment (GMA) screenings.
- 18% of infants had abnormal GMA results, with 22% of those receiving a cerebral palsy diagnosis.
- The average age of CP diagnosis decreased from 25 months to 7 months among high-risk infants.

## Abstract

Early identification of cerebral palsy (CP) enables timely intervention during critical periods of neuroplasticity, yet diagnosis remains delayed in many health systems. In British Columbia (BC), fragmented referral pathways and restrictive neonatal follow-up criteria have limited access to standardized early motor assessment, particularly for infants outside major urban centers. To address these gaps, a province-wide virtual screening pathway was developed to improve equitable access to early CP detection. The Early Motor Screening Program (EMSP) was implemented in 2022 as a virtual, risk-stratified screening pathway for infants at elevated neurological risk. The program integrates caregiver-recorded General Movements Assessment (GMA) videos, telehealth-based clinical review, and coordinated referral to an interdisciplinary Cerebral Palsy Early Detection Clinic (CPEDC). Eligibility criteria were defined using epidemiological risk stratification, prioritizing infants with medical conditions associated with substantially increased CP risk. This community-based implementation case study used a descriptive observational design drawing on routinely collected program and clinical data. Outcomes included program uptake, screening completion, GMA findings, referral patterns, caregiver experience, and system-level indicators. Analyses were descriptive and interpreted as implementation and pathway outcomes rather than diagnostic performance. Between June 2022 and September 2025, 883 infants were referred to the EMSP, with 622 (70%) completing GMA assessments. Abnormal GMA findings were identified in 114 infants (18%), who were referred to CPEDC for further evaluation. Among these infants, 25 (22%) received a CP diagnosis, while others required monitoring or were discharged. Referral volumes increased steadily across the study period, with participation from all health authorities and substantial engagement from rural and remote regions. Caregiver feedback indicated high acceptability and feasibility of the virtual screening model. Provincial data demonstrated a temporal, system-level reduction in the average age of CP diagnosis among high-risk infants engaged in early detection pathways, from approximately 25 months to 7 months. This case study demonstrates the feasibility of implementing a province-wide virtual early motor screening pathway within a publicly funded health system. Coordinated, risk-based, and telehealth-enabled models may expand access to early CP identification and support more timely clinical pathways, with potential applicability to other jurisdictions seeking equitable early neurodevelopmental screening.