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Preliminary analysis of developmental observations in a survey of morbidity in infants
Insights
A brief home-based developmental assessment by trained lay interviewers is feasible for one-year-old infants, including those of low birthweight. This method shows reliable results for assessing infant development and can aid in designing follow-up programs.
Area of Science:
- Developmental Pediatrics
- Public Health
- Infant Health Monitoring
Background:
- Assessing developmental status is crucial for evaluating early infant health programs.
- Identifying severe developmental disability is a key outcome measure.
- Home-based assessments offer a practical approach for large-scale surveys.
Purpose of the Study:
- To evaluate the feasibility of using a brief developmental observation battery by lay interviewers in the home.
- To assess the reliability and validity of this method for one-year-old infants, particularly those of low birthweight.
- To determine its utility in large-scale infant morbidity surveys.
Main Methods:
- Conducted a large-scale survey involving 4989 home visits to one-year-old infants.
- Utilized trained lay interviewers to administer a brief battery of developmental observations.
- Assessed reliability through internal consistency (coefficient alpha, item-total correlations) and inter-rater agreement on a subsample (n=137).
- Compared developmental status classifications with maternal interview data on health and diagnostic variables.
Main Results:
- High cooperation rates were achieved from infants in the home setting.
- Reliability was sufficient for research purposes for most observations, excluding receptive language items.
- Good agreement was observed between interview data and the developmental status classification.
- The method proved feasible for assessing developmental status in a large cohort, including low birthweight infants.
Conclusions:
- Home-based developmental assessments by trained lay interviewers are a feasible and reliable tool for infant follow-up programs.
- This approach can effectively identify developmental status and aid in the evaluation of perinatal and early infant health interventions.
- Further refinement, particularly for language assessments, may enhance its utility.
Abstract:
Assessment of developmental status, particularly the identification of severe developmental disability, is an important outcome measure of the effect of many types of perinatal and early infant health programs. This report examines the feasibility of the use of a brief battery of developmental observations by a trained lay interviewer in the home as part of a large-scale survey of morbidity in one-year-old infants. A total of 4989 home visits was completed, and of these 3179 were to infants of low birthweight. The interviewers obtained a high degree of cooperation from the infants in this setting. Internal consistency, as measured by coefficient alpha and item-total score correlations, and inter-rater agreement for each observation on a small random sample (137) of revisits indicated reliability sufficient for research purposes for all except receptive language items. Good agreement was found between diagnostic and health are variables obtained through the interview with the mother and a developmental status classification based on the observations. While preliminary, these results are of importance in the design of infant follow-up programs.