The role of the early motor clinic in the diagnosis of neurodevelopmental conditions other than cerebral palsy

Objectives The Early Motor Clinic (EMC) was established in Manitoba following international recommendations for early diagnosis of cerebral palsy (CP). Clinical experience suggested that the EMC was capturing children with a wide variety of diagnoses other than CP. This study aimed to (1) assess the percentage of primary diagnoses other than CP made at the EMC, (2) determine the proportion of children referred to genetics/neurology following EMC assessment, and (3) describe other diagnostic testing conducted thereafter. Methods Retrospective chart review of all children ≤2 years of age referred for motor delay as a primary developmental concern, and who were assessed at the EMC between November 2019 and December 2023. Data collected included referral sources, subspecialty consultations, diagnostic testing, and primary diagnoses. Outcomes were analyzed using descriptive statistics. Results Among 142 children included, 78/142 (54.9%) were referred by family physicians, and 45/142 (31.7%) by paediatricians, the median age at referral was 16 months (IQR 10 to 24), and the median age at assessment was 20 months (IQR 16 to 31). Other than CP (diagnosed in 37/142 [26%] children), 83/142 (58.5%) were identified/suspected to have a genetic/metabolic condition, and 32/142 (22.5%) were diagnosed with autism. Among those tested for suspected genetic/metabolic conditions, 31/72 (43%) had a positive finding. Overall, 56.3% had associated global developmental delay. Following EMC assessment, 72/142 (50.7%) were referred for genetic/metabolic evaluation, and 49/142 (34.5%) were referred to neurology. Conclusion Early motor delay may be associated with diverse neurodevelopmental conditions and requires a multidisciplinary approach. Its association with autism warrants further study.