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Validation of rapid neurodevelopmental assessment instrument for under-two-year-old children in Bangladesh
Naila Zaman Khan1, Humaira Muslima, Dilara Begum
1Child Development and Neurology Unit, Dhaka Shishu (Children's) Hospital, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh. naila.z.khan@gmail.com
Insights
The Rapid Neurodevelopmental Assessment (RNDA) is a reliable and valid tool for assessing neurodevelopment in young children. It aids early identification of impairments in developing countries.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Global Health
Background:
- Early identification of neurodevelopmental impairments is crucial for intervention.
- Developing countries face challenges in accessing specialized expertise for child assessments.
- A reliable and valid assessment tool is needed for multidisciplinary professionals in resource-limited settings.
Purpose of the Study:
- To determine the reliability and validity of the Rapid Neurodevelopmental Assessment (RNDA).
- To assess its suitability for use by multidisciplinary professionals in developing countries for children aged 0-24 months.
Main Methods:
- The Rapid Neurodevelopmental Assessment (RNDA) was developed to evaluate functional status across multiple domains.
- Reliability was assessed with 8 professionals across 80 children (aged <3 months and 3-24 months).
- Validity was determined by comparing RNDA results with the Bayley Scales of Infant Development II in 115 children.
Main Results:
- The RNDA demonstrated good to excellent reliability among professionals across different age groups and domains.
- Concurrent validity was good, with lower scores for children identified with impairments.
- Discriminant validity was good, identifying more impairments in disadvantaged communities.
Conclusions:
- The RNDA is a reliable and valid tool for assessing neurodevelopmental status in children under 2 years.
- It can be utilized by professionals with diverse backgrounds in developing countries.
- Findings support early identification and intervention for neurodevelopmental impairments in large populations.
Objective:
The objective of this study was to determine the reliability and validity of a comprehensive assessment procedure for ascertaining neurodevelopmental status of children aged 0 to 24 months for use by multidisciplinary professionals in a developing country.
Methods:
We developed the Rapid Neurodevelopmental Assessment (RNDA) to determine functional status in the following domains: primitive reflexes, gross motor, fine motor, vision, hearing, speech, cognition, behavior, and seizures. Reliability was determined for 50 children who were aged <3 months and 30 children who were aged > or =3 to 24 months and were administered the RNDA by 8 different professionals (3 physicians, 4 therapists, and 1 special teacher). Validity was determined on 34 children aged <3 months in hospital and 81 children aged > or =3 to 24 months in urban (n = 47) and rural (n = 34) community-based populations by any 1 of the 8 professionals, with simultaneous administration of the adapted Bayley Scales of Infant Development II by a psychologist as the gold standard.
Results:
Mean kappa coefficients of agreement among professionals in overall and individual domains in the 2 age groups ranged from good to excellent. For both younger and older children, there was good concurrent validity (ie, significantly lower mean Mental Development Index and Psychomotor Development Index scores) for children with > or =1 neurodevelopmental impairment and for children with impairments in most functional domains, compared with children with no impairments. Significantly more impairments were found in children from disadvantaged compared with socioeconomically more advantaged communities, indicating good discriminant validity.
Conclusions:
The RNDA can be used by professionals from a range of backgrounds with high reliability and validity for determining functional status of children who are younger than 2 years. The study findings have important practical implications for early identification and intervention to mitigate neurodevelopmental impairments in large populations that live in developing countries where professional expertise is sparse.
