Identifying 4-month-old infants at risk in community screening.

Purpose: To validate a 2-step infant developmental screening protocol administered by nonphysician health professionals.

Methods: The Parent Concerns Survey and the Meade Movement Checklist (MMCL) were administered during 5 community clinics. Infant scores at 4 months were compared with the Bayley Scales of Infant Development II and Movement Assessment of Infants at 6 months and to the Ages and Stages Questionnaires at 8 months.

Results: Parents identified significantly more concerns on the Parent Concerns Survey (x2 = 6.43, p = 0.011) than parents not attending clinics. The correlation between infant MMCL scores at 4 months and Movement Assessment of Infants was r = 0.58 (p = 0.01) and r = -0.48 (p = 0.01) with Bayley Scales of Infant Development II scores at 6 months. The MMCL demonstrated 87.5% sensitivity, 91.4% specificity, and 70% positive predictive value.

Conclusion: Combining parent concerns and observational screening effectively identified infants for further evaluation. This 2-step screening by nonphysician health professionals provides a valid, new perspective for screening young infants.