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Published on: August 25, 2014
Predictive validity of the Standardized Infant NeuroDevelopmental Assessment (SINDA) to identify 4-5 year-old
Selena J Rosinda1, Pieter J Hoekstra2, Mijna Hadders-Algra3
1University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Paediatrics, Beatrix Children's Hospital, Division of Developmental Neurology, Groningen, the Netherlands; Accare Child Study Center, Groningen, the Netherlands.
Insights
The Standardized Infant NeuroDevelopmental Assessment (SINDA) has low predictive value for identifying developmental delay in low-risk infants. Further research is needed to determine its utility in general healthcare settings.
Area of Science:
- Pediatric Neurodevelopment
- Developmental Pediatrics
- Infant Assessment
Background:
- Early detection of developmental problems is crucial for timely intervention.
- Previous studies in high-risk infants showed high predictive values for the Standardized Infant NeuroDevelopmental Assessment (SINDA) for neurodevelopmental disorders.
- The utility of SINDA in low-risk populations requires further investigation.
Purpose of the Study:
- To explore the predictive value of the Standardized Infant NeuroDevelopmental Assessment (SINDA) in identifying the risk of developmental delay in low-risk children at 4-5 years of age.
Main Methods:
- A cohort study was conducted with 786 low-risk Dutch children.
- The Standardized Infant NeuroDevelopmental Assessment (SINDA) was administered at 2-12 months.
- Risk of developmental delay was assessed using the Ages and Stages Questionnaire (ASQ) at 4-5 years.
Main Results:
- Atypical SINDA scores showed low sensitivity (12-88%) but high specificity (66-94%) for developmental delay.
- Positive predictive values (PPVs) were low (3-16%), while negative predictive values (NPVs) were high (95-100%).
- Multiple atypical SINDA scores slightly improved predictive values but remained limited.
Conclusions:
- The Standardized Infant NeuroDevelopmental Assessment (SINDA) demonstrates low predictive value for detecting developmental delay in low-risk infants at preschool age.
- Low prevalence of developmental delay in this population may explain the limited predictive accuracy.
- The findings suggest caution in applying SINDA in general pediatric healthcare settings without further validation.
Background:
Early detection of developmental problems is important as it allows for early intervention. Previous studies, in high-risk infants, found high predictive values of atypical scores on the Standardized Infant NeuroDevelopmental Assessment (SINDA) for later neurodevelopmental disorders (i.e., cerebral palsy, intellectual disability).
Aims:
The present study explored SINDA's predictive values to identify risk of developmental delay at 4-5 years.
Study Design:
Cohort study.
Subjects:
786 low-risk Dutch children (367 boys; median gestational age: 40 (27-42) weeks; mean birth weight: 3455 (SD 577) grams).
Outcome Measures:
The SINDA was assessed at 2-12 months and risk of developmental delay was assessed using the Ages and Stages Questionnaire (ASQ) at 4-5 years. SINDA's predictive values were determined for five ASQ domains and the total ASQ score for children at risk of marked (all ASQ domains deviant) and any (one or more ASQ domains deviant) developmental delay.
Results:
Presence of one atypical SINDA scale score showed low to moderate sensitivities (12-88 %, depending on the SINDA scale and ASQ domain involved), moderate to high specificities (66-94 %), low positive predictive values (PPVs; 3-16 %), and high negative predictive values (NPVs; 95-100 %) for children at risk of marked and any developmental. Presence of multiple atypical SINDA scale scores predicted deviant ASQ domains slightly better (sensitivities = 11-62 %, specificities = 90-98 %, PPVs = 6-30 %, and NPVs = 95-100 %).
Conclusions:
In low-risk infants, SINDA's predictive value is low for detecting children at risk of marked and any developmental delay at 4-5 years, as reflected by the low sensitivities. One of the explanations is the relatively low prevalence of developmental delay in low-risk populations. This might have consequences for the application of the SINDA in general healthcare settings (e.g. child health clinics), but further studies are needed to draw this conclusion.
