Evaluation of the Developmental Assessment for Intervention Manual (DAIM) for developmental screening in high-risk infants at 12 months of corrected age

Abstract

Early detection of developmental delay provides opportunities for early intervention. The Developmental Assessment for Intervention Manual (DAIM) is the simplified screening tool for detection of developmental delay in Thai young infants implemented country-wide by the Ministry of Public Health since 2015. Unlike standard assessment tool, DAIM can be obtained by lay staff or parents and takes less time. We aimed to evaluate the accuracy of the DAIM for detection of developmental delay among high-risk infants. This single center prospective study was conducted from May, 2017 to December, 2021. The infants with corrected aged of 12 months with history of birth asphyxia or low birth weight (<2500 g) who visited a tertiary hospital for developmental assessment were invited to participate the study. The four developmental domains (gross motor, fine motor, receptive language, and expressive language) were assessed by Bayley-III and followed by DAIM in the same visit. The 126 infants were enrolled, 50% were male. Using Bayley-III score < 7 as reference, the sensitivity for gross motor domain, fine motor domain, receptive language and expressive language were 83.3%, 57.1%, 55% and 19.2%, respectively. Specificity for each domain was 75.4%, 88.2%, 74.5% and 92%. Positive predictive value for each domain was 26.3%, 22.2%, 28.9% and 38.5%. Negative predictive value (NPV) for each domain was 97.7%, 97.2%, 89.8% and 81.4%. With high sensitivity and NPV of DAIM in motor domain, but low in expressive language domains, using DAIM alone in high-risk infants can detect motor delay well but will miss many infants with expressive language delaye.