Validation of rapid neurodevelopmental assessment for 2- to 5-year-old children in Bangladesh.
OBJECTIVE
Validate a tool to determine neurodevelopmental impairments (NDIs) in >2- to 5-year-old children in a country with limited child development expertise.


METHODS
Rapid Neurodevelopmental Assessment (RNDA) is a tool designed to detect functional status and NDIs across multiple neurodevelopmental domains. Validity was determined in 77 children enrolled by door-to-door sampling in Dhaka and who were administered the RNDA by 1 of 6 testers (4 developmental therapists, 2 special education teachers) and simultaneously administered a test of adaptive behavior (AB; Independent Behavior Assessment Scale) and intelligence quotient (IQ) tests (Bayley Scales of Infant Development II, Stanford Binet Intelligence Scale, Wechsler Preschool and Primary Scales of Intelligence) by psychologists.


RESULTS
Interrater reliability ranged from good to excellent. There were significant differences in AB in mean percentile scores on the Independent Behavior Assessment Scale for motor (P = .0001), socialization (P = .001), communication (P = .001), and full-scale (P = .001) scores in children with ≥1 NDI ("any NDI") versus no NDI. Significant differences in those with versus those without "any NDI" were found on IQ scores. Sensitivity and specificity for "significant difficulties" (defined as AB z-scores < -2 SDs and/or IQ <70) and "mild difficulties included" (AB z-scores < -1SD and/or IQ <85) were 90% and 60% and 80% and 76%, respectively.


CONCLUSIONS
The RNDA validity results are promising for use by child care professionals in field and clinical settings, but the tool needs further replication and refinement for assessment of specific impairments of vision, hearing, and seizures.
Department of Pediatric Neuroscience, Dhaka Shishu (Children's) Hospital, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh. naila.z.khan@gmail.com
Naila Z
NZ
Khan
Humaira
H
Muslima
Asma Begum
AB
Shilpi
Dilara
D
Begum
Monowara
M
Parveen
Nasima
N
Akter
Shamim
S
Ferdous
Kamrun
K
Nahar
Helen
H
McConachie
Gary L
GL
Darmstadt
D000223:Adaptation, Psychological; D001459:Bangladesh; D002675:Child, Preschool; D003906:Developing Countries; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D007361:Intelligence Tests / Q000706:statistics & numerical data; D008297:Male; D008403:Mass Screening; D009460:Neurologic Examination / Q000592:standards*; D015588:Observer Variation; D015203:Reproducibility of Results; D012494:Sampling Studies