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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Comparison of Griffiths-II and Bayley-II tests for the developmental assessment of high-risk infants
Ilaria Cirelli1, Myriam Bickle Graz1, Jean-François Tolsa1
1Department of Paediatrics, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
Insights
The Griffiths-II and Bayley Scales of Infant Development (BSID-II) provide comparable neurodevelopmental assessments for high-risk infants. Their scores are interchangeable, offering reliable developmental diagnoses.
Area of Science:
- Pediatric Neurodevelopment
- Neonatal Follow-up Care
- Developmental Diagnostics
Background:
- Preterm birth and neonatal hypoxic ischemic encephalopathy are key risk factors for abnormal neurodevelopment.
- The Griffiths Mental Development Scale-II (Griffiths-II) and Bayley Scales of Infant Development-II (BSID-II) are widely used developmental assessment tools.
- Griffiths-II yields a global development quotient (QD) and five subscale scores, while BSID-II provides a Mental Development Index (MDI) and Psychomotor Development Index (PDI).
Purpose of the Study:
- To compare the developmental diagnoses from the Griffiths-II and BSID-II in high-risk infants.
- To establish the concurrent validity between the two frequently used developmental scales.
- To determine if scores from Griffiths-II and BSID-II are interchangeable for clinical use.
Main Methods:
- Retrospective analysis of 18-month-old high-risk children assessed with both Griffiths-II and BSID-II.
- Paired t-tests and Pearson correlation coefficients were used to assess concurrent validity.
- Receiver operating characteristic (ROC) curves analyzed Griffiths-II performance against BSID-II as the gold standard.
Main Results:
- The study included 61 infants, predominantly preterm (80.3%).
- No significant difference was found between Griffiths-II QD (mean 96.95) and BSID-II MDI (mean 96.21), with high correlation (r > 0.8) and strong validity (AUC = 0.93).
- The Griffiths-II locomotor subscale score was significantly higher than the BSID-II PDI (p<0.001).
Conclusions:
- The Griffiths-II QD and BSID-II MDI scores are interchangeable for assessing neurodevelopment in high-risk infants.
- Both tests provide consistent developmental meaning for individual children.
- These findings support the use of either scale for comparable developmental diagnoses in neonatal follow-up.
Introduction:
Two important risk factors for abnormal neurodevelopment are preterm birth and neonatal hypoxic ischemic encephalopathy. The new revisions of Griffiths Mental Development Scale (Griffiths-II, [1996]) and the Bayley Scales of Infant Development (BSID-II, [1993]) are two of the most frequently used developmental diagnostics tests. The Griffiths-II is divided into five subscales and a global development quotient (QD), and the BSID-II is divided into two scales, the Mental scale (MDI) and the Psychomotor scale (PDI). The main objective of this research was to establish the extent to which developmental diagnoses obtained using the new revisions of these two tests are comparable for a given child.
Material And Methods:
Retrospective study of 18-months-old high-risk children examined with both tests in the follow-up Unit of the Clinic of Neonatology of our tertiary care university Hospital between 2011 and 2012. To determine the concurrent validity of the two tests paired t-tests and Pearson product-moment correlation coefficients were computed. Using the BSID-II as a gold standard, the performance of the Griffiths-II was analyzed with receiver operating curves.
Results:
61 patients (80.3% preterm, 14.7% neonatal asphyxia) were examined. For the BSID-II the MDI mean was 96.21 (range 67-133) and the PDI mean was 87.72 (range 49-114). For the Griffiths-II, the QD mean was 96.95 (range 60-124), the locomotors subscale mean was 92.57 (range 49-119). The score of the Griffiths locomotors subscale was significantly higher than the PDI (p<0.001). Between the Griffiths-II QD and the BSID-II MDI no significant difference was found, and the area under the curve was 0.93, showing good validity. All correlations were high and significant with a Pearson product-moment correlation coefficient >0.8.
Conclusions:
The meaning of the results for a given child was the same for the two tests. Two scores were interchangeable, the Griffiths-II QD and the BSID-II MDI.
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