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The predictive validity of HINE, Bayley, general movements and MOS-R in infancy
Michelle Jackman1, Catherine Morgan2, Carly Luke3
1Cerebral Palsy Alliance Research Institute, PO Box 171, Forestville, NSW 2087, Australia; John Hunter Children's Hospital, Lookout Rd, New Lambton Heights, NSW 2305, Australia; University of Sydney, Faculty of Medicine and Health, Camperdown, NSW 2006, Australia.
Insights
Early screening tools like the Hammersmith Infant Neurological Examination (HINE) and Motor Optimality Score - Revised (MOS-R) can help identify surgical infants at risk for developmental delays. These tools show promise in guiding early intervention for cognitive support.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Neonatal surgery
Background:
- Infants undergoing surgery for congenital anomalies face heightened risks of developmental delays.
- Early identification of at-risk infants is crucial for timely intervention.
- This study evaluated the predictive accuracy of key developmental assessments in this population.
Purpose of the Study:
- To assess the concurrent predictive validity of the General Movements Assessment (GMA), Motor Optimality Score - Revised (MOS-R), Hammersmith Infant Neurological Examination (HINE), and Bayley Scales of Infant Development, Third Edition (Bayley-III).
- To identify which assessments are most effective in predicting adverse neurodevelopmental outcomes at 1 year in infants with surgical congenital anomalies.
Main Methods:
- A retrospective cohort study included 95 infants who had surgery for congenital anomalies.
- Assessments (GMA, MOS-R, HINE, Bayley-III) were administered at 3 months corrected age.
- Developmental outcomes were evaluated at 1 year using the Bayley-III; logistic regression analyzed predictive validity.
Main Results:
- All tested assessments demonstrated a correlation with 1-year developmental outcomes.
- Combining assessments did not enhance predictive value.
- MOS-R scores below 23 or HINE scores below 60 showed over 70% sensitivity for detecting delays in two or more Bayley-III domains and over 80% accuracy in identifying infants not at risk.
Conclusions:
- While overall concurrent predictive validity was low, the HINE and MOS-R show potential for identifying infants needing cognitive support.
- These findings suggest that HINE and MOS-R may aid in targeting early intervention for surgical infants.
- Further research into early screening tools is recommended to optimize identification of infants benefiting from early intervention.
Introduction:
Infants born with congenital anomalies requiring surgery are at greater risk of developmental delays. Early screening tools are needed to identify infants who would benefit from early intervention. This study aimed to investigate the concurrent predictive validity of the General Movements Assessment (GMA), Motor Optimality Score - Revised (MOS-R), Hammersmith Infant Neurological Examination (HINE) and Bayley-III in identifying infants at risk of adverse neurodevelopmental outcomes.
Methods:
A retrospective cohort study of 95 surgical infants. Participants were assessed at 3 months using the GMA, MOS-R, HINE, and Bayley-III. Development was assessed at 1 year using the Bayley-III. Logistic regression investigated the relationship between measures at 3 months and developmental outcome, using sensitivity, specificity, positive (PPV) and negative (NPV) predictive value and area under the ROC curve (AUC).
Results:
All assessments had a relationship with development. Combining assessments at 3 months did not increase predictive value. MOS-R < 23 or HINE<60 had >70 % sensitivity for identifying delays in ≥2 domains of the Bayley-III at 1 year, and > 80 % accuracy in ruling out infants not at risk. MOS-R < 23 (NPV 0.957), and HINE <60 (NPV 0.971) were significantly correlated with delayed cognition.
Discussion:
In a surgical cohort, the concurrent predictive validity of the GMA, MOS-R, HINE and Bayley-III, administered at 3 months of age was low, however all assessment tools showed correlations with outcomes. The HINE and MOS-R might help to identify infants who need support with cognition. Further exploration of early screening tools may help to identify infants who would benefit from early intervention.
