Consistency in the Diagnosis of Cognitive, Motor, and Neurologic Function Over the First Three Years

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Abstract
Profiles of diagnostic consistency in cognitive, motor, and neurologic functioning from 40 weeks to 36 months and from 9 to 36 months were evaluated in approximately 270 children enrolled in an NHLBI collaborative study. The influence of background variables on consistency profiles from 9 to 36 months was also determined. The 40-week neurobehavioral evaluation was generally congruent with later assessments. Most infants were normal and tended to remain so. Diagnoses of motor functioning were most stable longitudinally whereas diagnoses of cognitive functioning were least stable. There was a I in 4 chance that a normal diagnosis of cognitive function made at either 40 weeks or 9 months would worsen by 36 months. Change in diagnosis occurred most frequently between 18 and 36 months. In regard to specific diagnoses, profiles of babies classified as suspect generally improved or became ambiguous. Demographic factors influenced cognitive diagnostic consistency more than neurologic or motor functioning. Early assessments appear fairly adequate for diagnosis of motor and neurologic function; longer follow-up may be needed for assessment of cognitive abilities. The implications of these findings are discussed.