Comparison of caretaker report and hands-on neurodevelopmental screening in high-risk infants.
Caretaker report in developmental screening of high-risk infants has not been investigated adequately. We compare a caretaker-completed neurodevelopmental prescreening questionnaire (NPQ) to a hands-on screener (Bayley Infant Neurodevelopmental Screener; BINS) and attempt to identify factors that influence agreement in a high-risk sample. From 1,436 infants drawn from 5 centers, 471 were prospectively evaluated at 6-months corrected age, 376 at 12-months, and 244 at 24-months. Fifty-five percent were male; 28% African American, 70% Caucasian, 3% other; M gestational age = 31.2 weeks, M birth weight = 1568 g. Caretakers completed the NPQ (based on the BINS) while watching a video depicting infants engaged in items. The BINS was subsequently administered. Sensitivity ranged from 80%-91%, specificity 57%-82%, and overall agreement 70%-83%, depending on age. Mean NPQ summary scores were lower than the BINS. Agreement varied depending on BINS risk status, being best in the high-risk group, and worst in the moderate risk group. Background variables had minimal impact at 6 and 12 months with BINS risk status being the primary influence; at 24-months, race, intraventricular hemorrhage, and respiratory distress syndrome were influential. Caretaker report is useful in a high-risk population, although the infant's neurodevelopmental status influences such early on; ethnic background and biomedical variables become more important at 2 years.
Aylward
Glen P
GP
Division of Developmental and Behavioral Pediatrics, Southern Illinois University School of Medicine, Springfield, IL 62794-9658, USA. Gaylward@siumed.edu
Verhulst
Steven J
SJ
D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000523:psychology; D002552:Cerebral Ventricles; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000523:psychology; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000523:psychology; D008297:Male; D008403:Mass Screening; D009460:Neurologic Examination / Q000706:statistics & numerical data*; D015588:Observer Variation; D011446:Prospective Studies; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires