PEDIATRICS Vol. 97 No. 5 May 1996, pp. 676-681
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Do Parents and Professionals Agree on the Developmental Status of High-risk Infants?

M. Marie Kim MD1, Kathleen Steel O'Connor PhD2, Jennifer McLean MD3, Ann Robson PhD4, and Graham Chance MB1

1 St Joseph's Health Centre, Department of Pediatrics, University of Western Ontario, London, Ontario, Canada
2 Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
3 Child Parent Resource Institute, Department of Pediatrics, University of Western Ontario, London, Ontario, Canada
4 Department of Psychology, University of Western Ontario, London, Ontario, Canada

Objectives. To examine the degree of agreement between parental reporting of the development of high-risk infants and professional assessment by a multidisciplinary team.

Methods. The developmental status of 196 infants discharged from neonatal intensive care units (NICUs) was assessed by their parents using the Infant Monitoring Questionnaire (IMQ) at 4, 8, or 12 months' corrected age. On the same day, a clinical assessment was done by a multidisciplinary team consisting of a developmental pediatrician, physical therapist, and psychologist. The kgr statistic was used to measure agreement between the assessments. Logistic regression was used to investigate factors that might influence agreement.

Results. Both the IMQ and the multidisciplinary team classified infants as developing normally ("normal"), being at risk for abnormal development ("suspect"), or developing abnormally ("abnormal"). Although the same proportion of children fell into the three categories by both assessments, parents and the multidisciplinary team showed poor agreement with respect to the classification of individual infants (k = 0.276). No infant or family characteristic was found to have an influence on agreement.

Conclusions. For a group of high-risk infants discharged from NICUs, the agreement between parental assessment of developmental status using the IMQ and the professional assessment by a multidisciplinary team is poor in the first year of life. We do not recommend the use of this questionnaire as a substitute for clinical assessment of biologically at-risk infants discharged from NICUs. However, it may be useful for those groups of infants for whom no other information is available or as an adjunct to clinical assessment when infants are not behaving typically because of an unfamiliar setting or concurrent illness.

Submitted on May 19, 1995
Accepted on August 2, 1995




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