Validation of a Rapid Neurodevelopmental Assessment Tool for 5 to 9 Year-Old Children in Bangladesh

Abstract

To validate a rapid neurodevelopmental assessment tool for use by child care professionals to determine neurodevelopmental impairments (NDIs) in children ages 5-9 years (61-108 months) in Bangladesh. In a convenience sample of community children (n = 18), interrater reliability was determined between 6 testers. Validity was determined in 121 children by simultaneous administration of a test of adaptive behavior (AB) (ie, the Independent Behavior Assessment Scale, or Gold Standard I) and IQ tests (Wechsler Preschool and Primary Scales of Intelligence or the Wechsler Intelligence Scales for Children, or Gold Standard II) by child psychologists. Interrater reliability was excellent (kappa = 1.00). Significantly lower scores were obtained on AB and IQ tests in those identified with "any (≥1) NDI" and most specific NDIs. Sensitivity and specificity for "any NDI" with (a) "significant difficulties" (defined as AB z-scores < -2 SD and/or IQ < 70) or (b) "mild difficulties included" (AB z scores < -1 SD and/or IQ < 85) were 84% and 57%; and 83% and 70%, respectively. The rapid neurodevelopmental assessment tool shows promise as a tool for use by a range of professionals for identifying NDIs in children of primary school age. Further refinement for identifying specific impairments is needed.