Apr 23, 2016 - PDF The Bayley Scales of Infant and Toddler Development, Third. San Antonio, TX: The Psychological Corporation. The Bayley scales screening instrument, which consists of five domains. By comparing the two versions, the discrepant parts were identified and corrected. Bayley scales of infant and toddler development In Technical Manual.

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To Cite: Soleimani F, Azari N, Vameghi R, Sajedi F, Shahshahani S, et al. Is the Bayley Scales of Infant and Toddler Developmental Screening Test, Valid and Reliable for Persian Speaking Children?, Iran J Pediatr.

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DRAFT Bayley III Crosswalk 6-8-06 3 Bayley Scales of Infant and Toddler Development – Third Edition: Crosswalk to Child Outcomes Note: Because the Bayley is a norm-referenced, standardized assessment, the subscale scores are the smallest unit of information that.

2016; 26(5):e5540. Abstract Background: Advances in perinatal and neonatal care have substantially improved the survival of at-risk infants over the past two decades. Objectives: The purpose of this study was to assess the reliability and validity of the Bayley Scales of infant and toddler developmental Screening test in Persian-speaking children. Methods: This was a cross-sectional prospective study of 403 children aged 1 - 42-months. The Bayley scales screening instrument, which consists of five domains (cognitive, receptive, and expressive communication and fine and gross motor items), was used to measure infants’ and toddlers’ development. The psychometric properties examined included the face and content validity of the scale, in addition to cultural and linguistic modifications to the scale and its test-retest and inter-rater reliability. Results: An expert team changed some of the test items relating to cultural and linguistic issues.

In almost all the age groups, cultural or linguistic changes were made to items in the communication domains. According to Cronbach’s alpha for internal consistency, the reliability of the cognitive scale was r = 0.79, and the reliability of the receptive scale was r = 0.76. The reliability for expressive communication, fine motor, and gross motor scales was r = 0.81, r = 0.80, and r = 0.81, respectively. The construct validity of the tests was confirmed using a factor analysis and comparison of the mean scores of the age groups. The intra- and inter-rater reliabilities of the Bayley Scales were good-to-excellent. Conclusions: The results indicated that the Bayley Scales had a high level of reliability in the present study. Thus, the scale can be used in a Persian population.

Keywords: Screening Tools; Validity; Reliability; Infant. Copyright © 2016, Growth & Development Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. Background Advances in perinatal and neonatal care have substantially improved the survival of at-risk infants over the past two decades. However, these advances have produced little change in the prevalence of developmental disorders among at-risk survivors (, ). Identifying infants at risk for developmental disabilities is the first step in providing services to maximize their physical and cognitive abilities and to minimize complications.

Health conditions, such as a low birth weight, preterm birth, perinatal infection, and birth defects, increase the risk of developmental difficulties. For example, children born with birth defects are almost 27 times more likely to have a developmental disability by age 7 compared to children who were not born with a birth defect. In Iran, asphyxia, low birth weight, preterm birth, and a high-risk pregnancy have been shown to adversely affect neurological development (-). The American Academy of Pediatrics recommends that pediatricians screen all infants and children during routine office visits for developmental problems. In the U.S., the emphasis has shifted to screening for disabilities at a younger age: from birth to 2 years. Recent epidemiological data indicated that the rate of moderate-to-severe disabilities in at-risk infants in the early years of life was approximately 6.7% - 14% (, ). It has been estimated that more than 200 million children under 5 years do not reach their full potential in terms of growth, cognition, or socio-emotional development due to risk factors for neurological delay.

In the U.S., about 13% of children aged 3 - 17 years were reported to have at least one developmental disability, and about 1.6% of children were shown to have three or more developmental disabilities. Robust estimates of the prevalence of development disabilities in less developed countries are rare. However, given the overall higher prevalence of most diseases of early childhood in less developed countries compared to developed countries, the rates are expected to be at least similar to, if not higher, than those in developed countries. The availability of adequate screening for developmental disabilities is limited in less developed countries where the expenditure on health is significantly lower than in developed countries. Research has shown that improved economic status has positive effects on child development in both developed and developing countries (, ) and that it may attenuate the negative effects of early developmental problems in the future.

Given the higher rates of poverty in less developed countries, developmental disabilities may have substantial adverse effects on future health and socioeconomic outcomes. In addition to the paucity of data on pediatric neurological development, most extant data were collected using assessments developed for use in European or North American populations. Only a few psychometric tools have been developed specifically to measure neurological development in settings outside of Europe and North America.

There is a need for standardized, psychometrically sound developmental screening instruments that can be used by primary care providers for the early identification of infants with developmental problems in developing countries. In the present study, the Bayley scales was chosen as a screening instrument.

The scales is an individually administered instrument, which assesses the cognitive, language, and motor functioning of infants and young children aged 1 - 42 months. It can be administered by a wide range of health professionals after limited training and in an acceptable time frame. The Bayley scales can be used to obtain detailed information about the functioning of children, even nonverbal infants. In common with the majority of available psychometric tests, the Bayley scales originated in the Western world and was designed to suit the culture, language, and socio-economic status of the respective populations. According to De Klerk , many tests can be adapted from one language and culture to another. However, individual scores based on tests supposedly measuring the same construct in various cultures cannot be interpreted at face value.

The influence of culture on measuring specific psychological constructs needs to be explored to be able to adjust measurements to make them meaningful to the particular culture and to obtain equivalent or comparable measures across cultures. The two most important and fundamental characteristics of any measurement procedure are the reliability and validity of the scales. Any kind of assessment, whether traditional or “authentic,” must be developed in a way that provides accurate information about the performance of the individual. Objectives This study was conducted for the purpose of cultural modifications and validation of the Bayley Scales for Persian-speaking children aged 1 - 42 months. Methods The Bayley screening Test is a subtest of the diagnostic Bayley scales of infant and toddler development.

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Items in the subtest have been shown to be particularly valuable in screening high-risk infants for developmental delay. The cut scores are used to determine whether the child shows competence in age-appropriate tasks, shows evidence of emerging age-appropriate skills, or shows evidence of being at risk for developmental delay. The infant’s total score is then compared to norms in order to classify the child as competent or at risk of developmental delay.

The test takes approximately 15 - 30 minutes to administer (15 - 20 minutes for children aged 12 months and younger and approximately 30 minutes for children aged 13 months and older). In this study, an expert team performed translation and back-translation, assessed the content and construct validity of the scale, and made cultural and lingual modifications. To assess the reliability, the internal consistency (Cronbach’s alpha coefficient for each the five domains and each age group), test-retest, and inter-rater reliability were determined. A factor analysis and comparison of the mean scores of the groups were used to assess the validity. In accordance with other studies that used factor analysis and the Comrey sample size criterion , the sample size was determined to be 400 people in four age groups. The participants were selected from our centers using continuous sampling.

A principal components analysis (PCA) was used to determine how many factors were significant in the test. Prior to performing the factor analysis, the Kaiser-Meyer-Olkim measure of sampling adequacy was applied.

The results yielded a sample adequacy value of 0.948 - 0.964. In addition, Bartlett’s test of sphericity was significant (P 90% compared with the results of the experienced psychologist. After seeking the approval of health centers, the translated versions of the items were administered by the raters to the participants in the study. Results Among the 403 children in the study, 195 (48.4%) were girls. Seventy-eight (19.4%) of the children were aged 7 - 12 months, and 125 (31%) were aged 1 - 6-months.

To determine the psychometric properties of the test, the items in each domain were translated to the Persian language and then back-translated by two independent native translators who also had experience in the field of child development. By comparing the two versions, the discrepant parts were identified and corrected. A panel of eight experts (two pediatricians, one psychologist, two speech pathologists, two pediatric occupational therapists, and one psychometrist) then assessed the content validity of the resulting Persian test. This expert team performed cultural and lingual modifications. Although the team attempted to preserve the headings in the original version, some modifications had to be made to ensure cultural compatibility and greater clarity of the Persian version. Most of the modifications in the domain “receptive and expressive communication” pertained to the language domain but were not limited to this domain.

Bayley Scales Test Manual

The modifications to the instructions of the receptive communication subscale were as follows: Unfamiliar games were replaced with more familiar ones, and the words “glass,” “ball,” “sweet,” and “bird” were replaced with “cup,” “cube,” “cake”, and “fish,” respectively. These modifications were in accordance with studies on vocabulary development in Persian-speaking children (, ). Another modification made to the instructions related to the expression of possession. Furthermore, as the Persian language has only one pronoun for both boys and girls, gender was mentioned, in addition to the pronoun.

The modifications to the instructions of expressive communication subtests were changes made in auxiliary verbs (not usually used in Persian), continuous verbs in the administration manual, different signs for future and continuous present verbs in Persian grammar, and plurals because Persian-speaking children would have difficulty expressing these items. Some modifications were also made to the cognitive and motor domains, such as the replacement of traditional games and changes to pictures and storybooks. The internal consistency of the Bayley subtests was assessed using the Cronbach alpha method. The reliability coefficients and standard error of measurement (SEM) are presented in.

The stability of the scores of the Bayley Scales over time was assessed in a separate study of 45 children who were tested twice (4 - 7 days retest) by the same raters. The test-retest reliability was estimated using Pearson’s correlation coefficient. To determine the inter-rater reliability, two raters administered the revised version of the test to 36 children. Reliability Coefficients and Standard Error of Measurement (SEM) of the Bayley Screening Subtests (n = 403). Subtests Pearson’s Correlation Coefficient Cognitive 0.993 Receptive communication 0.999 Expressive communication 0.991 Fine motor 0.998 Gross motor 0.990 aP.

Scores

Bayley Scales Scores

Factors Cognition Receptive Communication Expressive Communication Fine Motor Gross Motor The first Eigen value 14.91 11.074 11.398 11.391 11.670 Percentage of explained variance 42.700 46.142 47.490 42.190 41.680 The nature and content of the test are concerned with progressive development. Thus, to determine the performance in the test according to chronological age, the scores of the age groups in the five domains were compared using a one-way variance analysis (ANOVA). The F index for cognitive, receptive, and expressive communication subtests and gross and fine motor subtests was 1202.74, 969.88, 826.61, 814.51, and 872.94 respectively (P. Age Group 1 Age Group 2 Mean Test Difference (Significance Level; P Value) Cognition Receptive Communication Expressive Communication Fine Motor Gross Motor A B 6.58 4.19 3.82 4.38 6.03 C 14.27 10.87 10.56 10.67 12.16 D 22.59 16.90 16.87 17.41 17.98 B C 7.69 6.68 6.74 6.30 6.13 D 16.01 12.71 13.05 13.03 11.96 C D 8.32 6.03 6.30 6.73 5.28 aP 0.75) and small SEMs (.