Enhanced prediction of later normal outcome using infant neuropsychological assessment

Abstract

The Early Neuropsychologic Optimality Rating Scales (ENORS; a preliminary version of the Bayley Infant Neurodevelopmental Screener) was applied to a high‐risk infant population in an effort to enhance prediction of 3‐year outcome. A total of 573 infants was evaluated: 532 at 6 months, 380 at 12 months, 262 at 24 months, and 220 at 36 months. The SES‐Composite Index, Postnatal Complications Scale (PCS), and McCarthy Scales (MSCA) were also administered. A high degree of overlap was found between the ENORS‐6, –12, and ‐24. With hierarchical regression, ENORS versions accounted for 43% to 68% of the variance on MSCA subscales; the SES‐Composite added to the predictive model in a small but consistent manner. The PCS did not. In children having an optimal ENORS and SES‐Composite, 83% to 97% were later “normal”, depending on age and area of function. Using odds ratios, an optimal ENORS‐6 increased the likelihood of normal 3‐year outcome by 2.4 to 10.7 times; odds ratios ranging from 9.85 to 90.1 and from 10.5 to 54.5 were found for the ENORS‐12 and ENORS‐24, respectively. Clinicians can be fairly confident that if the ENORS and environmental measures are optimal, the likelihood of normal 36‐month outcome is quite high.