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CAT/CLAMS. A tool for the pediatric evaluation of infants and young children with developmental delay. Clinical
R C Wachtel1, B K Shapiro, F B Palmer
1Department of Pediatrics, University of Maryland School of Medicine, Baltimore.
Insights
Pediatricians can use the Clinical Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) to assess infants and toddlers with suspected developmental delays. This tool offers strong validity, aiding in early diagnosis and referral for developmental concerns.
Area of Science:
- Pediatric developmental assessment
- Child psychology
- Clinical audiology
Background:
- Routine developmental screening is recommended by the American Academy of Pediatrics.
- Pediatricians lack sufficient tools for evaluating developmental concerns identified during screening.
- A need exists for reliable instruments to assess infants and toddlers with suspected developmental delays.
Purpose of the Study:
- To introduce the Clinical Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) as a tool for pediatricians.
- To evaluate the psychometric properties of the CAT/CLAMS for assessing developmental delay.
- To provide pediatricians with a method for comparing language and nonlanguage skills in young children.
Main Methods:
- The CAT/CLAMS was developed to assess infants and toddlers with suspected developmental delay.
- Concurrent validity was assessed by comparing CAT/CLAMS results with the Bayley Scales of Infant Development (BSID) in 43 children (12-19 months).
- Predictive validity was evaluated over 6 and 12 months in the same population.
Main Results:
- The CAT/CLAMS demonstrated strong psychometric properties.
- High concurrent validity was found between CAT/CLAMS and BSID (correlation coefficients 0.63–0.87, P < .001).
- Significant predictive validity was observed at 6 and 12 months (correlation coefficients 0.73–0.77, P = .001).
Conclusions:
- The CAT/CLAMS is a valid and reliable tool for pediatricians to evaluate developmental concerns.
- This scale aids in differentiating language and nonlanguage abilities, supporting diagnosis and referral.
- Integrating CAT/CLAMS into routine care can improve the management of suspected developmental delays in young children.
Abstract:
The American Academy of Pediatrics recommends regular developmental screening as a part of routine child health supervision. However, the pediatrician has a limited number of tools available to further evaluate a child who is found to be suspect or abnormal on a developmental screening test. The Clinical Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) was therefore developed to provide pediatricians with a technique to assess infants and toddlers with suspected developmental delay. The CAT/CLAMS demonstrated strong psychometric properties. Concurrent validity with the Bayley Scales of Infant Development (BSID) was demonstrated in 43 children ages 12 to 19 months who were tested on three occasions with both instruments (correlation coefficient ranging between 0.63 and 0.87; P < .001). Predictive validity 6 and 12 months later was also demonstrated in this population with correlation coefficients ranging between 0.73 and 0.77, significant at the P = .001 level. Utilizing the CAT/CLAMS as part of the pediatrician's evaluation of children with developmental concerns would allow the pediatrician to compare language and nonlanguage problem-solving abilities and, therefore, aid in diagnosis and appropriate referral.
