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Predictive value of the Griffiths assessment in extremely low birthweight infants
J R Bowen1, F L Gibson, G I Leslie
1Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Insights
The Griffiths Mental Development Scales at 3 years strongly predict intelligence in extremely low birthweight (ELBW) children at 5 years. This assessment can identify ELBW children needing early intervention before school entry.
Area of Science:
- Developmental Pediatrics
- Neonatal Follow-up
- Child Psychology
Background:
- Extremely low birthweight (ELBW) infants face developmental challenges.
- Early identification of cognitive deficits is crucial for intervention.
- Longitudinal assessment tools are needed for ELBW neurodevelopmental monitoring.
Purpose of the Study:
- To evaluate the predictive validity of the Griffiths Mental Development Scales (GMDS) at 1 and 3 years for later cognitive outcomes.
- To assess the relationship between GMDS scores and the Stanford-Binet Intelligence Scale (S-B) and Beery Test of Visual-Motor Integration (VMI) at 5 years in ELBW children.
- To determine if early GMDS assessments can identify ELBW children requiring intervention.
Main Methods:
- Prospective study of 45 ELBW infants without severe neurosensory impairment.
- Administered GMDS at 1 and 3 years of age.
- Assessed cognitive function using S-B and VMI at 5 years of age.
Main Results:
- At 5 years, 80% of ELBW children had average intelligence, 18% borderline, and 2% mental retardation.
- The GMDS General Quotient (GQ) at 3 years strongly correlated with 5-year IQ (r=0.78).
- A 3-year GQ below -1 SD predicted a 5-year IQ below -1 SD in 67% of cases and an IQ below 89 in all cases.
Conclusions:
- The 3-year GMDS GQ is a robust predictor of 5-year cognitive outcomes in ELBW children.
- GMDS at 3 years can effectively identify ELBW children who may benefit from early intervention.
- This assessment aids in timely support for ELBW children prior to school entry.
Objective:
To assess the relationship between the Griffiths Mental Development Scales at 1 and 3 years and the Stanford-Binet Intelligence Scale (S-B) and Beery Test of Visual-Motor Integration (VMI) at 5 years in extremely low birthweight (ELBW) children.
Methodology:
Prospective study of 45 ELBW infants, without severe neurosensory impairment, cared for in a single Level III neonatal intensive care unit.
Results:
At 5 years, 36 (80%) children were of average intelligence, 8 (18%) had borderline intelligence and one was mentally retarded. The Griffiths general quotient (GQ) at 1 year had a weak correlation with the 5 year IQ (corr. coeff. = 0.47), with only 17% of children with a GQ < -1 s.d. at 1 year receiving an IQ < -1 s.d. at 5 years. In contrast, the Griffiths GQ at 3 years correlated strongly with 5 year IQ (corr. coeff. = 0.78). Among those children with a 3 year GQ < -1 s.d., 67% had a 5 year IQ < -1 s.d. and all had a 5 year 1Q < 89. The 3 year hearing and speech subscale correlated strongly with the 5 year S-B verbal comprehension factor (corr. coeff. = 0.753) and the 3 year combined eye/hand co-ordination/performance quotient had a moderate correlation with the S-B non-verbal reasoning factor (corr. coeff. = 0.597) and with the Beery VMI (corr. coeff. = 0.49).
Conclusions:
The 3 year Griffiths GQ is a good predictor of 5 year S-B IQ in ELBW children and can be used to identify children who may benefit from intervention prior to school entry.