Predictive utility of the Bayley Infant Neurodevelopmental Screener (BINS) risk status classifications: clinical interpretation and application

Abstract

Predictive validity and clinical implications of the increasingly popular Bayley Infant Neurodevelopmental Screener (BINS) risk status classifications have not been previously reported. In this longitudinal follow‐up study, the BINS was administered to high‐risk infants at 6, 12, and 24 months of age, and the McCarthy Scales at 3 years of age. Ninety‐two children were evaluated at 6 and 36 months, 105 at 12 and 36 months, and 118 at 24 and 36 months; 190, 125, and 140 infants were included in the comparisons at 6 to 12, 6 to 24, and 12 to 24 months. BINS risk status was classified as low, moderate, or high; or as a binary variable, LOWRISK/HIGHRISK. The three BINS items groups were moderately correlated. Consistency was most variable in the moderate‐risk group. BINS risk was predictive of 36‐month function in 18 out of 18 comparisons. Odds ratios, ranging from 2.76 to 54.70, were significant in 15 out of 18 logistic models. An early high‐risk classification was associated with increased probability of later developmental morbidity. The BINS offers an alternative to detailed assessment in high‐volume clinical applications and has good concurrent and predictive validity.

Topical Review: Developmental Screening

“…67 Four areas of development are assessed: basic neurologic functions, such as posture and muscle tone; expressive functions (ie, gross motor skills, and oral or verbal functions); receptive functions (ie, visual, auditory, and verbal) and cognitive functions (ie, object permanence, problem solving). 68 The Bayley Infant Neurodevelopmental Screener is composed of six item sets that are grouped according to age (3-4 months, 5-6 months, 7-10 months, 16-20 months, 21-24 months), chosen for their ability to effectively discriminate between clinical (ie, delayed) and nonclinical (normal) samples of infants. Each set contains approximately 11 to 13 items and takes between 15 and 20 minutes to administer and score.…”

“…85 Its current 178 test items evaluate developmental domains similar to those of its predecessor but are meant for individuals aged between 4 and 30 years. 68 The Slosson Intelligence Test-Revised was standardized on 2000 individuals representing the demographic profile of the United States. 80 The Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale is especially pertinent to the assessment of infant and toddler cognitive function.…”

Comparison of Caretaker Report and Hands-On Neurodevelopmental Screening in High-Risk Infants

“…For each BINS item set, three summary cut scores were established via comparison of clinical and normative standardization samples, to identify a given infant's level of risk for developmental problems: low risk, moderate risk, and high risk (Aylward, 1995;Gucuyener et al, 2006). In addition BINS total scores were categorized as a dichotomous or binary variable (Aylward, 1998;Aylward & Verhulst, 2000) by subdividing the moderate risk group. This division was based on the NEURODEVELOPMENTAL SCREENING cutoff score in the BINS manual that offered the best measures of sensitivity and specificity, indicated by a dashed line on the BINS form (Aylward, 1995).…”

Differences in early cognitive and receptive-expressive neurodevelopment by ancestry and underlying pathways in Brazil and Argentina

“…The BINS includes questions to assess infant’s risk of neurodevelopmental problems in four domains of abilities: cognitive functioning, expressive functioning, receptive functioning, and basic neurologic functioning. As a screener of early neurodevelopment, the BINS has been shown to be strongly predictive of the child’s performance on diagnostic instruments such the Bayley-II and the McCarthy Scales of Children’s Abilities and to have good psychometric properties (Aylward 1995; Aylward and Verhulst 2000). …”

“…Therefore, the total score may range between 0 (none of the activities are performed) and 11–13 (all activities are performed). Based on total score and the instrument’s norms, a child can be assigned to a category of high or low risk of developing neurodevelopmental problems (Aylward and Verhulst, 2000). …”