A Parent Questionnaire for Developmental Screening in Infants Born Late and Moderately Preterm
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.
- Accepted April 22, 2014.
- Copyright © 2014 by the American Academy of Pediatrics