January 1992

The Validity of Continuing Developmental Follow-up of High-Risk Infants to Age 5 Years

Author Affiliations

From the Kluge Children's Rehabilitation Center and Research Institute, Department of Pediatrics, University of Virginia, Charlottesville (Dr Blackman), and the Division of Pediatric Psychology (Dr Lindgren) and the Child Health Specialty Clinics (Ms Bretthauer), Department of Pediatrics, University of Iowa, Iowa City.

Am J Dis Child. 1992;146(1):70-75. doi:10.1001/archpedi.1992.02160130072024

• We conducted a study to determine whether performance on developmental tests at age 5 years could predict academic achievement at age 8 years. As part of a longitudinal developmental surveillance project, 179 children at risk due to perinatal complications who had passed developmental screening through age 2½ years and 50 comparison children underwent an extensive prekindergarten psychoeducational test battery at age 5 years and took the Iowa Tests of Basic Skills at age 8 years, if they had reached the third grade. The mean Iowa Tests of Basic Skills score was significantly lower for those children who were "flagged" on the prekindergarten psychoeducational test battery (t=5.39). Preacademic, rather than developmental, items appeared to be the best predictors. However, the prekindergarten psychoeducational test battery correctly predicted low achievement or grade retention in only 58% of cases. Its sensitivity was 0.45 and its specificity was 0.85. No significant difference was noted between group Iowa Tests of Basic Skills mean scores for the high-risk or comparison group. When low achievement and failure to reach the third grade were combined, prevalence of "failure" was higher for the high-risk group (31% vs 24%). The only perinatal variable predictive of low achievement was neonatal seizures. In summary, because the ability to predict future academic achievement at age 5 years is limited, routine developmental testing for symptom-free preschool children is not warranted. High-risk infant follow-up programs should focus on the first several years of life.

(AJDC. 1992;146:70-75)