Preliminary Validation of a New Developmental Screening Tool for Neurodevelopmental Delay in HIV-Infected South African Children

Abstract

Screening for developmental delays among HIV-infected children is not routine in most pediatric HIV clinics in Africa because of the lack of locally adaptable, simple, sensitive and rapid screening tools. The Division of Developmental Pediatrics of the Red Cross War Memorial Children's Hospital developed a tool for rapid screening of moderate to severe global developmental delays among HIV-infected children aged 9 to 36 months. The diagnostic accuracy of the novel screening tool was evaluated. Forty-seven HIV-infected children aged 9 to 36 months were screened using the Red Cross War Memorial Children's Hospital developmental screening tool. Full developmental assessments of same children were performed using the Bayley Scales of Infant and Toddler Development, Third Edition. The Red Cross War Memorial Children's Hospital tool's sensitivity was 78.5%, specificity 54.6%, positive predictive value was 42.6%, and negative predictive value was 85.4%. The Red Cross War Memorial Children's Hospital screening tool was adequately sensitive and therefore recommended for screening of moderate to severe developmental delays among HIV-infected children.

Keywords: Red Cross War Memorial Children’s Hospital developmental screening tool; developmental delay; diagnostic accuracy; pediatric HIV; screening.