A home-video method to assess infant gross motor development: parent perspectives on feasibility

Telehealth of Infants at Risk During the COVID-19 Pandemic: Physical Therapists' and Caregiver's Perceptions and Costs

AIM

We aimed to describe telehealth used to detect infants at risk of neurodevelopmental delay and assess the assessors' and caregivers' perceptions and costs.

METHODS

This was an observational study in which five physical therapists applied the General Movement Assessment, the neurological exam based on the Hammersmith Infant Neurological Examination, and the Alberta Infant Motor Scale via telehealth in 65 infants at risk of neurologic delay during the COVID-19 pandemic. The perceptions of assessors and caregivers were assessed using a questionnaire. We tabulated the family's costs (internet access) and the therapist's expenses (internet access and professional fees).

RESULTS

In general, assessors felt comfortable and reported good quality of teleassessment. They highlighted the significant effort they and caregivers required for synchronous methods, challenges in clearly guiding caregivers on infant positioning, difficulties in adjusting the camera's position, and unstable internet connections. Most assessors expressed a willingness to continue using telehealth. Caregivers displayed high satisfaction, and the costs were minimal.

CONCLUSION

Teleassessment during the COVID-19 pandemic was feasible, although implementing this method of health service in general clinical practice still requires further scrutiny.

Family-professional collaborative intervention via telehealth with an infant with Down syndrome and visual impairment: a case report

BACKGROUND

Collaborative interventions, involving partnerships between professionals and families, make it possible to actively engage families in the rehabilitation process. However, no study was found that used a physiotherapy intervention via telehealth for infants with Down syndrome (DS).

OBJECTIVE

Describe the case report of a family-professional collaborative intervention via telehealth for an infant with Down syndrome and visual impairment during the COVID-19 pandemic.

CASE DESCRIPTION

A male infant five months old participated in a collaborative intervention for a period of eight weeks. Three goals were set with the family, and a goal-oriented home program, involving visual stimulation strategies, was organized.

OUTCOMES

Two goals were achieved. The family scored changes in performance and satisfaction with the infant's performance according to the adapted Canadian Occupational Performance Measure. Improvement of motor skills was verified by Alberta Infant Motor Scale and changes in mobility and daily activities performance were measured by the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test.

CONCLUSION

The use of family-professional collaborative intervention via telehealth during the COVID-19 pandemic shows promising results for achieving the goals established by the family collaboratively with the physical therapists.

Hybrid developmental follow-up for preterm infants in Brazil: A feasibility study

INTRODUCTION

The low attendance of families in child developmental follow-up programs for at-risk preterm children is a challenge in Brazil.

OBJECTIVE

This study evaluates the feasibility of implementing a developmental follow-up program for Brazilian preterm infants in a hybrid format.

METHODS

This is an observational, prospective cohort study, involving preterm infants. Longitudinal developmental test results, the participation frequency in the program, and the number of referrals to early intervention programs were used to assess feasibility. The General Movements (GMs) assessment, Alberta Infant Motor Scale (AIMS) and, Survey of Wellbeing of Young Children (SWYC) Milestones were administered via telehealth. The Bayley-III was administered in-person.

RESULTS

Thirty-four preterm infants attended the follow-up until 12 months of corrected age and 18 (52.9 %) concluded all follow-up assessments. Twenty-six (76.5 %) attended all assessments via telehealth, and 26 (76.5 %) attended the in-person assessment. Eighteen (52.9 %) infants showed at least one altered result in development tests. Infants exhibiting abnormal results in the GMs assessment, motor developmental delay according to the AIMS, or developmental delay based on Balley-III were promptly referred to early intervention services.

CONCLUSION

This study demonstrated high participation rate and low dropout in a developmental follow-up program employing a hybrid format. The substantial number of identified infants with developmental delay emphasizes the importance of timely detection of motor delays to referral to early intervention services.

Telemonitoring of motor skills using the Alberta Infant Motor Scale for at-risk infants in the first year of life

INTRODUCTION

Remote assessment creates opportunities for monitoring child development at home. Determining the possible barriers to and facilitators of the quality of telemonitoring motor skills allows for safe and effective practices. We aimed to: (1) determine the quality, barriers and facilitators of Alberta Infant Motor Scale (AIMS) home videos made by mothers; (2) verify interrater reliability; (3) determine the association between contextual factors and the quality of assessments.

METHODS

Thirty infants at biological risk aged between three and ten months, of both sexes, and their mothers were included. Assessments were based on asynchronous home videos, where motor skills were evaluated by mothers at home according to AIMS guidelines. The following were analyzed: video quality; stimulus quality; camera position; and physical environment. The video characteristics were analyzed descriptively. The intraclass correlation coefficient was used to calculate interrater reliability and the regression model to determine the influence of contextual factors on the outcome variables. Significance was set at 5%.

RESULTS

Remote assessment of AIMS exhibited high image and stimulus quality, and a suitable physical environment. Interrater reliability was high for all domains: prone (r = 0.976); supine (r = 0.965); sitting (r = 0.987); standing (r = 0.945) and total score (r = 0.980). The contextual factors had no relation with assessment quality.

DISCUSSION

Assessments conducted remotely by the mothers showed high video quality and interrater reliability, and represent a promising assessment tool for telemedicine in at-risk infants in the first year of life.

Home Videos for Remote Assessment in Children with Disabilities: A Scoping Review

Background: Analysis of parent-provided home videos is a mode of technology that can facilitate a telehealth assessment, allowing observation of function in the child's natural home environment. This scoping review investigated areas of use of home videos for functional assessment by health professionals with a pediatric population with disabilities. Methods: Four databases were searched for articles in which parent-provided home videos were employed by health professionals for functional assessment in children with disabilities. Articles published from 2013 to 2023 were included in the review if they met the inclusion criteria, and the data were extracted into an Excel file. Results: After screening 3,019 articles, 30 articles were included in the data extraction. The majority of studies utilized home videos for diagnosis of autism, followed by assessment of motor development in infants. Studies found that using home videos for assessment is feasible and empowers parents. The validity and reliability of various home video platforms were demonstrated. Conclusions: Analysis of home videos can aid in making a timely diagnosis for prompt intervention, and can be used to assess various body functions, interchangeable with a live clinic assessment. It is important to provide parents with clear instructions when using this method. Future studies are necessary to determine whether parent-provided home videos can be utilized by a multidisciplinary team to assess diverse factors, including activity, participation, and the environment, in a variety of populations of children with disabilities, thus extending services beyond the physical borders of the clinic.

Agreement of synchronous remote and in-person application of the Alberta Infant Motor Scale: Cohort study

INTRODUCTION

Using standardized scales to assess motor development via telemedicine can increase access for low-income populations. Our aim was to verify the agreement and feasibility between remotely and synchronously applying the Alberta Infant Motor Scale (AIMS) and the in-person format.

METHODS

This was a concordance study, with 77 typical infants aged 4-18 months (mean = 13 months). The AIMS was applied remote via video calls and face-to-face. We applied a questionnaire to caregivers to verify feasibility.

RESULTS

There was a high level of agreement between the remote and in-person assessments, with intraclass correlation coefficients above 0.98 and low standard error measure values (<1 item for each posture, <2 items for the total raw score, and =5% for the normative score). The smallest detectable change was between 1.67 and 2.45 for each posture, 3 for the total raw score, and 6% for the normative score. The Bland-Altman analysis showed low bias with the mean difference close to zero (<0.80) and low error with little dispersion of the difference points around the mean. Caregivers' perspectives on the synchronous remote assessment were positive, with good quality, clear information during the assessment, and comfort with the method.

DISCUSSION

The synchronous remote application of the AIMS may be an alternative for families without access to in-person services that assess motor development.

Association between environmental factors during the COVID-19 pandemic and functioning of infants with biological risk in the first year of life: Cross-sectional exploratory study

BACKGROUND

Child development can be influenced by family and environmental factors, which changed during the COVID-19 pandemic. Thus, it is important to explore how these factors are associated with the functioning of infants with biological risk in the first year of life.

OBJECTIVE

This study aimed to investigate associations between family factors, home opportunities, caregiver perception of environmental support and barriers at home and environmental factors during the COVID-19 pandemic and gross motor skills and home participation in infants with biological risk in the first year of life.

METHODS

Fifty-six infants aged two to 12 months (M = 5.80 months; ±2.44) and their mothers performed remote assessments of gross motor skills using the Alberta Infant Motor Scale (AIMS); participation and environment (phone call) by the Young Children's Participation and Environment Measure (YC-PEM); family factors (income, age and maternal education), home opportunities - The Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) and environmental factors during the COVID-19 pandemic (social distancing, emotional and financial factors and physiotherapy) (online forms). Regression models were constructed, considering gross motor skills and home participation as outcome variables, with a 5 % significance level.

RESULTS

We found that older maternal age (p = 0.001), more home opportunities (p = 0.043), and less rigorous social distancing (as opposed to total social distancing [p = 0.045]) were significantly associated with better gross motor skills; and higher maternal education (p = 0.050) was associated with more involvement in home activities.

CONCLUSION

Family factors, home opportunities and social distancing were differently associated with the gross motor skills and home participation of infants with biological risk in the first year of life.

The psychometric properties and feasibility of the Alberta infant motor scale used in telehealth: A scoping review

BACKGROUND

Telehealth can be a viable option for improving equitable access to early motor assessment for financially vulnerable individuals.

AIM

This review aimed to identify the psychometric properties of the Alberta Infant Motor Scale (AIMS) when applied via telehealth and assess its feasibility.

METHODS

Papers were systematically retrieved from electronic databases until October 4, 2023. We included studies that assessed the motor development of infants using the AIMS through telehealth.

RESULTS

Thirteen studies, encompassing 897 infants (449 male and 396 female), were included in this review. Among them, 805 were typical infants and 92 were at risk of motor delay. The age range of participants spanned from 4.9 weeks to 20 months. The studies found good concurrent validity between telehealth and in-person assessments (ICC > 0.98, SEM < 1.6, mean difference = 0.5) and good to excellent reliability (ICC > 0.80) using home videos recorded by parents or video calls with researchers. Telehealth was perceived as feasible by parents, who expressed high satisfaction, and the quality of images and assessments met commendable standards.

CONCLUSION

Considering the limited number of studies that have assessed infants with neuromotor disorders, this scale has the potential for telehealth application in evaluating typical infants.

Using Telemedicine to Overcome Barriers to Neurodevelopmental Care from the Neonatal Intensive Care Unit to School Entry

Dedicated Neonatal Intensive Care Unit (NICU) follow-up programs are recommended for ongoing surveillance for infants at high-risk for future neurodevelopmental impairment (NDI). Systemic, socioeconomic, and psychosocial barriers remain for referrals and the continued neurodevelopmental follow-up of high-risk infants. Telemedicine can help overcome these barriers. Telemedicine allows standardization of evaluations, increased referral rates, and reduced time to follow-up as well as increased therapy engagement. Telemedicine can expand neurodevelopmental surveillance and support all NICU graduates, facilitating the early identification of NDI. However, with the recent expansion of telemedicine during the COVID-19 pandemic, new barriers related to access and technological support have arisen.

Enhancing motor screening efficiency: Toward an empirically derived abridged version of the Alberta Infant Motor Scale

Use of machine learning (ML) in the early detection of developmental delay is possible through the analysis of infant motor skills, though the large number of potential indicators limits the speed at which the system can be trained. Body joint obstructions, the inability to infer aspects of movement such as muscle tone and volition, and the complexities of the home environment - confound machine learning's ability to distinguish between some motor items. To train the system efficiently requires using an excerpted list of validated items, a salient set, which uses only those motor items that are the 'easiest' to see and identify, while being the most highly correlated to a low/qualifying score. This work describes the examination of motor items, selection of 15 items that comprise the salient set, and the ability of the set to reliably screen for motor delay in the first-year infant.

Modeling gross motor developmental curves of extremely and very preterm infants using the AIMS home-video method

BACKGROUND

Motor development is one of the first signals to identify whether an infant is developing well. For very preterm (VPT) infants without severe perinatal complications, little is known about their motor developmental curves.

AIMS

Explore gross motor developmental curves from 3 until 18 months corrected age (CA) of VPT infants, and related factors. Explore whether separate profiles can be distinguished and compare these to profiles of Dutch term-born infants.

STUDY DESIGN

Prospective cohort study with parents repeatedly recording their infant, using the Alberta Infant Motor Scale (AIMS) home-video method, from 3 to 18 months CA.

SUBJECTS

Forty-two Dutch infants born ≤32.0 weeks gestational age and/or with a birthweight (BW) of <1500 g without severe perinatal complications.

OUTCOME MEASURES

Gross motor development measured with the AIMS.

RESULTS

In total 208 assessments were analyzed, with 27 infants ≥five assessments, 12 with <four, and three with one assessment. Sigmoid-shaped gross motor curves show unidirectional growth and variability. No infant or parental factors significantly influenced motor development, although a trend was seen for the model where lower BW, five-minute Apgar score <7, and Dutch native-speaking parents were associated with slower motor development. Three motor developmental profiles of VPT infants were identified, early developers, gradual developers, and late bloomers, which until 12 months CA are comparable in shape and speed to profiles of Dutch term-born infants.

CONCLUSIONS

VPT infants show great intra- and interindividual variability in gross motor development, with three motor profiles being distinguished. From 12 months CA onwards, VPT infants appear to develop at a slower pace. With some caution, classifying infants into motor developmental profiles may assist clinical decision-making.

Pediatric Assessments for Preschool Children in Digital Physical Therapy Practice: Results From a Scoping Review

PURPOSE

To examine and map the extent and scope of pediatric physical therapy assessments previously used in the digital context.

METHODS

A 6-step evidence-based scoping methodological framework was used. Articles containing assessments conducted by a physical therapist using technology to assess a child aged 0 to 5 years were included and synthesized using descriptive statistics and thematic analysis.

RESULTS

Eighteen studies identifying 25 assessments were eligible. Asynchronous observational developmental instruments administered in the child's natural environment to those at risk or presenting with neurodevelopmental conditions were the most common. There is a need for detailed procedures and training for caregivers and clinicians.

CONCLUSION

Limited research exists on the use of pediatric physical therapy assessments for young children with musculoskeletal and cardiorespiratory conditions in a digital context. The development of new instruments or modifications of existing ones should be considered and be accompanied by detailed administration protocols and user guides.

The AIMS home-video method: parental experiences and appraisal for use in neonatal follow-up clinics

Background

In The Netherlands, prematurely born infants and their parents are offered regular developmental check-ups in a hospital setting. In line with providing healthcare at distance, the use of video footage showing the infant’s behavior and movements, taken by parents at home and assessed by professionals online, might be a fruitful future practice. The focus of this study was to gain insight into parental experiences with the Alberta Infant Motor Scale home-video method and their appraisal of its applicability for use in an outpatient neonatal follow-up clinic.

Method

A qualitative descriptive study among parents of healthy extremely or very premature infants (GA 26.2–31.5 weeks) participating in a longitudinal study of motor development between 3–18 months corrected age. Ten semi-structured interviews were conducted and transcribed verbatim. Data was analyzed independently. Inductive content analysis was performed following the process of the AIMS home-video method.

Results

Parents appraised the AIMS home-video method as manageable and fun to do. Instructions, instruction film, and checklists were clear. Transferring the video footage from their phone to their computer and uploading it to the web portal was sometimes time-consuming. Parents gained a better awareness of their infant’s motor development and found the provided feedback a confirmation of what they already thought about their infant’s development and was reassuring that their child was doing well. First-time parents seemed more uncertain and had a greater need for information about (motor) development, but on the other hand, also had confidence in their child.

All parents thought that home-videos can be an addition to follow-up visits, but cannot replace (all) visits. It may be an opportunity to reduce the frequency of hospital visits, while still having their infant monitored.

Conclusion

Parents appraised the AIMS home-video method positively and are of the opinion that home-videos can be of added value in monitoring infants at risk in neonatal follow-up additional to hospital visits. In future research a user-friendly application and/or platform to exchange video footage safely between parents and professionals should be developed with all possible stakeholders involved and implementation should be explored.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03398-9.

Online Assessment of Motor, Cognitive, and Communicative Achievements in 4-Month-Old Infants

Remote methods for data collection allow us to quickly collect large amounts of data, offering several advantages as compared to in-lab administration. We investigated the applicability of an online assessment of motor, cognitive, and communicative development in 4-month-old infants based on several items of the Bayley Scales of Infant Development, 3rd edition (BSID-III). We chose a subset of items which were representative of the typical developmental achievements at 4 months of age and that we could administer online with the help of the infant’s caregiver using materials which were easily available at home. Results showed that, in a sample of infants tested live (N = 18), the raw scores of the BSID-III were significantly correlated with the raw scores of a subset of items corresponding to those administered to a sample of infants tested online (N = 53). Moreover, for the “online” participants, the raw scores of the online assessment did not significantly differ from the corresponding scores of the “live” participants. These findings suggest that the online assessment was to some extent comparable to the live administration of the same items, thus representing a viable opportunity to remotely evaluate infant development when in-person assessment is not possible.

PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial

PURPOSE

Investigate feasibility of PreEMPT: a novel participation-focused, early physiotherapy intervention for preterm infants in regional Australia.

MATERIALS AND METHODS

Participants were infants born <35 weeks, residing in regional Australia. Sixteen infants were recruited then randomised to usual physiotherapy care (UPC: n = 8) or PreEMPT (n = 8). PreEMPT involved 14-weeks of alternating clinic- or telehealth-based, participation-focused intervention. Feasibility was evaluated by: demand, practicality, acceptability, implementation and limited efficacy testing for infants (motor, participation) and parents (mental well-being, self-efficacy).

RESULTS

Demand was lower than expected (45% recruitment rate). For practicality, attrition was high in the PreEMPT group (mean assessment attendance 3.8/5 sessions, range 2-5) compared to UPC (4.8/5 sessions, range 4-5). In addition, mean PreEMPT treatment dose received was approximately half intended (overall: 7.3/14 sessions, range 0-12; equivalent for face-to-face: 3.9/7, range 0-6, versus telehealth 3.4/7, range 0-6). The most common reason cited for treatment non-attendance was maternal mental health (22 sessions). Treatment acceptability for parents was high, with PreEMPT parents reporting they were offered choices in sessions (p = .02), and increased their knowledge (p = .01) and confidence (p = .009). There was a large effect size in favour of PreEMPT for increased parental self-efficacy (p = .021, ES = 1.34).

CONCLUSION

Early post-discharge physiotherapy for preterm infants in regional Australia is beneficial according to families but logistically challenging.

Tele-care intervention performed by parents involving specific task- environment- participation (STEP protocol) for infants at risk for developmental delay: protocol of randomized controlled clinical trial

BACKGROUND

With the implementation of social distancing due to the Covid-19 pandemic, many at-risk infants are without therapy. An alternative mode of therapy in this situation is tele-care, a therapy in which assessments and interventions are carried out online, in the home environment. We describe a tele-care protocol involving parent delivered task and context specific movement training, participation and environmental adaptation for infants at risk for developmental delay.

METHODS

Randomized controlled trial. Infants at risk, with 3 to 9 months corrected age, will be included, and randomized into two groups: control group (conventional guidelines) and experimental group (task, environment and participation in context-specific home program). Infants will be assessed for motor capacity (Infant Motor Profile and Alberta Infant Motor Scale); participation (Young Children's Participation and Environment Measure) and environment factors (Parent-Child Early Relational Assessment; Affordances in the Home Environment for Motor Development). The intervention period will be 10 weeks, and evaluations will be carried out before and after that period. All the assessment and intervention procedures will be carried out online, with instructions to parents for home therapy. The statistical analysis will be guided according to the distribution of the data, and a significance level of 5% will be adopted. All ethical approvals were obtained by the Ethics Committee of the University of São Carlos (Case number 31256620.5.0000.5504). The protocol will follow the SPIRIT statement. Findings will be disseminated in peer-reviewed publications and presented at national and international conferences.

DISCUSSION

The results of this study will describe the effectiveness of a home intervention, focusing on specific activities, participation and environmental changes. These results will support the implementation of a remote protocol, with lower financial costs and focused on the particularities of the family. This type of care model can possibly help public policies to ensure equal access to evidence-based quality healthcare.

TRIAL REGISTRATION

Brazilian Clinical Trials Registry: RBR8xrzjs , registered September 1, 2020.

Telehealth Program for Infants at Risk of Cerebral Palsy during the Covid-19 Pandemic: A Pre-post Feasibility Experimental Study

Aim: To verify the effects of a telerehabilitation program for infants at high risk for Cerebral Palsy (CP) during the COVID-19 pandemic.Method: Longitudinal study. Infants were aged 3-18 months corrected age, at risk of developmental delay. The General Movement Assessment or a neurologic examination were performed to identify the risk of CP. Motor function was assessed using the Gross Motor Function Measure-88 (GMFM-88) and the Alberta Infant Motor Scale (AIMS). Caregivers of infants at high risk of CP applied a home-based program supervised by a Physical therapist, five times a week over 12 weeks. The program included guidance for optimal positioning, optimization of goal-directed activities, environmental enrichment, and educational strategies.Results: 100 infants at risk for delayed motor development were recruited. Eighteen infants were classified at high risk of CP, and 10 families completed telerehabilitation (83% final retention rate). No adverse events were reported. Adherence to the telecare program was high (90%). The costs were low. We found increased scores for all dimensions and the total score of the GMFM-88, and the AIMS percentile at the end of the intervention. Most infants presented a clinically significant change for the GMFM-88.Conclusions: The telecare program was feasible.

Standardized Neurodevelopmental Surveillance of High-risk Infants Using Telehealth: Implementation Study during COVID-19

INTRODUCTION

Neurodevelopmental surveillance is critical for high-risk infants following neonatal intensive care discharge and is traditionally performed in-person. COVID-19 interruption of regular surveillance necessitated a rapid development of telehealth models for effective and standardized care.

METHODS

We used implementation science and lean methodologies to develop an effective telehealth neurodevelopmental surveillance program for high-risk infants. Interventions included reorganization of visit flow processes and a telehealth toolkit for standardized neurological and developmental assessments. We tested and improved our intervention through plan-do-study-act cycles, value-added analysis, and parent- and provider-satisfaction questionnaires. Process metrics (standard elements, subspecialty referrals, diagnostic tests, and prescriptions ordered) were compared in group-level analyses between telehealth patients (N = 97) March 16, 2020-July 1, 2020 and a matched in-person cohort at the same period the previous year. Run charts examined shifts in balancing measures (provider efficiency and missed visits) over 8 weeks before and after implementation.

RESULTS

Primary outcomes were visit completion (100%), patient parent satisfaction (>90% strongly agreed or agreed telehealth procedures were valuable and easy to use) and ability to accurately diagnose cerebral palsy (no statistical difference with comparison visits). Providers (N = 6) rated telehealth experiences favorably. Process metrics indicated no differences between telehealth and in-person visits (all P > 0.05). Following telehealth implementation, provider efficiency increased to near baseline (median 88.9% versus 91.7%) and median missed visits decreased to 0% from 20% (in-person).

CONCLUSIONS

Implementation of telehealth for neurodevelopmental surveillance in a tertiary high-risk infant follow-up clinic successfully provided standardized and timely care during stay-at-home orders; broader telehealth applications may overcome access barriers in this field.

Modeling a gross motor curve of typically developing Dutch infants from 3.5 to 15.5 months based on the Alberta Infant Motor Scale

BACKGROUND

Interindividual variability in gross motor development of infants is substantial and challenges the interpretation of motor assessments. Longitudinal research can provide insight into variability in individual gross motor trajectories.

PURPOSE

To model a gross motor growth curve of healthy term-born infants from 3.5 to 15.5 months with the Alberta Infant Motor Scale (AIMS) and to explore groups of infants with different patterns of development.

METHODS

A prospective longitudinal study including six assessments with the AIMS. A Linear Mixed Model analysis (LMM) was applied to model motor growth, controlled for covariates. Cluster analysis was used to explore groups with different pathways. Growth curves for the subgroups were modelled and differences in the covariates between the groups were described and tested.

RESULTS

In total, data of 103 infants was included in the LMM which showed that a cubic function (F(1,571) = 89.68, p < 0.001) fitted the data best. None of the covariates remained in the model. Cluster analysis delineated three clinically relevant groups: 1) Early developers (32%), 2) Gradual developers (46%), and 3) Late bloomers (22%). Significant differences in covariates between the groups were found for birth order, maternal education and maternal employment.

CONCLUSION

The current study contributes to knowledge about gross motor trajectories of healthy term born infants. Cluster analysis identified three groups with different gross motor trajectories. The motor growth curve provides a starting point for future research on motor trajectories of infants at risk and can contribute to accurate screening.

A survey on the attitudes of parents with young children on in-home monitoring technologies and study designs for infant research

Remote in-home infant monitoring technologies hold great promise for increasing the scalability and safety of infant research (including in regard to the current Covid-19 pandemic), but remain rarely employed. These technologies hold a number of fundamental challenges and ethical concerns that need addressing to aid the success of this fast-growing field. In particular, the responsible development of such technologies requires caregiver input. We conducted a survey of the opinions of 410 caregivers on the viability, privacy and data access of remote in-home monitoring technologies and study designs. Infant-friendly wearable devices (such as sensing body suits) were viewed favourably. Caregivers were marginally more likely to accept video and audio recording in the home if data was anonymised (through automated processing) at point of collection, particularly when observations were lengthy. Caregivers were more open to international data sharing for anonymous data. Caregivers were interested in viewing all types of data, but were particularly keen to access video and audio recordings for censoring purposes (i.e., to delete data segments). Taken together, our results indicate generally positive attitudes to remote in-home monitoring technologies and studies for infant research but highlight specific considerations such as safety, privacy and family practicalities (e.g. multiple caregivers, visitors and varying schedules) that must be taken into account when developing future studies.