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Evaluation of the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) in 2 year-old children
Elizabeth Murray1, Michelle Fernandes2,3,4, Charles R J Newton1
1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom.
Insights
The novel INTER-NDA tool accurately assesses early child development in 2-year-olds. It shows good agreement with the BSID-III, demonstrating reliable psychometric properties for developmental screening.
Area of Science:
- Developmental Psychology
- Pediatric Assessment
- Psychometrics
Background:
- Early child development (ECD) assessment is crucial for identifying developmental delays.
- The INTER-NDA is a new, rapid (15-minute) assessment tool for 2-year-olds.
- Validation against established measures like the Bayley Scales of Infant Development III edition (BSID-III) is essential.
Purpose of the Study:
- To evaluate the INTER-NDA's agreement with the BSID-III.
- To determine the sensitivity and specificity of the INTER-NDA.
- To assess the psychometric properties of the INTER-NDA for early child development screening.
Main Methods:
- Eighty-one infants aged 23.1-28.3 months were assessed using both INTER-NDA and BSID-III.
- Interclass correlations, Bland-Altman analyses, and sensitivity/specificity analyses were performed.
- Internal consistency and subscale unidimensionality of the INTER-NDA were evaluated.
Main Results:
- Strong interclass correlations (0.745-0.883) were found between INTER-NDA and BSID-III for cognitive, motor, and behavior scores.
- INTER-NDA showed high sensitivity (100%) and specificity (100%) for identifying very low cognitive scores.
- Over 97% of children scoring in the normal INTER-NDA range also scored normally on the BSID-III.
Conclusions:
- The INTER-NDA demonstrates good agreement with the BSID-III in assessing early child development.
- The INTER-NDA possesses satisfactory psychometric properties for use in children aged 22-28 months.
- This rapid assessment tool shows promise for efficient developmental screening.
Background:
The INTER-NDA is a novel assessment of early child development measuring cognition, language, motor skills, behaviour, attention, and socio-emotional reactivity in 2 year olds in 15 minutes. Here, we present the results of an evaluation of the INTER-NDA against the Bayley Scales of Infant Development III edition (BSID-III), its sensitivity and specificity and its psychometric properties.
Methods:
Eighty-one infants from Oxford, UK, aged 23.1-28.3 months, were evaluated using the INTER-NDA and the BSID-III. The agreement between the INTER-NDA and the BSID-III was assessed using interclass correlations (for absolute agreement), Bland-Altman analyses (for bias and limits of agreement), and sensitivity and specificity analyses (for accuracy). The internal consistency of the INTER-NDA and uni-dimensionality of its subscales were also determined.
Results:
The interclass correlation coefficients between the BSID-III and the INTER-NDA cognitive, motor and behaviour scores ranged between 0.745 and 0.883 (p<0.001). The Bland-Altman analysis showed little to no bias in the aforementioned subscales. The sensitivity and specificity of INTER-NDA cognitive scores ≤1 SD below the mean are 66.7% and 98.6% respectively, with moderate agreement between INTER-NDA and BSID-III classifications (κ = 0.72, p<0.001). The sensitivity and specificity of INTER-NDA scores <2 SD below the mean, in predicting low BSID-III scores (<70), are 100% each for cognition, and 25% and 100% respectively for language. More than 97% of children who scored in the normal range of the INTER-NDA (<1SD below mean) also scored in the normal range in the BSID-III (≥85). The INTER-NDA demonstrates satisfactory internal consistency and its subscales demonstrate good unidimensionality.
Conclusion:
The INTER-NDA shows good agreement with the BSID-III, and demonstrates satisfactory psychometric properties, for the assessment of ECD at 22-28 months.
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