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Parent screening questionnaires to detect cognitive and language delay at 2 years in high-risk infants: an analysis from the Victorian Infant Collaborative Study 2016–2017 cohort
  1. Kate L Rawnsley1,2,
  2. Lex W Doyle2,3,4,5,
  3. Peter J Anderson2,6,
  4. Joy E Olsen2,3,
  5. Amanda K L Kwong1,2,3,
  6. Rheanna M Mainzer5,7,
  7. Elisha K Josev2,5,8,
  8. Gehan Roberts2,5,9,
  9. Alicia J Spittle1,2,
  10. Jeanie L Y Cheong2,3,4,5
  1. 1 Department of Physiotherapy, The University of Melbourne, Carlton, Victoria, Australia
  2. 2 Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  3. 3 Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia
  4. 4 Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Parkville, Victoria, Australia
  5. 5 Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
  6. 6 Turner Institute for Brain and Mental Health & School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
  7. 7 Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  8. 8 Neonatal Services, Mercy Hospital for Women, Heidelberg, Victoria, Australia
  9. 9 Centre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia
  1. Correspondence to Kate L Rawnsley, Department of Physiotherapy, The University of Melbourne, Carlton 3053, Victoria, Australia; kate.rawnsley{at}student.unimelb.edu.au

Abstract

Objective To determine the accuracy of two developmental screening questionnaires to detect cognitive or language delay, defined using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III), in children born extremely preterm (EP: <28 weeks’ gestation) or extremely low birth weight (ELBW: <1000 g).

Design Prospective cohort study.

Setting State of Victoria, Australia.

Patients 211 infants born EP/ELBW assessed at 2 years’ corrected age (mean 2.2, SD 0.2).

Main outcome measures Cognitive and language delay (<−1 SD) on the Bayley-III. The screening questionnaires were the Parent Report of Children’s Abilities-Revised (PARCA-R) and the Ages & Stages Questionnaires Third Edition (ASQ-3).

Results The PARCA-R performed better than the ASQ-3, but neither questionnaire had substantial agreement with the Bayley-III to detect cognitive delay; kappa (95% CI): PARCA-R 0.43 (0.23, 0.63); ASQ-3 0.15 (−0.05, 0.35); sensitivity (95% CI): PARCA-R 70% (53%, 84%) ASQ-3 62% (47%, 76%); specificity (95% CI): PARCA-R 73% (60%, 84%) ASQ-3 53% (38%, 68%). When both tools were used in combination (below cut-off on at least one assessment), sensitivity increased to 78% (60%, 91%) but specificity fell to 45% (29%, 62%). Similar trends were noted for language delay on the Bayley-III, although kappa values were better than for cognitive delay.

Conclusions Neither screening questionnaire identified cognitive delay well, but both were better at identifying language delay. The PARCA-R detects delay on the Bayley-III more accurately than the ASQ-3. Sensitivity for detecting delay is greatest when the PARCA-R and ASQ-3 were used in combination, but resulted in lower specificity.

  • Infant Development
  • Neonatology
  • Paediatrics
  • Child Development
  • Child Health

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/archdischild-2023-326618

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • AJS and JLYC are joint senior authors.

    • Collaborators Members of the Victorian Infant Collaborative Study Group: Convenor: Jeanie Cheong.1,2,3,4,5 Collaborators (in alphabetical order): Niranjan Abraham,6 Peter Anderson,2,4,7 Rosemarie Boland,2,3 Alice Burnett,2,4,5,8 Margaret Charlton,9 Marissa Clark,9 Noni Davis,4 Lex Doyle,1,2,3,4,5 Julianne Duff,4,10 Anjali Haikerwal,2,4 Leah Hickey,2,5,8 Emily Johnston,9 Elisha Josev,2,5,10 Rheanna Mainzer,5,11 Marion McDonald,4 Elizabeth Noble,6 Bronwyn Novella,10 Joy Olsen,2,4 Gillian Opie,3,10 Lauren Pigdon,2,4 Gehan Roberts,2,4,5,12,13 Alicia Spittle,1,2,14 Penelope Stevens,9 Alice Stewart,9 Anne-Marie Turner,10 Tania Woods.1,4

      1Neonatal Services, Royal Women’s Hospital, Melbourne, Australia

      2Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia

      3Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, Australia

      4Premature Infant Follow Up Program, Royal Women’s Hospital, Melbourne, Australia

      5Department of Paediatrics, University of Melbourne, Melbourne, Australia

      6Newborn Services, Joan Kirner Women’s and Children’s Hospital, Melbourne, Australia

      7Turner Institute for Brain and Mental Health & School of Psychological Sciences, Monash University, Melbourne, Australia

      8Department of Neonatal Medicine, Royal Children’s Hospital, Melbourne, Australia

      9Department of Neonatology, Monash Medical Centre, Melbourne, Australia

      10Neonatal Services, Mercy Hospital for Women, Melbourne, Australia

      11Clinical Epidemiology and Biostatistics, Murdoch Children’s Research Institute, Melbourne, Australia

      12Centre for Community and Child Health, Royal Children’s Hospital, Melbourne, Australia

      13Population Health, Murdoch Children’s Research Institute, Melbourne, Australia

      14Department of Physiotherapy, University of Melbourne, Melbourne, Australia

    • Contributors All listed authors have made substantial contributions to this work within various areas of the research process: KLR—conception and design of the study, analysis and interpretation of data, drafting and revising the work and approval of the final manuscript as submitted. LWD, JEO, AJS and JLYC—conception and design of the study, acquisition, analysis and interpretation of data, revising the work and approval of the final manuscript as submitted. PJA —conception and design of the study, acquisition and interpretation of data, revising the work and approval of the final manuscript as submitted. AKLK—analysis and interpretation of data, revising the work and approval of the final manuscript as submitted. RMM—analysis and interpretation of data, drafting and revising the work and approval of the final manuscript as submitted. EKJ and GR—acquisition and interpretation of data, revising the work and approval of the final manuscript as submitted. All authors are accountable for the work. AJS and JLYC are responsible for the work as guarantors.

    • Funding Supported by grants from the National Health and Medical Research Council of Australia (Centre of Clinical Research Excellence #546519; Centre of Research Excellence #1060733 & #1153176; project grant #108702; Leadership Level 1 #2016390 to JLYC and #1176077 to PJA), and the Victorian Government’s Operational Infrastructure Support Program. KLR is supported by the University of Melbourne’s Fay Marles Scholarship.

    • Disclaimer The funding sources had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.