Comparison of Caretaker Report and Hands-On Neurodevelopmental Screening in High-Risk Infants

• Published in: Developmental neuropsychology 2008-03, Vol.33 (2), p.124-136
• Main Authors: Aylward, Glen P., Verhulst, Steven J.
• Format: Article
• Language: English
• Subjects: Babies; Biological and medical sciences; Brain Damage, Chronic - diagnosis; Brain Damage, Chronic - psychology; Cerebral Ventricles; Child care; Comparative studies; Developmental Disabilities - diagnosis; Developmental Disabilities - psychology; Female; Follow-Up Studies; Gestational Age; Humans; Infant; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature, Diseases - diagnosis; Infant, Premature, Diseases - psychology; Intracranial Hemorrhages - diagnosis; Intracranial Hemorrhages - psychology; Male; Mass Screening; Medical sciences; Medical screening; Neurologic Examination - statistics & numerical data; Neuropsychology; Observer Variation; Pediatrics; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychometrics - statistics & numerical data; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Reproducibility of Results; Respiratory Distress Syndrome, Newborn - diagnosis; Respiratory Distress Syndrome, Newborn - psychology; Surveys and Questionnaires; Techniques and methods
• ISSN: 8756-5641; 1532-6942
• DOI: 10.1080/87565640701884220

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.