Related Experiment Videos
Infant screening: the usefulness of the Bayley Infant Neurodevelopmental Screener and the Clinical Adaptive
M M Macias1, C F Saylor, M K Greer
1Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA.
Insights
The Bayley Infant Neurodevelopmental Screener (BINS) shows good sensitivity for identifying developmental issues in high-risk infants. However, the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) has poor sensitivity, cautioning its use for early detection.
Area of Science:
- Neonatal screening
- Developmental pediatrics
- Infant neurodevelopment
Background:
- High-risk infants require accurate developmental screening tools.
- Premature birth and perinatal insults increase the risk of developmental delays.
- Existing screening tools may have limitations in sensitivity or specificity.
Purpose of the Study:
- To evaluate the diagnostic utility of the Bayley Infant Neurodevelopmental Screener (BINS) and the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS).
- To compare the sensitivity and specificity of BINS and CAT/CLAMS in a high-risk infant population.
- To inform clinical practice regarding the selection of appropriate screening instruments for early identification of developmental problems.
Main Methods:
- A cohort of 78 infants with a history of premature birth and/or perinatal insults was assessed.
- The Bayley Infant Neurodevelopmental Screener (BINS) and CAT/CLAMS were administered.
- Results were correlated with the Bayley Scales of Infant Development-II.
- Sensitivity and specificity analyses were performed using varying cutoffs.
Main Results:
- Both BINS and CAT/CLAMS demonstrated high correlation with the Bayley Scales of Infant Development-II.
- BINS achieved optimal sensitivity (90%) at high or moderate referral scores.
- CAT/CLAMS exhibited excellent specificity (95%-98%) but poor sensitivity (5%-36%).
Conclusions:
- The BINS appears more suitable for early identification of developmental problems in high-risk infants due to its higher sensitivity.
- The CAT/CLAMS, despite high specificity, is less effective as a primary screening tool for early detection due to its low sensitivity.
- Clinicians should exercise caution when using CAT/CLAMS for primary screening, pending clarification of optimal cutoff scores.
Abstract:
We assessed the usefulness of the Bayley Infant Neurodevelopmental Screener (BINS) and the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) for screening high-risk infant populations in a sample of 78 infants followed after premature birth and/or perinatal insults. Both measures were highly correlated with the Bayley Scales of Infant Development-II, but sensitivity and specificity analyses revealed disparities related to the tests administered and the cutoffs used. The BINS had optimal sensitivity (true positives) of 90% when referral was made for a BINS score of high or moderate. The CAT/CLAMS had excellent specificity (true negatives) of 95% to 98% but poor sensitivity (5%-36%). Until the cutoff issue can be clarified, clinicians should be cautious in using the CAT/CLAMS as the primary screening instrument in settings in which early identification of infants with developmental problems is the main goal.