We thank Madaan et al. for their letter in response to our scoping review on human coronavirus (HCoV) infections of the nervous system of children.1 , 2 We agree with their consideration of the utility of the longitudinal general movements assessment (GMA) and motor optimality score (MOS) as tools for prognostic evaluation following injuries to the nervous system including from COVID-19.3
In our writing, we sought to provide clinical guidance for general pediatricians as children who have recovered from COVID-19 infections return for follow-up. Thus, as the letter writers learned the results of their own study, their future work might include partnering of general pediatricians and child neurologists to gather the specific, at times sophisticated, data needed to complete these motor evaluations. Because the neurological impact on infants and toddlers can be challenging, it is also important to consider other aspects of development, such as age-appropriate self-regulation, irritability, and vocalizations. A comprehensive evaluation of motor, verbal, and behavioral assessment will ensure that all children can receive optimal follow-up. Moreover, if and when deficits are noted, another consideration could be to include no-cost or low-cost tools for parents to engage in their child's recovery. There are excellent resources through the “Head Start” program run by the US Department of Health and Human Services depending on the child's age and medical history.4
We wish the authors luck in their study and look forward to its publication!
References
- 1.Madaan P., Saini L., Einspieler C. Prediction of neurodevelopmental outcomes in SARS-CoV-2 infections. Pediatr Neurol. 2021;120:3. doi: 10.1016/j.pediatrneurol.2021.04.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Singer T.G., Evankovich K.D., Fisher K., Demmler-Harrison G.J., Risen S.R. Coronavirus infections in the nervous system of children: a scoping review making the case for long-term neurodevelopmental surveillance. Pediatr Neurol. 2021;117:47–63. doi: 10.1016/j.pediatrneurol.2021.01.007. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Saini L., Madaan P., Naik M.R.R. General movements: longitudinal assessment better than cross-sectional. Brain Dev. 2019;41:563–564. doi: 10.1016/j.braindev.2019.03.001. [DOI] [PubMed] [Google Scholar]
- 4.“Parents' Guide to Digital Tools to Support Children's Learning,” Early Childhood Learning and Knowledge Center, Head Start, United States Department of Health and Human Services. 2018. https://eclkc.ohs.acf.hhs.gov/publication/parents-guide-digital-tools-support-childrens-learning Available at: