Journal of Pediatric Psychology 29(5) pp. 321-330, 2004
Journal of Pediatric Psychology vol. 29 no. 5 © Society of Pediatric Psychology 2004; all rights reserved
Use of the Bayley Infant Neurodevelopmental Screener with an Environmental Risk Group
1 Department of Psychology, University of Maryland, Baltimore County, and 2 Department of Pediatrics, University of Maryland School of Medicine
All correspondence should be sent to Maureen Black, Department of Pediatrics, University of Maryland School of Medicine, 655 W. Lombard Street, Suite 311, Baltimore, Maryland 21201. E-mail: mblack{at}umaryland.edu
Objective To determine predictive validity of the Bayley Infant Neurodevelopmental Screener (BINS) during the first 2 years of life with a group of children at risk for developmental delay due to environmental risk factors. Method The setting consisted of home visits to participants. The BINS was administered to 106 children, ages 6 and 13 months, of low-income, African American, adolescent mothers. Three risk groups were identified: low, moderate, and high. The Bayley Scales of Infant Development, second edition (BSID-II), were administered at 24 months and served as the criterion standard. A cut score of 85 (1.00 SD below mean) represented a clinically meaningful indicator of delayed development on the mental and psychomotor developmental indices, as well as a composite of these indices. Two other cut scores on the BSID-II were also included for comparison: 90 (0.75 SD below mean) and 77 (1.50 SD below mean). Results Using BSID-II scores at 24 months as the criterion measure, 6- and 13-month BINS scores yielded low sensitivity values but high specificity values, regardless of how BINS risk groups were defined and which cut points on the BSID-II were used. Positive predictive value was higher when the cut score was set below 90 than when it was set below 85. Conclusions Low predictive validity of the BINS with an environmental risk group highlights the difficulties inherent in developmental screening among infants who have environmental, but not biological, risk factors. Because infants at environmental risk tend to experience developmental declines after infancy, it may be beneficial for primary care providers to use psychosocial screening tools to identify which children need closer monitoring and referral to enrichment programs to prevent developmental declines during toddlerhood.
Key words: environmental risk; predictive validity; Bayley Infant Neurodevelopmental Screener; child development; African American; low income; infant of adolescent parent.
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