Introduction: The Prechtl General Movement Assessment (GMA) is predictive of cerebral palsy (CP), however it has not been well studied in resource limited countries such as Sri Lanka.

Objective: Characterize the spectrum of movement abnormalities and predictive value of the GMA in high risk Sri Lankan infants.

Method:All high risk infants seen at Karapitiya Teaching Hospital from 01/01/2017 to 30/05/2018 underwent GMA before3 months gestational age by a certified Prechtl assessor using a standard video, blinded to clinical status.

Results:315 high risk infants(57% male) were assessed. Diagnoses included prematurity (65%), neonatal encephalopathy (14%), meningitis (18%) and seizures (22%). Of 270 neonates assessed in the writhing period before gestational age 40 weeks, 54% were normal,45% demonstrated poor repertoire (suggesting moderate risk for CP) and1 infant showed cramped synchronized movements (high risk for CP). 22% of 111 infants assessed in the fidgety period at 3 months of age had absent fidgety movements (higher risk for CP). These infants had the following risk factors: prematurity (64%), neonatal encephalopathy (34%), meningitis (16%), and seizures (36%). Of this group, 60% were ventilated >24 hours and 36% had an abnormal brain ultrasound. Chi square statistical analysis found no correlation between CP risk and any risk factor except ventilation> 24 hours (P-value =0.001).

Conclusion: Similar to reports from other countries, we found 8% of high risk infants were at high risk of developing CP, suggesting that the GMA is an appropriate screening tool in resource limited settings.