LEAP-CP: Learning through Everyday Activities with Parents for Indigenous Australian infants at high risk of cerebral palsy and neurodevelopmental disabilities

The LEAP-CP project involves the implementation of early screening (early detection sub-study) and intervention for Aboriginal and Torres Strait Islander infants at risk of CP and/or adverse Neurodevelopmental outcomes. The early detection sub-study will implement early detection programs for 'at risk' Aboriginal and/ or Torres Strait Islander infants born in Queensland (birth years 2020-2022). Eligible infants are those aged 0-9 months corrected age (CA) who are at risk of later adverse neurodevelopmental outcomes due to a history of any of the following factors; birth or pregnancy complications, preterm birth, low birth weight, maternal risk factors, admission to neonatal intensive care unit or special care nursery or post-neonatal complications (infection, head injury, stroke). Participants will be recruited from study geographical sites prior to 9 months CA and will be screened at two time points, (i) birth to 5 months CA (2x5 minute observational videos which can be taken at home on a mobile phone), and (ii) 4 to 9 months CA (1 hour visit with a health professional for neurological and developmental assessment). Medical information collected is consistent with the intervention study (as described in the outcomes). Infants can enter the study at any time between birth and 9 months CA, and will commence the relevant screening protocol based on their age at study entry. Outcome measures will be completed at 12 months. Eligible infants (based on early screening results) will commence the LEAP-CP intervention. The LEAP -CP intervention is a multidisciplinary family-centred intervention delivered peer to peer in the home during 30 weekly 2-hour visits (over a 7-10 month period, allowing for missed visits due to illness and family/ ceremonies). During the visit, the Indigenous Allied Health Worker (peer trainer) will (1) gather feedback and troubleshoots the previous visit's activities, (2) deliver the therapeutic modules includes motivating infant-generated activities practiced to optimise learning; using principles of structure, repetition, and variation. Functional motor skills, such as reach/grasp and attaining anti-gravity postures. (3) deliver the educational module. The caregiver will be provided with written and pictographic information of the program specific to this study, to facilitate their use of the strategies each day during the upcoming week. The education is discussion on topics based with question prompts for the community worker following 'the 5As' - ask (find out what the parent is currently doing through questions and observation), affirm (affirm their parenting strengths and wisdom), add (build on what they are doing), answers to problem (support the parent to problem silver barriers to implementing change) and action (support the parent to identify action for the coming week). The Indigenous Allied Health Worker will receive a 3-day training package at the onset of the programme. This will include topics such as: * Building rapport and positive therapeutic relationship with caregivers * Exploring customs, beliefs and family culture * Using everyday opportunities and routines to encourage infant development * Observation skills and coaching * Motor training and therapeutic principles * Understanding typical development and development in children with cerebral palsy * Ethics and research practices Monitoring of the sessions will be conducted by the regional team leader, and they will collaborate with a centralised allied health coordinator on the program content on a monthly schedule utilising online telehealth facilities.