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Early developmental screening: sensitivity and specificity of chronological and adjusted scores
M C Piper1, L E Pinnell, J Darrah
1Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Insights
Adjusting for prematurity in preterm infants improves motor development assessment at 4 months. This ensures better detection of neurological abnormalities, aiding early intervention and developmental outcomes.
Area of Science:
- Developmental Pediatrics
- Neonatal Neurology
- Motor Development Assessment
Background:
- Preterm infants face higher risks of motor and neurological developmental issues.
- Early and accurate assessment is crucial for timely intervention in preterm infants.
- The Movement Assessment of Infants (MAI) is a tool used to evaluate motor development.
Purpose of the Study:
- To evaluate the effectiveness of the Movement Assessment of Infants (MAI) in assessing motor development in preterm infants.
- To compare the utility of chronological versus adjusted age for MAI assessments.
- To determine optimal MAI cutoff scores for identifying neurological abnormalities.
Main Methods:
- Seventy-five preterm infants were assessed using the MAI at 4 months chronological and 4 months adjusted ages.
- Infants were followed until 18 months for neurological and motor outcome classification by a developmental pediatrician.
- Sensitivity, specificity, and predictive values were calculated for various MAI cutoff scores.
Main Results:
- Adjusting for prematurity at 4 months improved the combined screening rates for detecting neurologically abnormal and abnormal/suspicious children.
- Different MAI cutoff scores were needed to identify neurologically abnormal versus abnormal/suspicious children for comparable rates.
- Optimal assessment performance (sensitivity, specificity, predictive values) varied with assessment age, disorder, and cutoff scores.
Conclusions:
- Adjusted age assessment using the MAI at 4 months enhances the detection of developmental abnormalities in preterm infants.
- The choice of MAI cutoff scores should be tailored to the specific diagnostic goals (e.g., identifying abnormal vs. suspicious outcomes).
- Motor development screening in preterm infants requires careful consideration of age correction and appropriate assessment parameters.
Abstract:
The motor development of 75 preterm infants was assessed at 4 months chronological and 4 months adjusted ages using the Movement Assessment of Infants (MAI). Infants were followed until 18 months old when neurological and motor outcomes were assessed by a developmental pediatrician, and outcomes were classified as normal, suspicious, or abnormal. Sensitivity, specificity, and positive and negative predictive values were calculated at the two points in time using a variety of cutoff MAI scores. At 4 months, the practice of adjusting for prematurity resulted in the better combination of screening rates for the detection of both neurologically abnormal and neurologically abnormal/suspicious children. To obtain comparable rates, different cutoff MAI scores were used to identify the neurologically abnormal versus the neurologically abnormal/suspicious children. The optimal combination of sensitivity, specificity, positive and negative predictive values varies according to the age of assessment, the disorders being identified, and the cutoff scores employed.
