Validation of the Brief Developmental Assessment in pre-school children with heart disease

Area of Science:

• Pediatric Cardiology
• Neurodevelopmental Pediatrics
• Developmental Screening Tools

Background:

• Children with heart disease are at increased risk for neurodevelopmental abnormalities.
• Early identification of these abnormalities is crucial for timely intervention.
• Existing assessment tools may not be optimized for use by cardiac teams.

Purpose of the Study:

• To prospectively validate the Brief Developmental Assessment (BDA) as an early recognition tool for neurodevelopmental abnormalities.
• To assess the BDA's utility in children with heart disease within a UK tertiary cardiac center setting.

Main Methods:

• A prospective validation study involving 960 pre-school children with heart disease across five age bands.
• The BDA was compared against the Mullen Scales of Early Learning (MSEL) for inter-rater reliability and external validity.
• Validation thresholds included a correlation coefficient's 95% lower confidence limit above 0.75.

Main Results:

• The BDA was successfully validated in four age bands (infants 4 months and older).
• Validation thresholds were met for inter-rater agreement and correlation with the MSEL.
• The BDA demonstrated sensitivity and specificity between 70-80% for detecting significant developmental delays (MSEL scores >2 SD below mean).
• The BDA was not validated in infants under 4 months.

Conclusions:

• The Brief Developmental Assessment can enhance the quality of neurodevelopmental assessment in children with heart disease.
• Implementation requires a user training package and a guide for managing abnormal results.
• Further research is needed to optimize BDA deployment and management strategies for infants under 4 months.