Does the Bayley-III Motor Scale at 2 years predict motor outcome at 4 years in very preterm children?

Dev Med Child Neurol. 2013 May;55(5):448-52. doi: 10.1111/dmcn.12049. Epub 2012 Dec 6.


Aim: To assess the predictive validity of the Bayley Scales of Infant and Toddler Development - Third Edition (Bayley-III) for later motor outcome.

Method: Ninety-six infants (49 males, 47 females) born at less than 30 weeks' gestation admitted to two tertiary hospitals in Melbourne, Australia, were assessed with the Bayley-III Motor Scale at 2 years' corrected age and were classified as suspect or definite motor impairment if they scored less than -1 or -2 standard deviations respectively, relative to the test mean. At 4 years' corrected age, children completed Movement Assessment Battery for Children - Second Edition (MABC-2); for the total motor score, cut-offs of not more than the 15th were used to classify motor development and cut-offs of not more than the 15th centile were classified as having a significant movement difficulty.

Results: Of the 96 children assessed at both ages, at 2 years 9% had suspect and 4% had definite motor impairment; however, by 4 years, rates had increased to 22% and 19% respectively. The specificity of the Bayley-III for motor impairments for later motor outcome was excellent (ranging from 94 to 100% for cerebral palsy [CP] and 97 to 100% for motor impairment), although the sensitivity was low (ranging from 67 to 83% for CP and 18 to 37% for motor impairment); many children with later impairment were not identified by the Bayley-III.

Interpretation: The Bayley-III Motor Scale at 2 years underestimates later rates of motor impairment, particularly in the absence of CP at 4 years on the MABC-2 total motor score in children born at less than 30 weeks' gestational age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Child, Preschool
  • Developmental Disabilities / diagnosis*
  • Developmental Disabilities / etiology
  • Female
  • Gestational Age
  • Humans
  • Infant, Extremely Premature*
  • Longitudinal Studies
  • Male
  • Movement Disorders* / complications
  • Movement Disorders* / diagnosis
  • Movement Disorders* / etiology
  • Neurologic Examination / methods*
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Sensitivity and Specificity