Gerry Taylor H, Quach Jessica, Winning Adrien M, Smith Lindsay, Backes Carl, Khalid Omar, Warschausky Seth, Berglund Patricia, Lajiness-O'Neill Renee
Department of Pediatrics, The Ohio State University, Columbus, OH, USA.
Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, NEOB 3rd Floor, Columbus, OH, 43205, USA.
Pediatr Cardiol. 2025 Jul 15. doi: 10.1007/s00246-025-03944-z.
Early identification of the infants with critical congenital heart disease (CCHD) exhibiting developmental delays would allow for timely interventions to reduce adverse longer-term consequences. Web-based caregiver assessments of developmental milestones complement direct testing as a means for identifying delays outside of the clinic setting. The purpose of this study was to evaluate the validity of a recently developed caregiver rating of early development, the PediaTrac™, as an alternative to ratings of developmental milestones in a sample of infants and toddlers with CCHD. The PediaTrac, along with ratings of developmental milestones, on the Ages and Stages Questionnaire, 3rd Edition (ASQ-3), were administered to caregivers of 45 infants and toddlers with CCHD ages 2 to 18 months. PediaTrac ratings were analyzed using item response theory modeling to obtain scores reflecting skill levels in the motor and social-communication-cognition domains. Validity was examined by comparing scores to those for a reference group of term-born infants/toddlers assessed in a prior study and to delays in milestones on the ASQ-3 and medical and sociodemographic risk factors. Motor scores were lower than expected for the CCHD sample relative to term reference group, t(44) = - 3.269, p = 0.002, indicating a high rate of motor deficits (31%). Although the CCHD sample did not differ from the reference group in the social-communication-cognition domain, lower scores in one or both domains were associated with delayed milestones on the ASQ-3, longer length of hospitalizations, and single ventricle physiology. Findings confirm delays in motor development in infants and toddlers with CCHD and support PediaTrac as a valid alternative to milestone-based caregiver screening of early development in this population.
早期识别患有严重先天性心脏病（CCHD）且发育迟缓的婴儿，将有助于及时进行干预，以减少长期不良后果。基于网络的照顾者对发育里程碑的评估作为在临床环境之外识别发育迟缓的一种手段，可补充直接测试。本研究的目的是评估一种最近开发的照顾者早期发育评分工具——PediaTrac™，作为患有CCHD的婴幼儿样本中发育里程碑评分的替代工具的有效性。PediaTrac以及《年龄与阶段问卷》第3版（ASQ - 3）中的发育里程碑评分，被施用于45名年龄在2至18个月的患有CCHD的婴幼儿的照顾者。使用项目反应理论模型分析PediaTrac评分，以获得反映运动和社会沟通认知领域技能水平的分数。通过将分数与先前研究中评估的足月儿/幼儿参考组的分数进行比较，并与ASQ - 3上的里程碑延迟情况以及医学和社会人口统计学风险因素进行比较，来检验有效性。相对于足月儿参考组，CCHD样本的运动分数低于预期，t(44) = - 3.269，p = 0.002，表明运动缺陷发生率较高（31%）。尽管CCHD样本在社会沟通认知领域与参考组没有差异，但一个或两个领域的较低分数与ASQ - 3上的里程碑延迟、更长的住院时间和单心室生理状况相关。研究结果证实了患有CCHD的婴幼儿存在运动发育迟缓，并支持PediaTrac作为该人群中基于里程碑的照顾者早期发育筛查的有效替代工具。
