ENHANCED PREDICTION OF LATER NORMAL OUTCOME USING INFANT NEUROPSYCHOLOGICAL ASSESSMENT

The Early Neuropsychologic Optimality Rating Scales (ENORS; a prelimin ary version of the Bayley Infant Neurodevelopmental Screener) was appl ied to a high-risk infant population in an effort to enhance predictio n of 3-year outcome. A total of 573 infants was evaluated: 532 at 6 mo nths, 380 at 12 months, 262 at 24 months, and 220 at 36 months. The SE S-Composite Index, Postnatal Complications Scale (PCS), and McCarthy S cales (MSCA) were also administered. A high degree of overlap was foun d between the ENORS-6, -12, and -24. With hierarchical regression, ENO RS versions accounted for 43% to 68% of the variance on MSCA subscales ; the SES-Composite added to the predictive model in a small but consi stent 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 EN ORS-12 and ENORS-24, respectively. Clinicians can be fairly confident that if the ENORS and environmental measures are optimal, the likeliho od of normal 36-month outcome is quite high.