Predictive Value of the BSID-II and the Bayley-III for Early School Age Cognitive Function in Very Preterm Infants

Abstract

Objective: To compare the predictive validity of the Bayley Scales of Infant Development, Second Edition (BSID-II) and the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) for cognitive function at early school age in very preterm infants. Methods: Seventy-seven former preterm infants (born <32 weeks gestation and ≤2000 g) completed both the BSID-II and the Bayley-III at 2 years corrected age. Children enrolled at hospitals that perform follow-up beyond 2 years had cognitive assessments with the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI-IV). Associations between Bayley and WPPSI scores were assessed using correlation coefficients, linear regression, and Bland-Altman plots. Results: Thirty-one of 45 eligible children were tested with the WPPSI-IV at 47 ± 11 months. Average BSID-II Mental Development Index (MDI) was 86 ± 19, Bayley-III Cognitive composite score was 101 ± 12 and WPPSI Full Scale IQ (FSIQ) was 96 ± 12. Correlation between MDI and FSIQ was 0.54 ( P < .001); correlation between Bayley-III cognitive composite score and FSIQ was 0.31 ( P = .03). Bayley-III language composite had a modestly stronger correlation with FSIQ than cognitive composite (correlation coefficient 0.39; P = .005). Linear regression models also demonstrated that BSID-II was more closely correlated with FSIQ than Bayley-III. This bias was consistent across the full range of scores. Conclusion: The BSID-II underestimated FSIQ and the Bayley-III overestimated FSIQ. Children at risk for impairment might be missed with the Bayley-III. As the Bayley-4 is introduced, clinicians and researchers should be cautious about interpretation of scores until performance of this new measure is fully understood.

Enhancing the Follow-up Assessment of Very Preterm Children with Regard to 5-Year IQ Considering Socioeconomic Status

“…As confirmed by our findings, this risk is low when applying the BSID-II, as only one single child scored as ‘normal’ on MDI at the age of two years and ‘critical’ three years later. Altogether we interpret our results with Flynn et al (2020) “that the older BSID-II may actually be more predictive of later cognitive function than the Bayley-III” 70 . The younger the children are, the more combined developmental variables – as given in the BSDI-II – are indicative of cognition 40 .…”

Diffusion Tensor Imaging Changes Do Not Affect Long-Term Neurodevelopment following Early Erythropoietin among Extremely Preterm Infants in the Preterm Erythropoietin Neuroprotection Trial

“…Although we also demonstrated that infants born at 24-25 weeks' gestation have delays in measures of brain development (FA and MD) compared to infants 26-27 weeks' gestation at birth, these structural changes were not linked to any significant changes in BSID-III scores at 2 years of age. It is possible that as BSID-III scores may overestimate neurodevelopmental scores, thus our analysis may have missed an association between DTI measures and infants with some level of NDI not identified by BSID-III testing [87][88][89].…”

Executive Function Assessment in 2-Year-Olds Born Preterm

“…Studying the outcome of preterm infants remains critical to enable early identification of high-risk children and to provide appropriate support (2,17,38). BSID-III is a widely used measure to study neurodevelopmental outcome in preterm infants (20). In contrast to other studies, BSID-III scores in our cohort were comparable with scores in term born children (38,39).…”

“…The (20,21) and a multidisciplinary risk evaluation for autism spectrum disorder (ASD) according to DSM-5 criteria (binarized as no risk (0) versus risk ( 1)) (22). The EF assessment took 15 minutes and was performed in the context of a global developmental assessment during the regular follow up of these children.…”