A comparison of the performance of normal middle social class Egyptian infants and toddlers with the reference norms of the Bayley Scales -third edition (Bayley III): A pilot study

PLoS One. 2021 Dec 2;16(12):e0260138. doi: 10.1371/journal.pone.0260138. eCollection 2021.

Abstract

Background: Developmental assessment is an important facility for early detection and intervention of developmental delay in children. Objective: to assess the performance of a sample of middle social class Egyptian infants and toddlers on Bayley Scales of Infant and Toddler Development-third edition (Bayley III), and to compare their cognitive, motor, and communication scores with that of the reference norms.

Methods: It was a cross-sectional pilot study, included 270 children aged 18-42 months. Mothers filled a questionnaire including questions about family socioeconomic background, perinatal history, and family history. Physical examination and growth assessment of children were performed. Developmental assessment of cognitive, language and motor skills was performed using the Bayley III scales and compared the American norm scores with the Egyptian mean scores.

Results: The mean cognitive, language and motor composite scores were 92.5+18.5, 91.76+ 15.6, and 95.67+18.9 respectively. All were lower than the American mean (100+ 15) with highly significant differences. About one-fourth of the enrolled Egyptian children had below-average composite scores according to the US cutoff point. The ranks of Egyptian children on the American versus the Egyptian percentile curves were significantly different.

Conclusion: Mean values of all assessed developmental domains of Egyptian children are within the norm-referenced average of Bayley III, but lower than the recorded American mean. Assessing Egyptian children according to the American norms may result in overestimating developmental delay. This pilot study raised the question about using different cutoff points suitable for the developmental trajectory of Egyptian children. Answering this question needs further studies on Bayley-III after cultural adaptation and standardization, using a larger, more diverse, and representative sample of the Egyptian population.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development
  • Child, Preschool
  • Cognition
  • Cross-Sectional Studies
  • Developmental Disabilities / diagnosis
  • Egypt
  • Female
  • Humans
  • Infant
  • Language*
  • Male
  • Motor Skills*
  • Neuropsychological Tests*
  • Pilot Projects
  • Reference Values
  • Social Class
  • United States

Grants and funding

This work was supported by grant from The National Research Center (NRC) of Egypt where all the authors are working. NRC is the largest Governmental multidisciplinary R&D center in Egypt devoted to basic and applied research. This study was one of the accepted and granted researches among the projects of the eleventh plan of NRC, dated from 2016 to 2019. The project’s title was: A Pilot Study to Evaluate the Performance of Egyptian Infants on the Bayley Scales of Infant and Toddler Development -third edition (Bayley III). Its number was: 11010141. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.