title: Overestimating neurodevelopment using the Bayley-III after early complex cardiac surgery.
abstract: BACKGROUND
  The newest measure of neurodevelopmental outcomes, the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III), gives higher-than-expected scores for preterm infants; results after cardiac surgery are unknown.
  
  
  OBJECTIVE
  The goal of this study was to report Bayley-III scores after cardiac surgery and compare the results with those of the Bayley Scales of Infant Development, 2nd Edition (BSID-II) on a subset of the same children.
  
  
  METHODS
  In this prospective, inception cohort, neurodevelopmental outcome study after complex cardiac surgery in infants from 2004 to 2007, the Bayley-III was given to 110 survivors (68% boys) at a mean age of 21 months (SD: 4 months). Analysis of variance was used to compare intergroup differences. Results for both test editions on the same 25 children were compared by using paired-samples statistics.
  
  
  RESULTS
  Mean (SD) Bayley-III mean composite scores (CSs) for 110 children were as follows: cognitive, 95.9 (14.1); language, 90.8 (18.1); and motor, 93.7 (14.2), differentiating selected cardiac surgery groups. The average difference in mean CSs was 7.4 points higher than BSID-II scores for a previous cohort from this site and 7.2 points higher than a systematic review report. Direct comparison of BSID-II and Bayley-III revealed an average difference in mean CSs of 6.1 points, similar to normative results. Mean cognitive CSs increased by 10.0 (P <.001), language by 1.4 (P = .526), and motor by 6.9 points (P = .009).
  
  
  CONCLUSIONS
  Researchers should be careful attributing higher Bayley-III scores to changes in acute care. At-risk children who previously qualified for early developmental intervention may no longer do so. School-age longitudinal studies are needed to determine the accuracy of early developmental estimates using the Bayley-III.
authors.affiliation: aDepartment of Psychology, University of Saskatchewan,Saskatoon, Saskatchewan, Canada.
authors.forename: Bryan V
authors.initials: BV
authors.lastname: Acton
authors.forename: Wayne S G
authors.initials: WS
authors.lastname: Biggs
authors.forename: Dianne E
authors.initials: DE
authors.lastname: Creighton
authors.forename: Karen A H
authors.initials: KA
authors.lastname: Penner
authors.forename: Heather N
authors.initials: HN
authors.lastname: Switzer
authors.forename: Julianne H Petrie
authors.initials: JH
authors.lastname: Thomas
authors.forename: Ari R
authors.initials: AR
authors.lastname: Joffe
authors.forename: Charlene M T
authors.initials: CM
authors.lastname: Robertson
mesh_terms: D006348:Cardiac Surgical Procedures; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007807:Language Tests; D008137:Longitudinal Studies; D008297:Male; D009048:Motor Skills; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011581:Psychological Tests