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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predicting neurodevelopmental outcomes for at-risk infants: reliability and predictive validity using a Chinese
1Department of Pediatrics, Xinqiao Hospital, the Third Military Medical University, Chongqing 400037, China.
Insights
The Chinese version of the Infant Neurological International Battery (INFANIB) effectively screens infants for neuromotor abnormalities in primary care. This tool demonstrates high reliability and validity, especially at 10 months, aiding early detection in Chinese settings.
Area of Science:
- Pediatrics
- Neurology
- Developmental Pediatrics
Background:
- Primary care in China faces challenges in infant developmental disorder screening due to high patient loads and limited resources.
- The Infant Neurological International Battery (INFANIB) is a practical tool for assessing neuromotor development in infants aged 0-18 months.
- Developing a culturally adapted version is crucial for effective implementation in diverse healthcare settings.
Purpose of the Study:
- To develop and validate a Chinese version of the Infant Neurological International Battery (INFANIB).
- To assess the reliability and validity of the Chinese INFANIB for screening neuromotor abnormalities in infants.
Main Methods:
- A Chinese version of the INFANIB was created.
- High-risk preterm and full-term infants (n=104) were assessed at 3, 7, and 10 months using the Chinese INFANIB.
- The Peabody Developmental Motor Scale (PDMS) was used concurrently for diagnostic confirmation and cerebral palsy assessment.
Main Results:
- The Chinese INFANIB demonstrated excellent inter- and intraobserver reliability (ICC >0.8) at 3, 7, and 10 months.
- High sensitivity, specificity, and predictive values were observed at 10 months for both preterm and full-term infants.
- Lower validity was noted for detecting abnormalities in preterm infants at or below 7 months of age.
Conclusions:
- The Chinese version of the INFANIB is a reliable and valid tool for screening high-risk infants for neuromotor abnormalities in Chinese primary care.
- The INFANIB shows particular utility at 10 months of age for effective screening.
- This adapted tool can help overcome challenges in developmental disorder screening within resource-limited primary care settings.
Background:
Chinese primary care settings have a heavy patient load, shortage of physicians, limited medical resources and low medical literacy, making it difficult to screen for developmental disorders in infants. The Infant Neurological International Battery (INFANIB) for the assessment of neuromotor developmental disorders in infants aged 0 ~ 18 months is widely applied in community health service centers because of its simplicity, time-saving advantages and short learning curve. We aimed to develop and assess a Chinese version of the INFANIB.
Methods:
A Chinese version of the INFANIB was developed. Fifty-five preterm and 49 full-term infants with high risk of neurodevelopmental delays were assessed using the Chinese version of the INFANIB at 3, 7 and 10 months after birth. The Peabody Developmental Motor Scale (PDMS) was simultaneously used to assess the children with abnormalities and diagnose cerebral palsy. The sensitivity, specificity, positive predictive value and negative predictive value of the scale were calculated.
Results:
At birth, a higher proportion of full-term infants had asphyxia (p < 0.001), brain damage ( p = 0.003) and hyperbilirubinemia ( p = 0.022). The interclass correlation coefficient and intraclass correlation coefficient values for the INFANIB at 3, 7 and 10 months were >0.8, indicating excellent reliability with regard to inter- and intraobserver differences. The specificity, sensitivity, positive predictive value and negative predictive value were high for both high-risk premature infants and full-term infants at the age of 10 months. For premature infants at the age of 7 months or below, INFANIB had low validity for detecting abnormalities.
Conclusions:
The Chinese version of the INFANIB can be useful for screening infants with high-risk for neuromotor abnormality in Chinese primary care settings.
