# Agreement Between Tele- and Face-to-Face Assessment of Neuromotor Development in High-Risk Children
## 1 Introduction  
Standard care for neonatal and pediatric healthcare includes surveillance and follow-up programs for neurodevelopmental outcomes. High-risk children require these programs to be more structured and specialized [1]. The American Academy of Pediatrics classifies high-risk children into four categories: (i) the preterm infant (born < 37 weeks' gestation); (ii) the infant with special healthcare needs or dependence on technology; (iii) the infant at risk due to social issues; and (iv) the infant with anticipated early death [2]. Early detection of neuromotor development disorders in this population involves motor assessment through standardized instruments that aim to measure developmental outcomes, monitor motor evolution and the achievement of new skills, and detect neurodevelopmental concerns [3]. In addition, it allows for referral to diagnostic procedures and ensures early intervention within the time window offered by the neuroplasticity of the infant brain [4, 5]. In this sense, early intervention seeks to improve prognosis, minimize developmental delays, and prevent functional deterioration [6, 7]. People living in underserved areas lacking health infrastructure have difficulties accessing timely specialist care, which is relevant in pediatric care. These limitations range from geographical to economic issues, as well as organizational and cultural factors that can impact the use of telehealth services [8; 9]. In addition, the recent COVID-19 pandemic became a major barrier to face-to-face attendance in health services due to the high risk of disease transmission. Restrictive measures, including the lockdown and limitations in face-to-face services, made it necessary to implement new strategies to maintain the quality of healthcare delivery while avoiding the aforementioned risk [10; 11]. [PERSON] et al. [12] found that the lockdown caused a significant decrease in pediatric services' utilization and hospitalization. The study conducted by [PERSON] et al. [13] affirms that telemedicine in this context was useful to provide support to healthcare systems, being the doctors' first line of defense to slow down the spread of the coronavirus. Additionally, [PERSON] et al. [14] assessed Spanish citizens' satisfaction with an online medical consultation service, for which the findings pointed out a plausible paradigm shift concerning a mixed and complementary care service in healthcare. Telerehabilitation refers to the telematic delivery of rehabilitation services, including assessments, diagnosis, and treatment. It utilizes telecommunication technologies either synchronously, such as real-time videoconferencing, or asynchronously, through recorded videos, images, or other forms of data sharing [15; 16]. Several health professionals made an unexpected and rapid transition to telematic services to ensure the continuity of care, including those from pediatric rehabilitation, physiotherapy, and early intervention areas [10; 15]. Telerehabilitation allows healthcare professionals to implement assessments and personalized therapeutic approaches tailored to the infant's developmental needs [10; 15]. In addition, it also ensures accessibility, particularly for families in remote or underserved areas, while allowing therapists to monitor progress and adjust treatment plans in real time. Telerehabilitation not only supports early and continuous intervention but also empowers caregivers to take an active role in their child's developmental progress [10]. Through real-time interactions, therapists can monitor progress, provide feedback, and adjust treatment plans as needed. An assessment of neuromotor development at an early age is key to identifying and intervening in time on a disorder that might compromise a person's development throughout their life span.