Use of the Ages and Stages Questionnaire and Bayley Scales of Infant Development-II in Neurodevelopmental Follow-up of Extremely Low Birth Weight Infants

Woodward, Barbara J; Papile, Lu-Ann; Lowe, Jean R; Laadt, Virginia L; Shaffer, Michele L; Montman, Rebecca; Watterberg, Kristi L

doi:10.1038/jp.2011.1

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Use of the Ages and Stages Questionnaire and Bayley Scales of Infant Development-II in Neurodevelopmental Follow-up of Extremely Low Birth Weight Infants

research-article

Author(s): Barbara J Woodward , MPH, OTR ^a , Lu-Ann Papile , MD ^b , Jean R Lowe , PhD ^c , Virginia L Laadt , PhD ^c , Michele L Shaffer , PhD ^d , Rebecca Montman , RN ^e , Kristi L Watterberg , MD ^c

Publication date (Electronic): 10 February 2011

Journal: Journal of perinatology : official journal of the California Perinatal Association

Keywords: Bayley Scales of Infant Development, Ages and Stages Questionnaire, neurodevelopment, developmental assessment, developmental screening, NICU

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Abstract

Objectives

For infants born extremely low birth weight (ELBW), we examined the 1) correlation between results on the Ages and Stages Questionnaire (ASQ), and the Bayley Scales of Infant Development II (BSID-II) at 18-22 months corrected age; 2) degree to which earlier ASQ assessments predict later BSID-II results; 3) impact of ASQ use on follow-up study return rates.

Study Design

ASQ data were collected at 4, 8, 12, and 18-22 months corrected age. The BSID-II was completed at 18-22 months corrected age. ASQ and BSID-II 18 – 22 month sensitivity and specificity were examined. Ability of earlier ASQs to predict later BSID-II scores was examined through linear regression analyses.

Results

ASQ sensitivity and specificity at 18-22 months were 73% and 65%, respectively. Moderate correlation existed between earlier ASQ and later BSID-II results.

Conclusions

For ELBW infant assessment, the ASQ cannot substitute for the BSID-II, but appears to improve tracking success.

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Most cited references 28

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Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994.

B. Vohr, L Wright, A Dusick … (2000)

The purposes of this study were to report the neurodevelopmental, neurosensory, and functional outcomes of 1151 extremely low birth weight (401-1000 g) survivors cared for in the 12 participating centers of the National Institute of Child Health and Human Development Neonatal Research Network, and to identify medical, social, and environmental factors associated with these outcomes. A multicenter cohort study in which surviving extremely low birth weight infants born in 1993 and 1994 underwent neurodevelopmental, neurosensory, and functional assessment at 18 to 22 months' corrected age. Data regarding pregnancy and neonatal outcome were collected prospectively. Socioeconomic status and a detailed interim medical history were obtained at the time of the assessment. Logistic regression models were used to identify maternal and neonatal risk factors for poor neurodevelopmental outcome. Of the 1480 infants alive at 18 months of age, 1151 (78%) were evaluated. Study characteristics included a mean birth weight of 796 +/- 135 g, mean gestation (best obstetric dates) 26 +/- 2 weeks, and 47% male. Birth weight distributions of infants included 15 infants at 401 to 500 g; 94 at 501 to 600 g; 208 at 601 to 700 g; 237 at 701 to 800 g; 290 at 801 to 900 g; and 307 at 901 to 1000 g. Twenty-five percent of the children had an abnormal neurologic examination, 37% had a Bayley II Mental Developmental Index <70, 29% had a Psychomotor Developmental Index <70, 9% had vision impairment, and 11% had hearing impairment. Neurologic, developmental, neurosensory, and functional morbidities increased with decreasing birth weight. Factors significantly associated with increased neurodevelopmental morbidity included chronic lung disease, grades 3 to 4 intraventricular hemorrhage/periventricular leukomalacia, steroids for chronic lung disease, necrotizing enterocolitis, and male gender. Factors significantly associated with decreased morbidity included increased birth weight, female gender, higher maternal education, and white race. ELBW infants are at significant risk of neurologic abnormalities, developmental delays, and functional delays at 18 to 22 months' corrected age.

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Poor predictive validity of the Bayley Scales of Infant Development for cognitive function of extremely low birth weight children at school age.

Maureen Hack, H Taylor, Dennis Drotar … (2005)

The Bayley Scales of Infant Development, Second Edition (BSID II) are commonly used to assess outcomes of extremely low birth weight (ELBW) infants. We sought to assess the predictive validity of the BSID II Mental Developmental Index (MDI) for cognitive function at school age. Of 330 ELBW infants admitted in 1992-1995, 238 (72%) survived to the age of 8 years, of whom 200 (84%) were tested at both 20 months' corrected age (CA) and 8 years. Mean birth weight was 811 g, mean gestational age was 26.4 weeks, 41% were boys, and 60% were black. Measures included the BSID II at 20 months' CA and the Kaufman Assessment Battery for Children (KABC) Mental Processing Composite (MPC) at 8 years' postnatal age. BSID II MDI and MPC scores were compared and the predictive validity calculated for all 200 ELBW children and for the 154 ELBW neurosensory-intact subgroup. Predictors of stability or change in cognitive scores were examined via logistic regression adjusting for gender and sociodemographic status. For all ELBW children, the mean MDI was 75.6 +/- 16 versus a mean KABC of 87.8 +/- 19. For the neurosensory-intact subgroup, the mean MDI was 79.3 +/- 16 and the mean KABC was 92.3 +/- 15. Rates of cognitive impairment, defined as an MDI or KABC of 70. The predictive validity of a subnormal MDI for cognitive function at school age is poor but better for ELBW children who have neurosensory impairments. We are concerned that decisions to provide intensive care for ELBW infants in the delivery room might be biased by reported high rates of cognitive impairments based on the use and presumptive validity of the BSID II MDI.

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Prophylaxis of early adrenal insufficiency to prevent bronchopulmonary dysplasia: a multicenter trial.

S. Jayne Garland, Teresa Shaffer, Kristi Watterberg … (2004)

Infants developing bronchopulmonary dysplasia (BPD) show decreased cortisol response to adrenocorticotropic hormone. A pilot study of low-dose hydrocortisone therapy for prophylaxis of early adrenal insufficiency showed improved survival without BPD at 36 weeks' postmenstrual age, particularly in infants exposed to histologic chorioamnionitis. Mechanically ventilated infants with birth weights of 500 to 999 g were enrolled into this multicenter, randomized, masked trial between 12 and 48 hours of life. Patients received placebo or hydrocortisone, 1 mg/kg per day for 12 days, then 0.5 mg/kg per day for 3 days. BPD at 36 weeks' postmenstrual age was defined clinically (receiving supplemental oxygen) and physiologically (supplemental oxygen required for O2 saturation > or =90%). Patient enrollment was stopped at 360 patients because of an increase in spontaneous gastrointestinal perforation in the hydrocortisone-treated group. Survival without BPD was similar, defined clinically or physiologically, as were mortality, head circumference, and weight at 36 weeks. For patients exposed to histologic chorioamnionitis (n = 149), hydrocortisone treatment significantly decreased mortality and increased survival without BPD, defined clinically or physiologically. After treatment, cortisol values and response to adrenocorticotropic hormone were similar between groups. Hydrocortisone-treated infants receiving indomethacin had more gastrointestinal perforations than placebo-treated infants receiving indomethacin, suggesting an interactive effect. Prophylaxis of early adrenal insufficiency did not improve survival without BPD in the overall study population; however, treatment of chorioamnionitis-exposed infants significantly decreased mortality and improved survival without BPD. Low-dose hydrocortisone therapy did not suppress adrenal function or compromise short-term growth. The combination of indomethacin and hydrocortisone should be avoided.

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Author and article information

Journal

Journal ID (nlm-journal-id): 8501884

Journal ID (pubmed-jr-id): 5061

Journal ID (nlm-ta): J Perinatol

Title: Journal of perinatology : official journal of the California Perinatal Association

ISSN (Print): 0743-8346

ISSN (Electronic): 1476-5543

Publication date Nihms-submitted: 12 April 2011

Publication date (Electronic): 10 February 2011

Publication date (Print): October 2011

Publication date PMC-release: 1 April 2012

Volume: 31

Issue: 10

Pages: 641-646

Affiliations

[a ]Department of Psychiatry and Behavioral Sciences, The Children’s Hospital of Denver, Denver, Colorado

[b ]Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas

[c ]Division of Neonatology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico

[d ]Departments of Public Health Sciences and Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania

[e ]General Clinical Research Center, University of New Mexico School of Medicine, Albuquerque, New Mexico

Author notes

Address correspondence to: Barbara J. Woodward MPH, OTR, Department of Psychiatry and Behavioral Sciences, The Children’s Hospital of Denver, Denver, Colorado 80045 USA, Woodward.Barbara@ 123456tchden.org , Phone: 303-503-7411, FAX number: 303-636-5603

Article

Manuscript ID: nihpa287342

DOI: 10.1038/jp.2011.1

PMC ID: 3139816

PubMed ID: 21311498

SO-VID: 6f8e6ed3-6288-40f1-a06a-1b41ededc9e3

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