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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Overestimating neurodevelopment using the Bayley-III after early complex cardiac surgery
Bryan V Acton1, Wayne S G Biggs, Dianne E Creighton
1aDepartment of Psychology, University of Saskatchewan,Saskatoon, Saskatchewan, Canada.
Pediatrics
|September 28, 2011
Summary
The Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) shows higher scores in infants after cardiac surgery compared to the 2nd Edition (BSID-II). This may affect early intervention eligibility for at-risk children.
Area of Science:
- Pediatric neurodevelopmental assessment
- Pediatric cardiac surgery outcomes
Background:
- The Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) is a new neurodevelopmental assessment tool.
- Previous studies indicate higher scores for preterm infants using Bayley-III.
- Neurodevelopmental outcomes after pediatric cardiac surgery using Bayley-III are not well-established.
Purpose of the Study:
- To report Bayley-III scores in infants following complex cardiac surgery.
- To compare Bayley-III results with the Bayley Scales of Infant Development, 2nd Edition (BSID-II) in a subset of these children.
Main Methods:
- A prospective, inception cohort study was conducted with 110 infants surviving complex cardiac surgery between 2004 and 2007.
- The Bayley-III was administered at a mean age of 21 months.
- Analysis of variance and paired-samples statistics were used for comparisons.
Main Results:
- Mean Bayley-III composite scores (CSs) for cognitive, language, and motor domains were 95.9, 90.8, and 93.7, respectively.
- Bayley-III scores were, on average, 6.1 points higher than BSID-II scores in a direct comparison.
- Significant increases in cognitive (10.0 points) and motor (6.9 points) CSs were observed (P <.001 and P = .009, respectively).
Conclusions:
- Caution is advised when interpreting higher Bayley-III scores as solely due to improved acute care.
- The elevated scores may lead to at-risk children no longer qualifying for early developmental interventions.
- Longitudinal studies into school age are necessary to validate the accuracy of early developmental estimates using Bayley-III.
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