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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Can parents accurately screen children at risk of developmental delay?

Glenys Dixon1, Nadia Badawi, Davina French

  • 1Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Subiaco, Western Australia. glenysd@ichr.uwa.edu.au

Journal of Paediatrics and Child Health
|June 5, 2009
PubMed

Insights

The Infant/Child Monitoring Questionnaire (IMQ) effectively screens high-risk infants for developmental delay. However, its low sensitivity in the general population suggests caution for widespread screening.

Area of Science:

  • Developmental Pediatrics
  • Neonatal Neurology
  • Screening Tool Validation

Background:

  • Developmental delay affects a significant number of infants, necessitating reliable early screening methods.
  • High-risk populations, such as those with newborn encephalopathy (NE), require accurate tools to identify potential developmental issues.
  • The Infant/Child Monitoring Questionnaire (IMQ) is a parent-completed tool proposed for developmental screening.

Purpose of the Study:

  • To assess the validity and utility of the parent-completed Infant/Child Monitoring Questionnaire (IMQ) for screening developmental delay in high-risk infants.
  • To compare the IMQ's performance against a standardized developmental assessment in a cohort of infants with and without high-risk factors.

Main Methods:

  • One hundred forty-one term infants with moderate to severe newborn encephalopathy (NE) and 374 comparison infants underwent concurrent Griffiths Mental Development Scales (GMDS) assessment and IMQ.
  • Key performance metrics including agreement, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.
  • Concordance between IMQ classifications and GMDS assessments was analyzed across different age groups.

Main Results:

  • For infants with NE, the IMQ demonstrated high sensitivity (87%) and negative predictive value (97%), with a positive predictive value of 57%.
  • In the comparison group, IMQ sensitivity was lower (50%), though specificity (94%) and negative predictive value (99%) remained high.
  • Under-referral rates were 13% for infants with NE versus 50% for comparison infants.

Conclusions:

  • The IMQ is supported as an accurate screening measure for infants identified as 'at risk' for developmental delay.
  • Caution is advised regarding the IMQ's application for general population screening due to its lower sensitivity in non-high-risk infants.
  • The findings highlight the IMQ's potential value in targeted screening programs for vulnerable infant populations.
Abstract

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