Bayley Scales of Infant Motor Development (BSID-II) Article Summary
Wang X, Carroll X, Wang H, Zhang P, Selvaraj JN and Leeper-Woodford S (2020) Prediction of Delayed Neurodevelopment in Infants Using Brainstem Auditory Evoked Potentials and the Bayley II Scales. Front. Pediatr. 8:485. doi: 10.3389/fped.2020.00485
The Brainstem Auditory Evoked Potential (BAEV) is used to analyze development in infants by measuring function of the central nervous system. An abnormality outside the normal BAEV range could indicate neurodevelopmental delays later on in infancy and childhood, measured by the mental development indices (MDI), a form of the Bayley II Scales.
Purpose: The purpose of the study was to examine the relationship of BAEP values obtained on 6-month old infants compared to MDI values of that same child at 2 years old to compare if abnormal scores on the BAEP correlate to low MDI scores, indicating a low BAEP value could predict neurodevelopmental delays in infants and children.
Population: 195 infants participated in this study, 95 preterm (28-36 weeks gestational age) and 100 term infants (≥37 weeks gestational age), born between June 1st, 2014 and October 31st, 2015. In order to be included, all participants had to be born with a perinatal condition. Participation consent rate was 85.7%. Socioeconomic (i.e. parental education, occupation and income) and demographic (i.e. gender) information was considered only after random selection of the infants. Exclusion criteria included: babies born with hearing impairments, cerebral palsy, severe cardiopulmonary disease, severe malformation and/or genetic metabolic diseases.
Methods: This study was an exploratory investigation. BAEP scores were recorded in the first 8 months of life; MDI scores were taken at age 2. These values were compared using a multivariate linear regressions model to check for an association between the two. Stratified linear regression was used to test interactions between gestational age and BAEP values with MDI scores.
Outcome Measures: BAEP, BSID II including the MDI and PDI
Intervention: The only interventions were conducting the BAEP at ~6 months of age and the MDI and 2 years of age.
Results: It was found that in premature infants, BAEP values were inversely associated with MDI scores. Also in premature babies, a direct correlation was documented regarding the BAEP value and MDI score; the lower the BAEP value (below the average), a greater decrease in MDI score two years later. Two covariates were linked to lower MDI scores – asphyxia and lower family socioeconomic status.
Study Limitations: This study lacked a control group of “normal” infants because due to ethical measures, this study would not have benefited a healthy infant. In addition, limited perinatal conditions associated with preterm infants enrolled in this study indicating future studies need to include higher numbers of preterm babies with more variable conditions. Data collected using the Bayley II Scale may not be comparable using the Bayley III Scale. Lastly, environmental and parental lifestyle factors were not considered but should be in future studies. This was an exploratory investigation and large scale, ling-term studies are needed for further information.
Conclusion: The researchers’ hypothesis was confirmed with data concluding that abnormal BAEP values taken at age 6-months in premature infants may predict neurodevelopmental delays in cognitive and motor skills, indicated by MDI scores. The authors suggest encouraging early intellectual and public health interventions to promote neurodevelopment in premature babies with abnormal BAEP values.
2 responses to “Bayley Scales of Infant Motor Development (BSID-II) Article Summary”
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Based on the results, this correlation between BAEP values and MDI scores could have significant implications on detecting developmental delays in children and perhaps lead to earlier intervention than currently in place. Of course, there are many factors that also need to be studied intensively before concrete conclusions are made, especially with the mentioned limitations of nature vs. nurture. Overall, this is an interesting find that could lead to exciting progressions in pediatrics. Great job, Kerri!
It is interesting how the Brainstem Auditory Evoked Potential can predict outcomes at just 6 months old for premature infants, although very encouraging to see that interventions have such a positive outcome for this population. This stresses the importance of early intervention within babies and early childhood. Great article and review!