This study evaluated the ability of a parent-completed questionnaire, the Infant Monitoring Questionnaire (IMQ) to identify at 12 months those high risk infants who will have neurodevelopmental abnormalities at 3 years. The predictive validity of the IMQ was then compared to that of a clinical assessment by a multidisciplinary team.

All consecutive infants referred to a neonatal follow-up program from a tertiary NICU at St. Joseph's Health Centre, London, Ontario were included in the study. One hundred and twenty-three high risk infants participated at 12 months and subsequently at 3 years corrected age. Infants were characterized by very low-birthweight (mean 1260±555) and prematurity (mean GA 29weeks±4). Parents were mainly white (96%) and had at least high school diploma (75%). At 12 months, parents completed the IMQ prior to an assessment of the infant by a developmental paediatrician and a psychologist. Assessment consisted of a neurodevelopmental examination and the Bayley Scales of Infant Development. At 3 years, children were seen for a neurodevelopmental examination and the McCarthy Scales of Children's Abilities.

The degree of agreement between 12 months and 3 year assessments by parents and multidisciplinary team as measured by the kappa statistics were k=0.27±0.09 and k=0.52±0.09 respectively. The proportions of children for whom the parents correctly predicted outcome was compared to that of the multidisciplinary team. Thirty-three (27%) parents correctly predicted outcome at 3 years, while the multidisciplinary team correctly predicted in 93(76%). This difference was highly significant (McNamar's chi-square=46.15, p<0.001). We conclude that the ability of parents to predict developmental outcome in using the IMQ is poor. However, earlier assessments by a clinical team may be more predictive of developmental outcome in high risk NICU graduates.