The validity of continuing developmental follow-up of high-risk infants to age 5 years

Area of Science:

• Developmental Psychology
• Educational Psychology
• Pediatrics

Background:

• Longitudinal developmental surveillance is crucial for identifying children at risk.
• Previous studies have explored predictors of academic success.
• Understanding the predictive validity of early assessments is essential for targeted interventions.

Purpose of the Study:

• To determine if 5-year-old developmental test performance predicts 8-year-old academic achievement.
• To evaluate the predictive accuracy of a prekindergarten psychoeducational test battery.
• To identify specific predictors of academic underachievement in at-risk children.

Main Methods:

• A cohort of 179 at-risk children and 50 comparison children were assessed.
• Children underwent a prekindergarten psychoeducational test battery at age 5.
• Academic achievement was measured using the Iowa Tests of Basic Skills at age 8.

Main Results:

• Children flagged on the prekindergarten tests had significantly lower Iowa Tests of Basic Skills scores.
• Preacademic items were better predictors than developmental items.
• The test battery predicted low achievement or grade retention in only 58% of cases (sensitivity 0.45, specificity 0.85).
• No significant difference in test scores between high-risk and comparison groups.
• Higher prevalence of academic "failure" in the high-risk group (31% vs 24%).
• Neonatal seizures were the only predictive perinatal variable.

Conclusions:

• The ability to predict future academic achievement from 5-year-old developmental tests is limited.
• Routine developmental testing for symptom-free preschoolers is not warranted.
• High-risk infant follow-up programs should prioritize the first few years of life.