Pediatric Research and Child Health

Validity of the Best Beginnings Developmental Screen in Former Preterm Infants

Author(s): Brenda T Hussey-Gardner, Abigail McNinch, Alison J Falck, Cynthia F Bearer

Background: Premature infants remain at significant risk for future developmental disabilities; as such, periodic developmental evaluation and early identification of developmental delays are especially important aspects of ongoing care for preterm infants after discharge. However, in-depth assessment can be costly and time consuming. The Best Beginnings Developmental Screen (BBDS) was created to screen former preterm infants for developmental delays, in an inexpensive and rapid manner.
Aims: The purpose of this study was to determine the sensitivity and specificity of the Best Beginnings Developmental Screen (BBDS) to identify infants who are >25% delayed on the Bayley Scales of Infant Development, Second Edition (BSID-II).
Study design: A prospective validation study was conducted to examine 8 different definitions of fail on the BBDS.
Subjects: 81 infants and toddlers born prematurely, and whose chronological ages ranged between 3 and 38 months, participated in the study.
Outcome measures: Children were evaluated using the BBDS and the BSID-II.
Results: Two of the 8 BBDS fail definitions (Definitions 4 and 6) resulted in adequate sensitivity (.95 and .90 respectively) and specificity (.77 and .83 respectively) for identifying children with at least a 25% delay on the BSID-II.
Conclusions: This validation study demonstrates that the BBDS may be a valid screening tool when used with children born prematurely. The following scoring and referral protocol is recommended: refer children who fail Definition 6 for further testing, rescreen children who fail Definition 4 at a closer interval, and rescreen children who pass both at the regular interval.

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