Despite advances in the medical management of high-risk pregnancies and deliveries, cerebral palsy (CP) remains the most common physical disability in childhood in high and low-to-middle-income countries (LMIC). Additionally, caregivers of children with CP are at higher risk of psychiatric issues, further increasing the health and socio-economic burden on families. Despite scientific advancements in early detection and intervention (EI) for CP, clinical service delivery remains inadequate.
BORNTOGETTHERE provides a multifaceted knowledge translation approach focused on:
i) optimizing context-specific health programs for early detection of CP to reduce age at diagnosis and referral to EI;
ii) optimizing early functional characterization of infants with CP to foster personalized EI and prevent secondary complications (e.g. hip dislocation); and
iii) testing the implementation of integrated EI programs adapted to country-specific welfare systems.
The service delivery protocol adapts early detection and EI programs based on proven, effective intervention strategies and those being researched with promising preliminary data. This framework is validated under real-world conditions through a large implementation program and a multicenter parallel controlled trial. Beneficiaries include families, communities, policymakers, public authorities, media, and citizen groups, ensuring evidence translation into routine practice.
The overarching aim of BORNTOGETTHERE is to exploit current evidence on early detection, characterization, and intervention for infants at high risk of CP by implementing the first International Clinical Practice Guideline in multiple sites across Europe (Italy, Denmark, Netherlands), LMICs (Georgia, Sri Lanka), and hard-to-reach populations (Remote Queensland, QLD).
We aim to improve maternal and infant health through three objectives:
**Aim 1:** Improve health programs for early detection (ED) of CP in a context-specific way, reducing the age at diagnosis and referral to CP-specific EI programs.
**Aim 2:** Enhance health programs for early surveillance (ES) of associated impairments in infants with CP and parental mental health, fostering individualized EI delivery, preventing secondary complications (e.g. hip dislocation), and supporting parents.
**Aim 3:** Improve health programs for early intervention (EI) in infants with CP, enhancing infant outcomes (motor, cognitive, social-emotional development) and caregiver mental health.
During the final reporting period, these aims remained stable, and Consortium actions continued toward achieving these goals.
The Borntogetthere Model demonstrates significant strengths in diagnostic accuracy, resource efficiency, and caregiver support, creating a robust framework for early detection and intervention in infants at risk of CP. Strong interconnections between service providers, patients, caregivers, and health systems ensure data-driven insights at one level generate positive impacts across the care continuum.
However, implementation revealed challenges for future scalability. Effective deployment requires continuous data collection and a comprehensive analysis infrastructure, demanding substantial resources. Additionally, ensuring uniform policy implementation across sites necessitates addressing disparities in data access and technical expertise.
The project developed a multi-language e-learning platform that will remain available for research projects further implementing clinical practice guidelines on early detection and intervention in CP (e.g. the ENSEMBLE Project).
