Bayley-III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years

Abstract

Aim: To determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley-III) motor scores and neurological examination at 2 years corrected age predict motor difficulties at 4.5 years corrected age.

Method: A prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley-III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC-2).

Results: Of 333 children, 8 (2%) had Bayley-III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC-2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC-2 scores. A Bayley-III motor score below 85 predicted MABC-2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity).

Interpretation: Bayley-III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years.

Figure 1

Flow chart of study participants. MABC-2, Movement Assessment Battery for Children (2nd edition); Bayley-III, Bayley Scales of Infant and Toddler Development (3rd edition). ^aThe test was not administered because trained assessors were unable to assess the child in person (only questionnaire data obtained).

Figure 2

Scatterplot of the relationship between 4.5-year MABC-2 total standard score and 2-year Bayley-III motor composite score. Regression line plotted (β=0.4 [95% CI 0.3–0.6]; R²=0.07; p<0.0001). Vertical lines indicate cut-off values of 70 (2 SD below mean) and 85 (1 SD below mean) on the Bayley-III motor scale. Horizontal lines indicate cut-off values of 5th and 15th centiles on the MABC-2 total scores. MABC-2, Movement Assessment Battery for Children (2nd edition); Bayley-III, Bayley Scales of Infant and Toddler Development (3rd edition).