Browsing by Author "Dusick, Anna M."

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    Are Outcomes of Extremely Preterm Infants Improving? Impact of Bayley Assessment on Outcomes
    (Elsevier, 2012) Vohr, Betty R.; Stephens, Bonnie E.; Higgins, Rosemary D.; Bann, Carla M.; Hintz, Susan R.; Epi, M. S.; Das, Abhik; Newman, Jamie E.; Peralta-Carcelen, Myriam; Yolton, Kimberly; Dusick, Anna M.; Evans, Patricia W.; Goldstein, Ricki F.; Ehrenkranz, Richard A.; Pappas, Athina; Adams-Chapman, Ira; Wilson-Costello, Deanne E.; Bauer, Charles R.; Bodnar, Anna; Heyne, Roy J.; Vaucher, Yvonne E.; Dillard, Robert G.; Acarregui, Michael J.; McGowan, Elisabeth C.; Myers, Gary J.; Fuller, Janell; Eunice Kennedy Shriver National Institute of Child Health and Network Human Development Neonatal Research; Pediatrics, School of Medicine
    Objectives: To compare 18- to 22-month cognitive scores and neurodevelopmental impairment (NDI) in 2 time periods using the National Institute of Child Health and Human Development's Neonatal Research Network assessment of extremely low birth weight infants with the Bayley Scales of Infant Development, Second Edition (Bayley II) in 2006-2007 (period 1) and using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), with separate cognitive and language scores, in 2008-2011 (period 2). Study design: Scores were compared with bivariate analysis, and regression analyses were run to identify differences in NDI rates. Results: Mean Bayley III cognitive scores were 11 points higher than mean Bayley II cognitive scores. The NDI rate was reduced by 70% (from 43% in period 1 to 13% in period 2; P < .0001). Multivariate analyses revealed that Bayley III contributed to a decreased risk of NDI by 5 definitions: cognitive score <70 and <85, cognitive or language score <70; cognitive or motor score <70, and cognitive, language, or motor score <70 (P < .001). Conclusion: Whether the Bayley III is overestimating cognitive performance or whether it is a more valid assessment of emerging cognitive skills than the Bayley II is uncertain. Because the Bayley III identifies significantly fewer children with disability, it is recommended that all extremely low birth weight infants be offered early intervention services at the time of discharge from the neonatal intensive care unit, and that Bayley scores be interpreted with caution.
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    Improving the Neonatal Research Network Annual Certification for Neurologic Examination of the 18–22 month Child
    (Elsevier, 2012) Newman, Jamie E.; Bann, Carla M.; Vohr, Betty R.; Dusick, Anna M.; Higgins, Rosemary D.; Follow-Up Study Group of Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network; Pediatrics, School of Medicine
    Objective: To describe the Neonatal Research Network's efforts to improve the certification process for the Follow-Up Study neurologic exam and to evaluate inter-rater agreement before and after two annual training workshops. Study design: The Neonatal Research Network Follow-Up Study is a multi-center observational study that has examined more than 11 500 infants from 1998-2010 and born ≤26 weeks gestational age at 18-22 months corrected age for neurodevelopmental outcome. The percentages of examiners who agreed with the Gold Standard examiner on 4 neurodevelopmental outcomes on the initial training video and a test video were calculated. Consistency among examiners was assessed with the first-order agreement coefficient statistic. Results: Improvements in agreement among examiners occurred between 2009 and 2010 and between initial training and test. Examiner agreement with the Gold Standard during the initial training was 83%-91% in 2009 and 89%-99% in 2010. Examiner agreement on the workshop test video increased from 2009-2010 with agreement reaching 100% for all four neurodevelopmental outcomes examined in 2010. First-order agreement coefficient values for the four neurodevelopmental outcomes on the training videos ranged from 0.64-0.82 in 2009 and 0.77-0.97 in 2010. Conclusions: We demonstrate the importance of annual certification and the benefits of evaluation and revision of certification protocols to achieve high levels of confidence in neurodevelopmental study outcomes for multi-center networks.
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    Screening for Autism Spectrum Disorders in Extremely Preterm Infants
    (Wolters Kluwer, 2012) Stephens, Bonnie E.; Bann, Carla M.; Watson, Victoria E.; Sheinkopf, Stephen J.; Peralta-Carcelen, Myriam; Bodnar, Anna; Yolton, Kimberly; Goldstein, Ricki F.; Dusick, Anna M.; Wilson-Costello, Deanne E.; Acarregui, Michael J.; Pappas, Athina; Adams-Chapman, Ira; McGowan, Elisabeth C.; Heyne, Roy J.; Hintz, Susan R.; Ehrenkranz, Richard A.; Fuller, Janell; Das, Abhik; Higgins, Rosemary D.; Vohr, Betty R.; Pediatrics, School of Medicine
    Background: Extremely preterm (EP) infants screen positive for autism spectrum disorders (ASD) at high rates. However, it is not clear whether this is because of high rates of ASD in EPs or to high rates of false-positive screens for ASD in children with a high rate of underlying neurodevelopmental impairments. Combining a parent questionnaire designed to distinguish developmental delay from ASD with direct observation of infant behavior may more accurately screen for ASD in EPs. Objectives: To determine rates of positive screen for ASD at 18 to 22 months(m) in EPs using 3 screens; to determine factors associated with a positive screen. Methods: Five hundred fifty-four infants born <27 weeks were screened at 18 to 22 m using the Pervasive Developmental Disorders Screening test, second edition Stage 2, and the response to name and response to joint attention items from the Autism Diagnostic Observation Schedule. Infants with severe cerebral palsy, deafness, and blindness were excluded. Associations between positive screen and neonatal/ infant characteristics were determined. Results: Of 554 infants, 113 (20%) had ≥ 1 positive screen. 10% had a positive Pervasive Developmental Disorders Screening test, second edition, 6% response to name, 9% response to joint attention; in only 1 % all 3 screens were positive. Positive screen was associated with male gender, more hospital days, white race, lower maternal education, abnormal behavioral scores, and cognitive/ language delay. Conclusions: The use of 3 screens for ASD in EPs results in higher screen positive rates than use of 1 screen alone. Diagnostic confirmation is needed before true rates of ASD in EPs are known.