A15. Assessing Early Developmental Functioning of Children Born Premature. Session Summary. Session Objectives. References

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1 A15 Assessing Early Developmental Functioning of Children Born Premature Doug Bodin, PhD, ABPP/CN Pediatric Neuropsychologist Nationwide Children s Hospital Assistant Clinical Professor of Pediatrics Ohio State University College of Medicine, Columbus, OH The speaker has signed a disclosure form and indicated he has no significant financial interest or relationship with the companies or the manufacturer(s) of any commercial product and/or service that will be discussed as part of this presentation. Session Summary The speaker will provide a review of several commonly used instruments designed to measure early childhood development. Particular attention will be paid to the conceptual and practical aspects of evaluating infants and toddlers. Session Objectives Upon completion of this presentation, the participant will: understand conceptual and practical issues in assessing infants and toddlers; be able to state commonly used tests. References Bayley, N. (2006). Bayley scales of infant and toddler development (3 rd ed.). San Antionio, TX: PsychCorp. Burns, T.G., VanWinkle, A., Gordon, S. & Bodin, D. (2006). Clinical sensitivity of the Mullen scales of early learning in a neurological population. The Clinical Neuropsychologist, 20(2): 211. Elliott, C.D. (2007). Differential ability scales (2 nd ed.). San Antionio, Tx: PsychCorp. Hack, M., et al. (2005). Poor predictive validity of the Bayley scales of infant development for cognitivie function of extremely low birth weight children at school age. Pediatrics, 116(2): Johnson, S. & Marlow, N. (2006). Developmental screen or developmental testing? Early Human Development, 82: Lichtenberger, E.O. (2005). General measures of cognition for the preschool child. Mental Retardation & Developmentlal Disability Research Reviews, 11: Mullen E.M. (1995). Mullen scales of early learning, AGS edition. Minneapolis, MN: Pearson. Roid, G.H. (2003). Stanford-Binet intelligence scales (5 th ed.). Rolling Meadows, IL: Riverside Publishing. A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 1 of 9

2 Salt, A. & Redshaw, M. (2006). Neurodevelopmental follow-up after preterm birth: Follow-up after two years. Early Human Development, 82: Session Outline See presentation handout on the following pages. A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 2 of 9

3 Primary questions Assessing early developmental functioning of children born premature Doug Bodin, Ph.D., ABPP/CN 1. What are the short-term and long-term consequences of premature birth on development? How do we measure development in these kids? 2. How can we identify those children at greatest risk for poor outcomes so that we can recommend appropriate p services? Can our tests predict outcomes? Outline Methods of developmental assessment Psychometrics Common tests Case examples Methodological Issues Types of assessments Screener vs detailed assessment Observational assessment Caregiver ratings Methodological Issues What are we testing? Development vs Intelligence When/how often to test? Correction for prematurity Outline Methods of developmental assessment Psychometrics Common tests Case examples A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 3 of 9

4 Psychometrics Standardized administration Norm referenced scores Norm referenced Scores Z-scores Mean = 0 Standard deviation = + 1 T scores Mean = 50 Standard deviation = 10 Norm referenced Scores Standard scores (IQ/composite scores) Mean = 100 Standard deviation = 15 Scaled scores Mean = 10 Standard deviation = 3 Percentile % of scores that fall at or below a given test score Mean = 50 th percentile Reliability Internal consistency Test-retest reliability Inter-rater reliability Psychometrics Validity Content validity Construct validity Concurrent validity Predictive validity Psychometrics A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 4 of 9

5 Outline Methods of developmental assessment Psychometrics Common tests Case examples Common Developmental Tests Bayley Scales of Infant Development 3 rd edition Mullen Scales of Early Learning Griffiths Mental Development Scales Extended Revised Battelle Developmental Inventory- 2 nd edition Common Early Childhood IQ tests Wechsler Preschool and Primary Scales of Intelligence 4 th edition (WPPSI-IV) Stanford Binet Scales of Intelligence 5 th edition (SB-V) Differential Ability Scales 2 nd edition (DAS-2) Bayley Scales of Infant Development-III Last updated in month 42 months minutes Domains Cognitive Tasks administered to the child Language Motor Social Emotional Caregiver questionnaire Adaptive Bayley Scales of Infant Development Bayley-III Manual suggests correction for prematurity up to 24 months Questionable predictive utility Hack et al (2005) Ramos et al (2010) A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 5 of 9

6 Mullen Scales of Early Learning AGS edition Last updated in 1995 Birth 5 years, 8 months Domains: Gross Motor (< 33 months) Fine Motor Visual Reception Receptive Language Expressive Language Early Learning Composite Mullen Scales of Early Learning Mullen More commonly used in Autism population Some support for sensitivity in neurological populations Burns et al. (2006) Griffiths Mental Development Scales Extended revised version 2006 Birth to 23 months minutes Domains: Locomotor Personal-social Hearing and language Eye and Hand Coordination Performance Developmental quotient Griffiths Mental Development Scales Griffiths Scales Used mostly in Europe Variable predictive utility Better at predicting nonverbal skills A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 6 of 9

7 Battelle Developmental Inventory- 2 nd edition Battelle Developmental Inventory -2 Birth 7 yrs 11 months minutes Domains Personal-social Adaptive Motor Communication Cognitive ability Battelle Developmental Inventory -2 Primarily used in Autism and Intellectual disability populations Not much evidence for predictive utility in LBW population WPPSI-IV 2012 Ages minutes Domains Full Scale IQ Verbal Comprehension Index Visual Spatial Index Working Memory Processing speed WPPSI-IV WPPSI-IV Strong reliability and validity Strong predictor of school performance Often used as an outcome measure in LBW A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 7 of 9

8 Stanford Binet 5 th edition Stanford Binet yrs 85 yrs minutes Domains Full Scale IQ Nonverbal IQ Verbal IQ Fluid Reasoning index Knowledge index Quantitative reasoning index Visual spatial index Working Memory index Stanford Binet 5 Strong psychometric properties Frequently used in autism and low IQ populations Less often used in LBW populations Differential Ability Scales 2 nd edition years 6 months 17 years 11 months Early Years battery General Conceptual Composite (not IQ) Verbal Ability Nonverbal Ability School age battery General Conceptual Composite Verbal Ability Nonverbal Reasoning Ability Spatial Ability DAS-2 DAS -2 Not much research on predictive utility Gaining wider use in clinical settings A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 8 of 9

9 Primary questions Case Examples 1. What are the short-term and long-term consequences of premature birth on development? How do we measure development in these kids? Screening instruments Standardized assessments 2. How can we identify those children at greatest risk for poor outcomes so that we can recommend appropriate services? Can our tests predict outcomes? Maybe? Screeners IQ tests A15: ASSESSING EARLY DEVELOPMENTAL FUNCTIONING OF CHILDREN BORN PREMATURE Page 9 of 9