ENHANCED PREDICTION OF LATER NORMAL OUTCOME USING INFANT NEUROPSYCHOLOGICAL ASSESSMENT

The Early Neuropsychologic Optimality Rating Scales (ENORS; a preliminary version of the Bayley Infant Neurodevelopmental Screener) was applied to a high-risk infant population in an effort to enhance prediction of 3-year outcome. A total of 573 infants was evaluated: 532 at 6 months, 380 at 12 months, 262 at 24 months, and 220 at 36 months. The SES-Composite Index, Postnatal Complications Scale (PCS), and McCarthy Scales (MSCA) were also administered. A high degree of overlap was found between the ENORS-6, -12, and -24. With hierarchical regression, ENORS versions accounted for 43% to 68% of the variance on MSCA subscales; the SES-Composite added to the predictive model in a small but consistent manner. The PCS did not. In children having an optimal ENORS and SES-Composite, 83% to 97% were later ''normal'', depending on age and area of function. Using odds ratios, an optimal ENORS-6 increased the likelihood of normal 3-year outcome by 2.4 to 10.7 times; odds ratios ranging from 9.85 to 90.1 and from 10.5 to 54.5 were found for the ENORS-12 and ENORS-24, respectively. Clinicians can be fairly confident that if the ENORS and environmental measures are optimal, the likelihood of normal 36-month outcome is quite high.