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ERIC: A new parental report instrument for detection of cognitive delay in at-risk infants

Presented at the Neonatal Society 2012 Spring Meeting.

Schafer G1, Genesoni L1, Boden G2, Jones R3

1 Department of Psychology, University of Reading, UK
2 Royal Berkshire NHS Trust, UK
3 Heatherwood & Wexham Park Hospitals NHS Trust, UK

Background: At 2 years, cognitive delay is the most common form of developmental disability in the preterm population (1). BAPM guidelines recommend as a minimum a protocol of 2 year follow up for children born at less than 31 weeks and less than 1000g. We are establishing the diagnostic properties of a new cognitive developmental screen, termed ERIC (Early Report by Infant Caregivers) for the NHS. ERIC is intended for use by caregivers of at-risk children aged 10-24 months; it gives a score of the child, which may provide an early warning to health professionals of cognitive delay. This research is approved by the Berkshire Ethics Committee. This abstract presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0807-14202). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Methods: Participants are infants aged between 10 to 24 months born with one of the following characteristics: weight below 1500g, less than 34 completed weeks of gestational age, perinatal complications (5 min Apgar < 7 or HIE). Parents/caregivers complete ERIC at home over the course of a week; ERIC has an interactive games section and an observational report section. The Cognitive Scale of the Bayley Scales of Infant Development (‘BSID’) III (2) is administered within a week of the ERIC completion. Specificity, sensitivity, positive/negative predictive value of ERIC is established using the gold standard for delay of <2SD below age-corrected mean on BSID III.

Results: Preliminary data are based on 334 children. Good diagnostic statistics are obtained. For the sample, ERIC has a sensitivity of 100%, specificity of 79%, negative predicative value of 100%. However positive predictive value is low (9%), partly due to low prevalence of delay in the sample.

Conclusion: To date, ERIC proved to have the capability of being a good diagnostic screening tool to be used within the NHS, able accurately to identify children with no cognitive delay, at a range of ages in infancy (10-24 months corrected).

Corresponding author: g.w.schafer@reading.ac.uk

References
1. Marlow, N. (2004). Neurocognitive outcome after very preterm birth. Archives of Disease in Childhood Fetal Neonatal Edition, 89, 224-228.
2. Bayley, N. (2006). Bayley Scales of Infant and Toddler Development. San Antonio, TX: Harcourt Assessment, Inc.

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