Assessment Of The Application Of Bayley Scales Of Infant Development-3^rd Edition-Screening Test

BackgroundTo preliminarily examine the reliability and validity of Bayley Scale of Infant and Toddler Development-3rd Edition-Screening Test(Bayley-Ⅲ Screening Test),make an analysis of its predictability on the neurobehavioral development outcome and discuss the feasibility of its utility in China and to provide clues for early screening and intervention of Developmental and Behavioral Disorders.And to provide clues for alleviating the current shortage of pediatric medical resources in China.Objects and Methods(1)A total of 2646 infants and toddlers aged from 0 to 18 months old were selected and tested in a maternal and children’s hospital in one district of Shanghai.The Cronbach α coefficient and Guttman Split-half coefficient were used to determine the internal reliability.Pearson correlation coefficient was used to evaluate the correlations between the subtests.The Intra-class Coefficient(ICC)was used to analyze the inter-rater reliability.(2)A total of 1073 infants aged from 0 to 18 months were included the above research point and were evaluated with both Bayley-Ⅲ Screening Test and ASQ-3.Item-level Content Validity Index(I-CVI)and one-way ANOVA were used to analyze the content validity and criterion-related validity.The Mann-Kendall trend test was performed to assess trends of behavior development,and post-hos Least Significant Difference test to compare the means of scores between two adjacent age group.(3)A total of 203 newborns born during October 2016 ~March 2017 in Shanghai First Maternal Children’s Hospital were selected in the cohort,and were tested with Bayley-Ⅲ Screening Test at 42 days after birth and 4-month(calculate corrected age for preterm infants).Bayley-Ⅲ diagnostic(Bayley Scale of Infant Development-3rd Edition,Bayley-Ⅲ)were performed at 6-month age(calculate corrected age for preterm infants)to evaluate neuro-behavioral development.The Pearson Correlation Coefficient was used to test the correlation of Bayley-Ⅲ Screening Test and the neuro-behavioral developmental outcomes.Results(1)The overall Cronbach’s α coefficient was 0.979(p<0.01).The Cronbach’s αcoefficient of the five subtests were 0.972~0.980.Pearson correlation coefficient was> 0.9(p <0.01)and Guttman Split-half coefficient was 0.963.The ICCs of each subtest were all above 0.8(p <0.01).(2)The I-CVIs of the five subtests were between 0.920 and 0.982 and the average I-CVI was 0.954.The scores of each subtest showed an increasing trend across age,female’s Receptive Communication scores decreased in the first two adjacent age groups but showed no statistical significance(p=0.487).In the three risk categories(normal,emerging and abnormal)of ASQ-3,Bayley-Ⅲ Screening’s Cognitive,Receptive Communication and Expressive Communication scores showed significantly difference between each other(p<0.05).However,the Fine Motor and Gross Motor subtests were inconsistent with the ASQ-3 categories.(3)At 42-day’s age,Fine Motor subtest(r=0.181,p <0.01)and Gross Motor subtest(r=0.155,p <0.05)showed associations with the 6-month’s cognitive DQ.Fine Motor subtest(r=0.153,p <0.05)and Gross Motor subtest(r=0.160,p <0.05)showed associations with the 6-month’s motor DQ.4-month’s Receptive Communication(r=0.253),Expressive Communication(r=0.230),Fine Motor(r=0.221)subtests showed significant correlations with the 6-month’s cognitive DQ(p <0.01),Fine Motor(r= 0.327)and Gross Motor(r=0.219)subtests showed significant correlations with the 6-month’s motor DQ(p <0.01).There was also associations between 4-month’s Gross Motor subtest and 6-month’s cognitive DQ(p <0.05).Conclusions(1)Bayley-Ⅲ Screening Test showed good internal and external reliability in 2646 infants aged from 0-18 months,indicating a good measurement stability of the Chinese version.(2)Bayley-III Screening Test showed satisfactory content validity and can well reflects the cognitive-motor development of corresponding age.The Cognitive,Receptive Communication and Expressive Communication subtests showed good criterion-related validity.The Receptive and Expressive Communication subtests need further study and revision due to the cross-cultural difference.(3)Fine Motor and Gross Motor at 42 days after birth have a certain predictive value of 6-month’s neurological-behavioral outcomes(cognitive-motor ability);Receptive Communication,Expressive Communication,Fine Motor and Gross Motor at 4-month age have a certain predictive value of 6-month’s neurological-behavioral outcomes.As a reliable early screening tool,Bayley III Screening Test is worth further studying and popularizing in China and developing Chinese norms.