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Updated: Nov 1, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predictive Value of Developmental Assessment in a Neonatal Intensive Care Unit (NICU) Follow-Up Clinic
Amanda W Kalstabakken1, Stephen J Molitor1, Amy C Gross1
1Department of Pediatrics, University of Minnesota Medical School.
Insights
Early developmental assessments using the Bayley Scales of Infant and Toddler Development (Bayley-III) can predict later intellectual functioning. However, continued monitoring is crucial as early scores do not fully identify all children at risk for cognitive delays.
Area of Science:
- Developmental Pediatrics
- Neurodevelopmental Outcomes
- Child Psychology
Background:
- Neonatal Intensive Care Unit (NICU) Follow-Up programs differ in monitoring duration for child development and neurocognitive outcomes.
- Determining optimal follow-up duration is essential for effective early intervention and support.
Purpose of the Study:
- To explore the early predictive value of a common developmental measure for intellectual functioning in early childhood.
- To inform the necessity of continued monitoring in NICU Follow-Up programs.
Main Methods:
- 209 children with at least two assessments between ages 1-6 years from NICU Follow-Up clinics were studied.
- Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) administered at ages 1 and 2 years.
- Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) administered at age 3+ years.
Main Results:
- Bayley-III scores at age 1 predicted performance at age 2.
- Bayley-III scores at ages 1 and 2 predicted WPPSI-IV performance.
- Prediction strength was moderate; early assessments had adequate specificity but insufficient sensitivity for identifying later cognitive deficits.
Conclusions:
- Ongoing assessment of children with perinatal complications is supported into early childhood.
- Infant and toddler developmental assessments alone are insufficient to identify all children at risk for lower preschool and early school-age cognitive functioning.
Objective:
Neonatal Intensive Care Unit (NICU) Follow-Up programs vary in the duration for which they monitor child development and neurocognitive outcomes. This study explores the early predictive value of a widely used developmental measure for intellectual functioning during early childhood to better inform whether there is value added in continued monitoring.
Methods:
Participants were 209 children who had at least two assessments between the ages of 1 and 6 years old as part of NICU Follow-Up clinic. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) was administered when children were 1 and 2 years old and the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) was administered when children were 3 years and older.
Results:
The Bayley-III at 1 year of age was a significant predictor of Bayley-III performance at age 2. Similarly, Bayley-III at ages 1 year and 2 years were significant predictors of WPPSI-IV performance. Strength of prediction was moderate with the majority of variance unexplained. Exploratory analyses examining whether early developmental abilities as assessed on the Bayley-III could identify patients at risk for poorer WPPSI-IV performance indicated appropriate specificity but inadequate sensitivity.
Conclusions:
This study supports ongoing assessment of children who were born with perinatal complications into at least early childhood. Assessing development only during the infant and toddler years did not sufficiently identify children who went on to have lower cognitive functioning in preschool and the early school years.
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