Research Centre 31 August 2020 Biannual Research Update
Dear Families and Collaborators, The Year of 2020 has certainly been a paradigm shift adapting quickly to COVID-19! The pandemic has been concerning both for the clinical community and families we support, however QCPRRC has transformed our way of research to telemedicine/health modes of delivery, adapting to the ever changing pandemic/world, supporting consumer needs and adapting many of our interventions and assessments to be delivered using telehealth technologies via Zoom and The University of Queensland edX platform. We have been busier than ever assisting our clinical colleagues with online screening using the BabyMoves App, temporarily shifting the telehealth delivered home based interventions, validating delivery of telehealth delivered assessments and providing additional support to families impacted by quarantine measures. The QCPRRC team spent the 3 months of reduced contact repurposing ourselves with updating publications and preparing for further grant rounds. Key highlights include: The QCPRRC team had a strong start to 2020 with major contributions to the AusACPDM conference in Perth in early March just prior to travel restrictions – bringing world class research experts in the field of child neurology research to Perth; despite COVID-19 pandemic (see full report page 17); Prof. Boyd has delighted to announce the first winner of the international Elsass Research Prize to Prof. Bernard Dan on behalf of the international jury; Taking the opportunity to progress our professional development – conducting a General Movements Training Course at Townsville University Hospital for local clinicians and indigenous researchers and two basic and one advanced courses in Brisbane led by GM accredited trainers Professor Andrea Guzzetta (University of Pisa), Professor Alicia Spittle (The University of Melbourne), and Dr Cath Morgan from the Cerebral Palsy Alliance (page 2); Over nine weeks from May to June we conducted our comprehensive Systematic Review course to 56 colleagues from across Australia, North America, and South East Asia. Within the course a GRADE Analysis Workshop was delivered by Dr Sue Brennan from The Melbourne Cochrane group; Our Centre of Research Excellence AusCP-CTN led an intensive Online Grant Writing Workshop for early and mid-career researchers with guest speakers including Prof. Anne Kelso (CEO NHMRC), Prof. Ian Fraser AC, with 19 local mentors and 43 mentees; I was honoured to receive an NHMRC Investigator grant (Level 1) for 2021-2025 entitled “Early Detection and Early Intervention of Infants at risk of Cerebral Palsy” (see more on page16); Our European Union Horizon Grant success for the Born-to-get-there project was further supported with $0.5M funding from the NHMRC (page 15); The LEAP-CP trial received additional funding from Perpetual Trustees to expand the project by supporting two part-time Physiotherapists (based in Townsville and Cairns) to work with local families (page 15). Our next focus has been taking our LEAP-CP success from working with LMIC to local communities through engagement with Aboriginal and Torres Strait Islander stakeholders, recruitment of Indigenous researchers who will lead the cultural adaptation of the LEAP-CP early detection and early intervention program. We look forward to your involvement in our research centre and our national programs. With warm regards, Ros Boyd Professor of Cerebral Palsy Research, Faculty of Medicine, The University of Queensland. Scientific Director, Queensland Cerebral Palsy & Rehabilitation Research Centre Email: r.boyd@uq.edu.au 1
AusCP-CTN CRE Education Program AusCP-CTN aims to foster and develop current and future leaders in cerebral palsy research and clinical practice. Our vision for the future workforce for children with CP is to build national capacity comprising individuals with expertise in more than one key area of research and/or training (basic science/ neuroscience, epidemiology, clinical/health services initiatives, and translation/ implementation). Through our Education Program we aim to provide and facilitate a range of interactive clinical trainings and workshops for researchers and clinical professionals. To date our Education Program has benefited over 2,000+ clinicians, health professionals, researchers, and higher degree research students in upskilling their knowledge and skills in novel paediatric neurological research, diagnosis and interventions. Further information about our Education Program please refer to our website1 https://cre-auscpctn.centre.uq.edu.au/education. General Movements Course Compelling evidence is now available that qualitative assessment of General Movements (GMs) at a very early age is the best predictor for cerebral palsy. This method has become a potent supplement to the traditional kind of neurological examination. AusCP-CTN has liaised with accredited trainers from GM Trust (Prof. Andrea Guzzetta, MD PhD, The University of Pisa, and Prof. Alicia Spittle, The University of Melbourne, and Dr Cathy Morgan, Cerebral Palsy Alliance) and held one Refresher and one Basic course in Townsville (25 – 29 February, 2020), and one Basic and one Advanced course in Brisbane (1 – 4 March, 2020). These courses fulfil the standards specified by the GM-Trust2. The Basic GMs Course provides an introduction to Prechtl's Method on the Qualitative Assessment of General Movements in young infants. This new assessment method has shown its merit for the prenatal and postnatal evaluation of the integrity of the nervous system. The Advanced GMs Course provides additional intensive training in correct judgement. This training deals with the details of the assessment, the proper terminology and techniques, as well as with the application of individual developmental trajectories. The General Movements courses across both Townsville and Brisbane has attracted over 75 researchers, medical clinicians, and allied health professionals from universities and hospitals across Queensland and New South Wales. The 2020 General Movements Course in Brisbane, 1 – 4 March 2020. Online Systematic Review Workshop and GRADE Analysis Course A virtual nine-week Systematic Review Workshop was held online, 1 May – 26 June 2020. The interactive workshop was designed to enable the attendees to gain a comprehensive knowledge and practical experience in conducting a systematic review and meta-analysis of efficacy of treatment, a clinimetric review of measures, 1 2 AusCP-CTN CRE Education Program: https://cre-auscpctn.centre.uq.edu.au/education GM-Trust: www.general-movements-trust.info. 2
nine-week workshop attracted 56 attendees (researchers, higher degree research students, medical clinicians and health professionals) from across the time zones, Australia, Nepal, and the USA. From QCPRRC, our inhouse Biostatistician, Mark Chatfield and Research Occupational Therapist and PhD Scholar, Andrea Burgess, presented lectures on Biostatistics for Clinical Trials, Meta Analysis and Clinimetrics. As part of the Systematic Review Workshop, Dr Sue Brennan from Melbourne GRADE Centre were also invited to conduct a one-day interactive session on GRADE analysis. GRADE (Grading of Recommendations, Assessment, Development and Evaluations) is a transparent framework for developing and presenting summaries of evidence and provides a systematic approach for making clinical practice recommendations. Workshop topics included: Overview (GRADE in systematic review, guideline process), Interpreting effect estimates, How to GRADE the evidence, Using the GRADE criteria, Making recommendations. For more information about our Systematic Review workshop: https://creauscpctn.centre.uq.edu.au/event/845/systematic-review-workshop-2020 GWW20203: Online Grant Writing Workshop As a collaborative initiative with colleagues across the AusCP-CTN CRE, The University of Queensland (Faculty of Medicine), Curtin University (School of Occupational Therapy, Social Work and Speech Pathology), and Telethon Kids Institute, Prof. Roslyn Boyd has led an online three-day intensive Grant Writing Workshop, delivered online via Zoom. The workshop was designed as a professional development opportunity for our researchers and clinicians who are undertaking research to ‘take advantage’ of down time that may have resulted from the COVID-19 pandemic, to work with experts from across the institutes to elevate and sharpen their grant writing skills to better prepare for future funding opportunities. Prof. Ian Frazer AC as our invited keynote speaker for the 4th AusCP-CTN Intensive Grant Writing Workshop, in collaboration with UQ, Curtin University, and Telethon Kids Institute. This is the fourth year Prof. Boyd has facilitated the workshop, and is our biggest – we were fortunate to have keynote presentations including Prof. Ian Frazer on grantsmanship and MRFF, Prof. Anne Kelso on activities/focus of NHMRC, and Dr Jodi Clyde-Smith on investigator grants and impact statements. The workshop has attracted 43 mentees (Early and Mid-career researchers and clinicians from hospitals and research institutes across Qld, NSW and WA), with 19 mentors from both UQ and Curtin who have very generously contributed their time and mentorship on achieving successful research profiles. We have also invited Research Development Managers, Biostatisticians, and Impact Metrics Librarians to work with workshop mentees to refining their draft applications. The workshop covered a range of topics and components in preparing a successful grant application, including consultation with mentors on investigator/partnerships/ideas grant and career directions, project pitch, developing impact statement, impact evidence using alt metrics, sample size and statistics analysis, philanthropic opportunities, and involving consumers and aboriginal communities. The workshop concluded with mock grant panel review and discussions, providing insight to early career researchers on areas to focus on when grant is being reviewed. For more information and presentations auscpctn.centre.uq.edu.au/GWW2020. from the workshop is available online: https://cre- Sign up to our AusCP-CTN CRE Education Program4 to be in the know for upcoming courses. 3 4 AusCP-CTN GWW2020: https://cre-auscpctn.centre.uq.edu.au/GWW2020 AusCP-CTN Education Program: https://cre-auscpctn.centre.uq.edu.au/education 3
with cerebral palsy and their Families The LEAP-CP trial is an early detection and intervention program for infants at high risk of cerebral palsy/ adverse neurodevelopmental outcomes whose families identify as Aboriginal and/ or Torres Strait Islander. What makes this program unique is its proactive approach (screening in the first year of life) and delivery through Indigenous Allied Health Workers from the local community. This ensures the cultural relevance and safety of the program content and service delivery model. The program is currently securing ethics and establishing governance for state-wide recruitment across Queensland, as well as sites in Western Australia. COVID-willing recruitment will start shortly! We are fortunate to have an experienced physiotherapist join as a PhD candidate, Ms Carly Luke, who is based in Townsville, and focuses on the screening and diagnostic accuracy/ cultural appropriateness of measures. We have also recently been joined by an experienced and highly connected public health clinician, Ms Leeann Mick-Ramsamy, as a PhD candidate, who will provide critical guidance on the cultural aspects of the program. We welcome interested clinicians and organisations who may like to explore involvement on the program to connect with us. The LEAP-CP program is based on a successful trial Dr Benfer has developed, trialled and implemented, in India. Through working with a team of dedicated researchers, local site coordinators, and community disability workers from Asha Bhavan Centre, Dr BC Roy Postgraduate Institute of Paediatric Science, Child in Need Institute, Indian Institute of Cerebral Palsy, Dr Benfer has led and implemented the intervention with local communities. The LEAP-CP project has now finished data collection in Kolkata India, with 749 babies with birth risk factors screened with the General Movements and HINE, and 142 babies at high risk of CP (12-40 weeks) recruited to an RCT of LEAP-CP. The project has received funding from Dr Katherine Benfer’s NHMRC Early Career Fellowship, Queensland Children’s Hospital Foundation and Cerebral Palsy Alliance, which will further assist Dr Benfer in carrying out her project in rural regions of Queensland and Western Australia working with indigenous communities. Infant with CP in Kolkata practicing Active motor and learning games with his mother and community worker. Contact Details: Dr Katherine Benfer, NHMRC Early Career Fellow, k.benfer@uq.edu.au. This project is funded by Children’s Hospital Foundation, Cerebral Palsy Alliance, and NHMRC Horizon 2020 Australia Funding. Chief Investigators: Dr Katherine Benfer, Prof. Roslyn Boyd, Prof. Anthony Smith, Dr Koa Whittingham, Prof. Yvonne Cadet-James, Dr Alan Ruben, Prof. Iona Novak, Dr Catherine Morgan, Dr Gulam Khandaker, Mark Chatfield, Dr Joshua Byrnes, Lynda McNamara, A/Prof. Jane Valentine, Prof. Catherine Elliott. LEAP-CP - Detection sub-study: Early Detection of Australian Aboriginal and Torres Strait Islander Infants at high risk of adverse neurodevelopmental, motor and cognitive outcomes at 12 months corrected age (CA) The LEAP-CP detection sub-study is designed to implement an early screening and detection program for infants at high risk of cerebral palsy or adverse neurodevelopmental outcomes, whose families identify as Aboriginal and/ or Torres Strait Islander. The study aims to determine the cultural appropriateness and diagnostic accuracy of assessments used to predict a later diagnosis of cerebral palsy or adverse neurodevelopmental outcomes, including autism spectrum disorder, fetal alcohol spectrum disorder and developmental delay, at 12 months corrected age (c.a). Participants will be a prospective cohort of 120 infants, aged 0 to 9 months corrected, from sites across North QLD including Townsville, Palm Island, Cairns, Torres Strait and the Cape, Mt. Isa, Mackay, and Rockhampton. Infants will complete screening assessments at 3 months c.a (General Movements assessment) and at 6 to 9 months c.a (neurological, motor and developmental assessments). Infants who are considered to be “at high risk of CP and/adverse neurodevelopmental outcome”, following the screening assessments, will be eligible for the LEAP-CP intervention trial. All participants will be followed up at 12 months c.a to determine motor, cognitive, 5 LEAP-CP Indigenous: https://qcprrc.centre.uq.edu.au/project/peer-delivered-early-detection-and-intervention-infants-high-risk-cerebralpalsyneurodevelopmental-disability-indigenous-australia-learning-through 4
state-wide recruitment across Queensland and are hoping to commence recruitment shortly. Ms Carly Luke, Paediatric Physiotherapist at the Queensland Children’s Hospital was recently awarded a PhD scholarship from the Cerebral Palsy Alliance6 to undertake ‘A Prospective cohort study of indigenous infants at high risk of Cerebral Palsy in Far North Queensland’, as part of the LEAP-CP program based at the Townsville University Hospital. To find out more about Carly’s PhD project: carly.dickinson@uq.edu.au. Carly Luke leading the HINE training at the 2019 LEAP-CP SAARC conference, Kolkata, India. RaceRunners roll into UQ Athletics Club In late May, Dr Sarah Reedman and colleague Dr Emma Beckman from Human Movement and Nutrition Sciences took receipt of the five RaceRunners funded by the Brisbane City Council Access and Inclusion Partnership Grant. RaceRunning is a sport designed specifically for people who are not able to run due to severe motor and coordination disabilities. First invented in Denmark in 1991 to challenge the stereotypes of what people with cerebral palsy could or should do, the RaceRunning participants uses a custom-built three-wheeled trike – with a seat and chest pad for user’s upper body and weight support but no foot pedals – so the racerunner is able to propel forward using their feet and steering with hands and arms. RaceRunning is adaptive to many activities – sport, general fitness, play, family time – it is also highly beneficial to people with neurological disabilities and cerebral palsy in building muscle growth and bone density, leading to better posture, general strength, endurance, and control of trunk and limbs. QCPRRC Dr Sarah Reedman and colleague Dr Emma Beckman from Human Movement and Nutrition Sciences took receipt of the five RaceRunners funded by the Brisbane City Council Access and Inclusion Partnership Grant. Recognising the multiple benefits of RaceRunning, Dr Sarah Reedman (The University of Queensland) was determined to promote the sport in Australia and introducing it to the community. As part of the RaceRunning Australia working group, Sarah has been collaborating with like-minded researchers, allied health clinicians, and many potential athletes, to participate in come-and-try events across New South Wales, South Australia, Queensland, Victoria and the ACT. Teaming up with another researcher from UQ, Dr Emma Beckman (Exercise Physiologist), Sarah and Emma are establishing training facilities for athletes in conjunction with The University of Queensland Athletics Club, BLK Performance Centre and Disability Sports Australia. RaceRunning is an innovative new sport for people with mobility and balance limitations. RaceRunning is now included on the World Para-athletics program for people with cerebral palsy and acquired brain injury who are not able to functionally run, and it is hoped that it will be included in the Paralympic games schedule by 2024. Sarah and Emma offer free squad training sessions on Tuesdays 4-6pm and Saturdays 9-10am at the UQ Athletics Track, and have bikes available to suit athletes between 6-99 years of age! To find out more details about RaceRunning: https://australian.physio/inmotion/race-running-promote-goodhealth. Contact Dr Sarah Reedman to get involved in the initiative: s.reedman@uq.edu.au. 6 Cerebral Palsy Alliance: https://cerebralpalsy.org.au/ 5
QEDIN7: The Queensland Early Detection and Early Intervention Network The Advancing CP in Queensland program has successfully designed, established and implemented the Queensland Early Detection and Intervention Network (QEDIN) across Queensland. The network now has over 230 registered clinicians from all 16 Hospital and Health Services across Queensland and the Mater Health Services, allowing recruitment and referral of infants for screening for at risk of Cerebral Palsy. The Network has successfully referred 178 infants, 128 consented, and over 80 infants referred and enrolled into various clinical trials. The network model has been translated into a larger national program (KiTE-CP) which is a multi-site study which connects clinical research across Victoria, New South Wales, and Queensland. QEDIN serves as the Queensland arm of the KiTE-CP program which aims to identify infants with CP in the first 6 months after birth to facilitate tailored CP-specific intervention. Since establishment, QEDIN has already trained ~700 clinicians in standardised assessments for the early detection of CP by conducting 4-hour practical courses on the Hammersmith Infant Neurological Assessment (HINE). Further General Movements Training (3.5 days) was conducted in February/March 2020 in Townsville and Brisbane. The QEDIN team has been actively assisting local teams to screen for infants at high risk of CP using the Baby Moves App to retrieve videos of infant between 12-16 weeks for screening on the General Movements Assessment. Dr Joanne George together with other Queensland HINE trainers have conducted 25 HINE courses across Queensland. This has enabled infants at high risk of CP with Absent Fidgety Movements and or low scores on the HINE to be referred to clinical trials that the infant is eligible for. Current studies that infants can be recruited to include REACH, GAME, and PREBO, and new studies that have commenced are Early-PACT, NEBO, Wearable Sensors, and VISIBLE. Studies currently recruiting Early Detection & Early Intervention Studies: KiTE CP: Early identification of infants with cerebral palsy: implementation of evidencebased guidelines into practice. KiTE CP is a multi-site study across Victoria, New South Wales and Queensland. The overall aim is to identify infants with CP in the first 6 months after birth to facilitate referral to targeted, best practice CP-specific early intervention. This is the time of maximal neuroplasticity to optimise long-term developmental outcomes. One thousand infants with increased risk of CP born between October 2018 and December 2020 will be recruited when infants are aged less than 7-months’ corrected age (CA). Infants will complete neurobehavioural assessments at 3-4 months CA, neurodevelopmental assessments at 3-6 months CA and a follow-up assessment at 2 years’ CA. KiTE CP may assist in identifying CP earlier than is currently possible allowing children to receive targeted interventions earlier during critical periods of brain development. This may lead to improved long-term developmental outcomes for the child. The study has recently commenced recruitment across Queensland, with 35 already recruited in Queensland and it is anticipated 300 infants will be recruited within the state. The already established ‘Early detection of infants at risk or with cerebral palsy: QLD Clinical network (QEDIN-CP)’ will be used to help identify eligible infants. Contact Details: Dr Tracey Evans, KiTE CP Clinical Research Coordinator, (07) 3069 7365, QCPRRC@uq.edu.au. This project is funded by NHMRC partnership grant (APP158200) Chief Investigators: Prof. Alicia Spittle, Prof. Iona Novak, Prof. Roslyn Boyd, Dr Cathy Morgan, Prof. Paul Scuffham, Prof. Russell Dale, Prof. Paul Colditz, A/Prof. Michael Fahey, Prof. Rodney Hunt, Dr Kerstin Pannek. 7 QEDIN: https://qcprrc.centre.uq.edu.au/qedin-cp 6
This is a prospective longitudinal cohort study which aims to recruit participants at high risk of cerebral palsy in order to describe motor trajectories over the first 2 years of life. 300 participants will be recruited in Australia (NSW, VIC and QLD) as part of a larger international study which aims to recruit 1000 participants. A maximum of six measurement time points will be included after enrolment: 3 months, 6, 9, 12, 18 and 24 months, with a minimum requirement of three to be completed. The standardised assessments will cover the following domains: neurological, motor, vision, sleep, independence in self-care, musculoskeletal, cognition, speech and language, feeding, adaptive behaviour, parental wellbeing and health resource use. These will provide the first comprehensive developmental trajectories of this group to contribute to the existing knowledge of CP development. This will to assist clinicians and therapists with accurate information on prognosis and provide targeted interventions early and at the 'just-right' challenge. Where indicated, individual participants' results from this study will be used to inform their therapy. The study is due to commence in Queensland soon following final site approvals. Contact Details: Dr Tracey Evans, Understanding the Early Natural History of Cerebral Palsy Clinical Research Coordinator, (07) 3069 7365, QCPRRC@uq.edu.au. This project is funded by NHMRC partnership grant (APP158200) Chief Investigators: Dr Cathy Morgan, Prof. Alicia Spittle, Prof. Iona Novak, Prof. Roslyn Boyd, Prof. Russell Dale, Prof. Paul Scuffham, Dr Koa Whittingham, A/Prof. Michael Fahey, Dr Kerstin Pannek, Ms Anna te Velde. NEBO: Neonatal Encephalopathy Brain Outcomes: Prospective study of Clinical and MRI Biomarkers in term born infants to improve accurate early prediction of Cerebral Palsy The NEBO trial is an observational study of infants born at term with Hypoxic Ischemic Encephalopathy (HIE). The aim of the study is to determine the ability of clinical assessments and neuroimaging to predict neurodevelopmental outcomes including motor, cognitive, neurological outcomes and a diagnosis of high risk of Cerebral Palsy. Up to 80 term born infants with HIE will be recruited at the Royal Brisbane and Women’s Hospital (RBWH) and the Mater Mothers’ Hospital (MMH) neonatal units. Assessment measures will be completed at 1-10 days after birth and at 3- and 24- months-of-age. A total of 54 infants have already been recruited and completed their post-birth assessments, with 40 of these also completing the 3-month assessment and 10 completing the 24-month assessment. A group of 20 healthy term born infants will also be recruited and complete the same assessments to allow for a comparison of results between the two groups. Identifying term born infants at a high risk of adverse developmental outcomes and cerebral palsy could enable earlier referral to specialist diagnostic teams and targeted interventions during infancy, which is a time of maximum neuroplasticity. Contact Details: Dr Tracey Evans, NEBO Research Coordinator, (07) 3069 7365, QCPRRC@uq.edu.au. This project is funded by the Advance Queensland Innovation Partnerships Program Grant 16-103. Chief Investigators: Prof. Roslyn N Boyd, Prof. Paul Colditz, Dr Pieter Koorts, Prof. Alan Coulthard, Dr Jane Bursle, Prof. Helen Liley, Prof. Stephen Rose, Dr Kerstin Pannek, Dr Jurgen Fripp, Dr Joanne George, Dr Nicola Previtera, Dr Steve Mehrkanoon, Prof. Boualem Boashash, Prof. Rob Ware, A/Prof. Josh Byrne, Prof. Paul Scuffham, Dr Simona Fiori, A/Prof. Andrea Guzzetta. GAME8: Harnessing Neuroplasticity to Improve Motor Performance in Infants with Cerebral Palsy: A Pragmatic Randomised Controlled Trial GAME study is a randomised controlled trial for infants with cerebral palsy to evaluate the effects of infantfriendly intensive, specific enriched training, known as “GAME” versus traditional passive early intervention on child development at 2 years-of-age. Infants are randomly assigned to either a traditional passive early 8 GAME: https://qcprrc.centre.uq.edu.au/article/2019/07/game 7
education and environmental enrichment. Families in the motor training group are visited weekly in their home by specially trained GAME therapists. Of the 300 families required for the study, 230 have already been recruited from New South Wales, Queensland, Victoria and Western Australia. Recruitment and home visits were temporarily suspended in March and April of this year due to the COVID-19 pandemic, to protect the clinical trial participants and staff. During this time, potentially eligible infants continued to be identified through referrals from hospitals and clinics. They were then contacted and recruited when restrictions were lifted to avoid families missing the opportunity to participate. For families already recruited to the GAME study, telehealth methods replaced home and clinic visits to continue the GAME therapy and assessments until faceto-face contact could be resumed. GAME baby working on her Contact Details: Dr Tracey Evans, GAME Clinical Research Coordinator, (07) 3069 motor function skills through 7365, QCPRRC@uq.edu.au. playing duplo. This project is funded by NHMRC Project Grant 1120031. Chief Investigators: Prof. Iona Novak, Dr Cathy Morgan, Prof. Nadia Badawi, Prof. Roslyn Boyd, Prof. Alicia Spittle, Prof. R Dale, Ms A Kirby, Prof R Hunt, Dr K Whittingham, Dr K Pannek. A/Prof M Fahey. Associate Investigators: A/Prof. K Walker, A/Prof. A Guzzetta, Dr K Prelog, Prof. W Tarnow-Mordi, Prof. S Rose, Ms C Galea, Ms S Clough, A/Prof. R Morton, Dr A Tran. REACH9: Rehabilitation Early for children at risk of Congenital Hemiplegia The REACH study is a multisite randomised controlled trial which directly compares two types of therapy, an intensive infant friendly one handed approach using modified Constraint Induced Movement Therapy (mCIMT) to an equally intensive two handed approach using Bimanual Therapy (BIM) in very young infants with asymmetric brain lesions. The aim is to determine whether mCIMT is more effective than BIM in improving unimanual capacity and bimanual coordination at 12-15 months corrected age (c.a.) and fine motor and cognitive development at 24 months c.a. Infants have been recruited from sites in Australia (QLD, NSW, VIC and WA) and the United States (Minnesota, Ohio, Riverside County). During COVID-19 restrictions investigators exchanged face-to-face home and clinic visits for telehealth sessions to complete the therapy and assessment measures. New telehealth manuals, protocols and guidelines were developed to REACH baby working with minimise the disruption to families and study timelines. The work and therapist on training his hand motor function skills. understanding of the study families, investigators, therapists and clinicians during this time was greatly appreciated, resulting in the continuation of recruitment and data collection. The study has now completed recruitment with a total of 96 infants entered into the study. A small number of families are completing their final therapy sessions and assessments time-points before the investigators can begin analysing the data and writing articles to publish the results. Contact Details: Dr Tracey Evans, REACH Clinical Research Coordinator, (07) 3069 7365, QCPRRC@uq.edu.au. This project is funded by NHMRC Project Grant 1078877. Chief Investigators: Prof. Roslyn Boyd, Prof. Jenny Ziviani, Dr Leanne Sakzewski, Prof. Iona Novak, Prof. Nadia Badawi, Dr Kerstin Pannek, Prof. Catherine Elliott, Dr Sue Greaves, A/Prof. Andrea Guzzetta, Dr Koa Whittingham, Dr Natalie Maitre, Dr Jill Heathcock, Dr Bernadette Gillick, Dr Young-min. Kim. VISIBLE: Vision Intervention for Seeing Impaired Babies: Learning through Enrichment VISIBLE is a pilot randomised controlled trial that will assess the feasibility of a vision-awareness program actively engaging parents in enriching their baby’s vision and development. The home-based program of goal directed early intervention is supported by a multidisciplinary team through parent training and fortnightly home or telehealth visits. The daily intervention activities are provided by the parents and focus on environmental enrichment and targeted vision-aware developmental goals. Behavioural assessments are completed to evaluate the program efficacy on vision, motor, and general developmental function. The five recruiting sites 9 REACH: https://qcprrc.centre.uq.edu.au/reach 8
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