A Parent Questionnaire for Developmental Screening in Infants Born Late and Moderately Preterm

Abstract

BACKGROUND: The Parent Report of Children’s Abilities-Revised (PARCA-R) is a questionnaire for assessing cognitive and language development in very preterm infants. Given the increased risk of developmental delay in infants born late and moderately preterm (LMPT; 32–36 weeks), this study aimed to validate this questionnaire as a screening tool in this population. METHODS: Parents of 219 children born LMPT completed the PARCA-R questionnaire and the Brief Infant Toddler Social and Emotional Assessment when children were 24 months corrected age (range, 24 months–27 months). The children were subsequently assessed by using the cognitive and language scales of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). RESULTS: An average Bayley-III, cognitive and language (CB-III) score and a total PARCA-R Parent Report Composite (PRC) score were computed. There was a large association between PRC and CB-III scores (r = 0.66, P < .001) indicating good concurrent validity. Using Youden index, the optimum PARCA-R cutoff for identifying children with moderate/severe developmental delay (CB-III scores < 80) was PRC scores < 73. This gave sensitivity 0.90 (95% confidence interval: 0.75–1.00) and specificity 0.76 (95% confidence interval: 0.70–0.82), indicating good diagnostic utility. Approximately two-thirds of the children who had a PRC score < 73 had false-positive screens. However, these children had significantly poorer cognitive and behavioral outcomes than children with true negative screens. CONCLUSIONS: The PARCA-R has good concurrent validity with a gold standard developmental test and can be used to identify LMPT infants who may benefit from a clinical assessment. The PARCA-R has potential for clinical use as a first-line cognitive screening tool for this sizeable population of infants in whom follow-up may be beneficial.

Parent ratings of child cognition and language compared with Bayley-III in preterm 3-year-olds

“…Our findings are consistent with other studies of the PARCA-R at age two years (6,8,14) and the PARCA3 at three years (7) . Of particular importance is that a number of studies, which have been conducted on different populations and using different individuallyadministered tests, provide evidence of the convergent validity of using the PARCA together with a vocabulary questionnaire to assess cognitive development of preschool-aged children.…”

“…Other preterm infants can be categorised in moderate (born 32 to 33 weeks gestation (10,11) ), and late-preterm or mild-preterm (born at 34 to 36 weeks gestation (10,11) ). Modified versions of the PARCA-R displayed concurrent validity with the Bayley Scales of Infant Development-II Mental Development Index in very preterm (12) , moderate preterm (13) , as well as late and moderately preterm toddlers (14) at age two years. Finally, the PARCA3 has been reported to correlate with the McCarthy Perceptual, Performance and Quantitative scales assessed concurrently at age 3 years (7) .…”

“…The results also suggest that the PARCA3 parental report may be used to assess the cognitive development of children born pre-term when aged 3 years. Other studies have provided evidence of the PARCA-R validity in assessing cognitive development of pre-term children at 2 years of age (12)(13)(14) . Overall, results from our study and these other studies suggest that parental assessments may be meaningfully used to monitor trajectories of cognitive development of pre-term children across early childhood.…”

Correcting for prematurity affects developmental test scores in infants born late and moderately preterm

“…Of the remaining 141 children not recruited, the parents of 49 (35%) declined to participate and for 92 (65%) children assessments could not be scheduled within the study period. An analysis of non-responders previously reported [22] showed that there were no significant differences between the sample recruited to LAMBS-II (n=253) and the rest of the LMPT cohort (n=860) in terms of sex (p=0.63), gestational age (p=0.81) and birth weight (p=0.67); however, the 253 infants recruited to LAMBS-II were less likely to be multiple births (p <0.001) and had a lower level of socio-economic deprivation (p <0.001) compared with the rest of the LMPT birth cohort.…”

The Verbal & Non-Verbal Communication Screening Checklist for Persian Speaking Children From 12 to 24 Months and Its Validity and Reliability

“…For example, the Parent Report of Children's Abilities-Revised (PARCA-R) is a questionnaire for clinical use. The validity of PARCA-R was reported by Blaggan et al [2]. Scherer and D'Antonio reported the efficacy of the parent questionnaire for screening early language development in children with cleft palate.…”