Are the Norms of Bayley Screening Test Appropriate for Persian Language Children?
Farin Soleimani1, Nadia Azari1, Roshanak Vameghi1
1Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Insights
Using the Bayley screening test for Persian children revealed misclassification risks when relying on standard norms. This highlights the need for culturally relevant developmental screening tools to accurately identify at-risk infants.
Area of Science:
- Pediatric developmental assessment
- Child psychology and development
- Public health and epidemiology
Background:
- Developmental disabilities significantly impact children's functional abilities.
- Early identification of developmental risks is crucial for timely intervention and minimizing complications.
- Standardized developmental screening tools require validation across diverse linguistic and cultural populations.
Purpose of the Study:
- To evaluate the age-specific distribution of the Bayley screening test results in Persian children.
- To compare developmental risk category classifications between Persian children and established reference norms.
- To assess the accuracy of using international norms for developmental screening in a non-English speaking population.
Main Methods:
- A sample of 417 children aged 1-42 months in Tehran, Iran, were assessed using the Bayley screening test.
- Cognitive, language, and motor development were evaluated.
- Risk categories (at-risk, emerging, competent) were determined using established cut-off points, and agreement was measured with weighted kappa statistics.
Main Results:
- Approximately 70%-80% of children were classified as normal by both Persian and reference norms.
- Moderate agreement (kappa 0.56-0.89) was found between classification norms.
- Expressive and receptive communication showed the lowest agreement (kappa 0.56, 0.59), while gross motor skills had the highest (kappa 0.89).
Conclusions:
- Reliance on reference-based norms for the Bayley screening test in Persian children can lead to misclassification of developmental risk.
- Developmental screening requires culturally and linguistically appropriate norms for accurate assessment.
- Further research is needed to establish culturally adapted Bayley norms for the Persian population.
Objective:
We aimed to assess the distribution of the Bayley screening test by age, and compare developmental risk category distributions between Persian language children and reference norms.
Materials & Methods:
A representative sample of 417 children, 1 to 42-months-old, by consecutive sampling from health -care centers were enrolled, during 2014 to 2015 in Tehran, Iran. The cognitive, language and motor development of children were evaluated using Bayley screening test. For determining cut-off point for the subtest scores, two cut-offs were determined for each age group, that classified children to the at risk, emerging, and competent categories. We estimated the agreement of the risk categories between the two samples using weighted kappa statistics.
Results:
About 70%-80% of all tests operated to the participating children were classified as normal by both norms. Weighted kappa coefficients for the five subtests ranged from 0.56 to 0.89 suggesting moderate agreement between two classification norms. Expressive and receptive communication had the lowest kappa scores (0.56 and 0.59, respectively), and classification of gross motor revealed the highest level of agreement (0.89).
Conclusion:
Developmental disabilities are common disorders that impose important functional limitations on the affected children. Identifying infants at risk for developmental disorders by screening is a main step to minimize complications. Dependence on reference-based norms for the Bayley screening test in Persian language children results in misclassification of risk category.
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