Harris S R, Langkamp D L
School of Rehabilitation Sciences, University of British Columbia, Sunny Hill Hospital for Children, Vancouver, Canada.
J Perinatol. 1994 Jul-Aug;14(4):275-9.
One of the most elusive developmental disabilities to diagnose during infancy is cognitive delay. Although infant intelligence tests have been identified repeatedly as poor predictors of future IQ, these predictions have typically been based on interage correlations. This retrospective study examined the sensitivity, specificity, and positive and negative predictive values of the Mental Scale of the Bayley Scales of Infant Development in detecting cognitive delay (IQ < 85) among a sample of 196 high-risk, mostly low birth weight, premature infants who were assessed initially at 4 months' corrected age and followed longitudinally to between 3 and 8 years' corrected age. As hypothesized, the Bayley Mental Scale was better at correctly identifying children with future normal IQs (specificity = 91.9%) than it was at identifying infants who would later show cognitive delays (sensitivity = 38.9%). The positive and negative predictive values were 51.9% and 87.0% respectively. Results of this study support recent assertions that cognitive delay, particularly in the mildest forms, is difficult to detect during early infancy.
婴儿期最难诊断的发育障碍之一是认知延迟。尽管婴儿智力测试一再被证明对未来智商的预测能力不佳，但这些预测通常是基于不同年龄段之间的相关性。这项回顾性研究考察了贝利婴儿发展量表心理量表在检测196名高危、大多为低体重早产儿认知延迟（智商<85）方面的敏感性、特异性、阳性预测值和阴性预测值。这些婴儿最初在矫正年龄4个月时接受评估，并纵向随访至矫正年龄3至8岁。正如所假设的那样，贝利心理量表在正确识别未来智商正常的儿童方面（特异性=91.9%）比识别后来会出现认知延迟的婴儿方面（敏感性=38.9%）表现更好。阳性预测值和阴性预测值分别为51.9%和87.0%。这项研究的结果支持了最近的论断，即认知延迟，尤其是最轻微形式的认知延迟，在婴儿早期很难被检测出来。
