Diagnostic Accuracy of Bayley III Screening Tool to Detect Developmental Delay in Moderate to High-Risk Indian Preterm Children.

The present study aimed to evaluate the ability of the Bayley III screening tool to detect developmental delay in moderate to high-risk preterm children in India. In this cross-sectional study, 94 preterm babies were enrolled. The Bayley III screener (index test) and the gold-standard, Developmental assessment scale for Indian Infants (DASII) test were administered to all the enrolled children. Researchers were blinded while performing the tests. Diagnostic accuracy parameters were compared. The Bayley III screener's sensitivity and specificity for predicting the delay (with a DASII cut-off of <70) were 84.62% and 85.18% in the mental domain and 61.11% and 96.05% in the motor domain, respectively. When the DASII cut-off was raised to 85, the sensitivity and specificity in the mental domain were 60.61% and 95.08%, respectively, whereas they were 36.11% and 98.27%, respectively, in the motor domain. The Bayley III screener is found to have good specificity rather than sensitivity with good predictive values.

Effectiveness of Bedside Clinical Screening Tools in Predicting Short-Term Neurodevelopmental Delay Among Very-Low-Birth-Weight Pre-terms: A Prospective Observational Study.

BACKGROUND: Pre-term births are associated with increased risk of various morbidities, especially neurological. Early detection and early intervention to prevent these morbidities will have immediate and long-term benefits to the individuals and society at large. However, the screening and assessment tools, including both clinical and radiological, are not uniformly available in resource-poor settings. The present study was carried out to evaluate the validity of the clinical screening tools for detecting neurodevelopmental delay among very-low-birth-weight (VLBW) pre-term babies. METHODS: This prospective observational study was undertaken in the child development unit of a tertiary care hospital from July 2015 to October 2017. All pre-term VLBW neonates admitted in level III Neonatal Intensive Care within the first 24 hours of life were included in the study. They were subjected to Hammersmith Neonatal Neurological Examination (HNNE) and magnetic resonance imaging (MRI) of brain at term-equivalent age. Subsequently, the same group was followed up with Amiel-Tison (AT) angles, Child Development Centre (CDC) grading for sitting developed at Trivandrum, Kerala, India, and Denver Development Screening Test (DDST-II gross motor) at eight months corrected age, and their outcomes were analyzed. RESULTS: 17.9% of the ex-preterm were abnormal as per HNNE evaluation at term-corrected age. At short-term follow-up screening, 13.8% were found to be abnormal based on AT angles, while 35.2% were found to be abnormal as per CDC grading and 30.4% were found to have risk for delay as per DDST-II (gross motor). A high level of sensitivity (93.6%) and positive predictive value (91.2%) was observed for HNNE at term equivalent with MRI brain assessment considered as gold standard. Among the follow-up screening tools, CDC grading for sitting, AT angles, and DDST-II had high sensitivity (>85%). CONCLUSION: The combination of HNNE along with radiological assessment at term-corrected age can be considered as appropriate for predicting long-term neurodevelopmental outcome in VLBW pre-term infants. During follow-up, simple tools like CDC grading for motor milestones, AT angles, and DDST-II may be utilized if facilities for standard assessment are not available as in resource-poor settings.