| dc.description.abstract | Cerebral Palsy (CP) is a neurodevelopmental disorder that leads to lifelong disability. An integral part of treatment of the disability to improve life-outcomes is through early detection, especially at very young ages when children are still developing and neuroplasticity is at its highest. It is problematic that many cases, especially in low-resource settings, are not diagnosed until later in childhood when these interventions become less effective. Countries such as Nepal, with an average age of CP diagnosis at 5.5 years, can benefit from early CP risk assessment and screening at-risk infants such as those born preterm or during birth complications. This thesis presents a pilot-feasibility study of a method that could serve to be a solution to overcome this challenge. That method is the In-Motion Assessment tool, which aims to fill this niche by providing individuals with the ability to take recordings and receive assessments remotely of their infants. Another advantage of this tool is with its accompanied machine-learning software that has been trained to do the risk assessments based on infant movements and give assessments without the need for a trained profession in General Movement Analysis. The In-Motion instruction was deemed feasible for use by a recent study in Norway, Denmark, and Belgium which demonstrated that families were able to produce and send recordings reliably and within the parameters for GMA (Adde et al., 2021). Although very promising, such results does not necessarily guarantee success in other parts of the world. In order to broaden its base, the tool was translated from English into Nepali.
The primary aim of this project was to assess the feasibility of parents and health workers using the English to Nepali translated In-Motion instructional tool, meant for infant movement analysis during an infant’s Fidgety Movements period of 12-17 weeks post-term age, as perceived by a Nepali target group. Individual, semi-structured interviews performed on 9 Nepali participants who were recruited through convenience and snowball-sampling for the purpose of the project. Demographic information was recorded, and both descriptive and content analysis methods were utilized to analyze the interviews.
Emerging themes identified from participant responses were ‘Education’, ‘Training and Adherence’, ‘Resources’, and ‘Relevant Anecdotes’ – all areas which are keys to assessing the instruction’s feasibility. The study found that the instructions for the Nepali texted version of the In-Motion instructional video are largely feasible for use by Nepali healthcare workers and parents, but some changes are necessary in order to improve the instruction’s clarity and adherence . Training and follow-up will be important methods to ensure the success of and adherence to the tool, and making small changes to the animation, text, and adding narration can broaden the demographic that can use the tool effectively. Once changes are made and the suggestions incorporated, future studies can take the pilot further and test the feasibility of the tool directly in Nepal across various contexts. | |