Standardized Infant NeuroDevelopmental Assessment developmental and socio-emotional scales: reliability and predictive value in an at-risk population.

The infants were seen in a specialised high-risk outpatient clinic, not a general paediatric setting, so the results may not apply to lower-risk infants. Infants who were doing relatively well were less likely to have follow-up, which may have missed some later problems. The follow-up paediatricians knew the infant's SINDA scores, although the psychologists doing the developmental testing did not. 29% of the infants had an atypical outcome, which can make predictive values look better than in a lower-risk group. The reliability group was assessed in a different setting by several assessor pairs, and only 60 infants were used. The trisomy 21 group had only 17 infants, and the socio-emotional analysis included only 165 infants. Follow-up used clinical routines and different developmental tests for some older children, and the Bayley Second Edition was used because German Third Edition norms were not available. The study shows prediction, not that therapy based on the scores improves outcomes.

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Do not treat a typical SINDA score as ruling out later disorder. Some infants with later cerebral palsy or behavioural or emotional disorder had typical early scores, and the study did not test whether early intervention improves outcomes.