| The purpose of this study was to survey infant specialists in the greater Washington, D.C., metropolitan area to determine how infant assessment instruments are utilized to identify infants at risk for developmental delay. The investigation sought to determine which infant developmental milestones, when delayed or aberrant, are identified by infant specialists as most significant to the assignment of risk status. A third purpose of the study was to determine which infant assessment test items are considered the most significant in the determination of risk status. A fourth purpose was the determination of patterns of follow-up for infants identified to be at risk for developmental delay.;Analysis of the data from the interviews with infant specialists indicated the following: (1) while neonatologists know of and respect the purpose of infant assessment instruments, their appraisal of infants typically does not include extensive use of developed infant assessment instruments; (2) in contrast, infant developmental follow-up and intervention specialist rely upon infant assessment instruments for programmatic intake, ongoing evaluation, and for the development of individualized education programs; (3) to the extent that neonatologists and developmental follow-up specialists do, in fact, utilize infant assessment instruments there is no agreement between them as to which instruments should be used for the assessment of infants at risk for developmental delay; (4) findings indicate that while all neonatologists rely upon their clinical training for physical examination of infants, the range and extent of inclusion of behavioral/temperamental, neurological, cognitive, social, and cumulative risk components varies from specialist to specialist; and, (5) while premature and small for gestational age babies are of most concern to infant specialists, the developmental findings which are considered worrisome vary from specialist to specialist.;This study reveals that despite the proliferation of infant assessment instruments, recently developed neonatal care techniques, and advanced medical technology, the assessment of risk is a neoteric science. Follow-up studies should be conducted to: (1) assess the range of components of infant physical examinations; (2) assess the long-term reliability of specific developmental assessment techniques, and (3) correlate findings of infant assessment instruments with school performance.;Two populations of infant specialists were interviewed for the study; neonatal specialists and infant intervention and developmental specialists. The survey population consisted of the chief medical officer in each of the Washington, D.C., metropolitan area hospitals with neonatal units, and the directors of infant developmental follow-up and intervention programs. Personal interviews were conducted with each of the 21 specialists between March and July, 1980. A non-directive, open-ended survey interview questionnaire format was used in each interview. Each subject was asked to respond to every survey interview question. |
