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CAT/CLAMS: its use in detecting early childhood cognitive impairment
D A Kube1, W M Wilson, M C Petersen
1Division of Developmental Pediatrics, Department of Pediatrics, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA.
Insights
The Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) strongly correlates with the Bayley Scales of Infant Development-II (BSID-II), proving useful for identifying cognitive impairment in infants and toddlers.
Area of Science:
- Neurodevelopmental assessment
- Pediatric cognitive evaluation
Background:
- The Bayley Scales of Infant Development-II (BSID-II) is a revised standard for infant cognitive assessment.
- The Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) is a neurodevelopmental tool for assessing infants and toddlers.
Purpose of the Study:
- To evaluate the correlation between the CAT/CLAMS and the BSID-II.
- To determine the utility of the CAT/CLAMS in identifying mild and severe cognitive impairment.
Main Methods:
- Sixty-eight infants and toddlers (14-48 months) with suspected developmental delays were assessed.
- Both CAT/CLAMS and BSID-II were administered, and results were compared.
Main Results:
- A strong correlation (r = 0.89, P<0.0001) was found between CAT/CLAMS and BSID-II.
- CAT/CLAMS demonstrated high sensitivity (81%) and specificity (85%) for overall cognitive impairment (BSID-II < 70).
- CAT/CLAMS showed excellent sensitivity (100%) and specificity (96%) for severe cognitive impairment (BSID-II < 50).
- Physician's clinical impression using CAT/CLAMS was highly sensitive (95%) and specific (84%) compared to formal testing.
Conclusions:
- The CAT/CLAMS is a reliable tool that correlates well with the BSID-II.
- CAT/CLAMS effectively detects and quantifies mild and severe cognitive impairment in young children.
- Physicians can use CAT/CLAMS to form accurate clinical impressions of cognitive impairment, including potential intellectual disability.
Abstract:
The Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS), a neurodevelopmental tool for the cognitive assessment of infants and toddlers, correlates well with the Bayley Scales of Infant Development. In 1993 the Bayley Scales were revised and the second edition published (BSID-II). This study was designed to determine how well the CAT/CLAMS correlates with the BSID-II and its utility in identifying mild and severe cognitive impairment. Sixty-eight infants and toddlers (age range = 14-48 months), referred for suspected developmental delays, were administered the CAT/CLAMS and BSID-II and the results compared. The correlation between the two instruments was strong (r = 0.89, P<0.0001). The CAT/CLAMS was sensitive (81%) and specific (85%) for detecting overall cognitive impairment (BSID-II less than 70) and was even more sensitive (100%) and specific (96%) in detecting severe cognitive impairment (BSID-II less than 50). The physician using the CAT/CLAMS formulated a clinical impression of cognitive impairment that was sensitive (95%) and specific (84%) compared with formal psychologic testing. The CAT/CLAMS correlates well with the BSID-II. It is useful for detecting and quantifying mild and severe cognitive impairment. It permits the physician to formulate an accurate clinical impression of cognitive impairment consistent with possible mental retardation.