The Clinical Utility of Korean Bayley Scales of Infant and Toddler Development-Ⅲ -Focusing on using of the US norm-

임유진, 이순행, & 방희정. (2017). 베일리영유아발달검사 제3판(Bayley-Ⅲ)의 미국 규준 적용의 문제: 미숙아 집단을 대상으로. 한국심리학회지: 일반, 36(1), 81-107, https://doi.org/10.22257/kjp.2017.03.36.1.081

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초록

베일리영유아발달검사 제3판(Bayley-Ⅲ)의 미국 규준이 영유아의 발달수행을 과대추정하고 발달지연율을 과소추정 한다는 논란이 있어서, 본 연구는 발달지연의 고위험군인 미숙아를 대상으로 미국 규준 적용시 Bayley-Ⅲ의 임상적 유용성을 살펴보고자 하였다. 본 연구는 생후 1개월부터 24개월(교정원령)의 미숙아(재태기간 37주 미만)와 만삭아 93명을 대상으로 Bayley-Ⅲ와 한국형베일리영유아발달검사 2판(K-BSID-Ⅱ)을 실시하였다. 연구결과는 다음과 같다. 첫째, 미숙아/만삭아 각 93명을 대상으로 혼합설계 분산분석을 실시한 결과 재태기간(경증미숙아, 중증미숙아, 극중증미숙아, 만삭아)에 따른 Bayley-Ⅲ의 발달지수 및 척도점수 간에 유의미한 차이가 있었다. 특히 경증미숙아 집단 내에서는 발달영역(인지, 언어, 운동)에 따라 유의미한 차이가 있는 것으로 나타냈다. 둘째, Bayley-Ⅲ와 K-BSID-Ⅱ을 모두 실시한 미숙아(n=79)를 대상으로 환산점수 평균 간의 차이를 살펴본 결과, Bayley-Ⅲ의 발달지수는 K-BSID-Ⅱ의 발달지수에 비해 유의미하게 높은 것으로 나타났으며 발달지연률은 크게 감소하는 것으로 나타났다. 마지막으로 ROC 분석을 통해 발달지연 변별에 대한 Bayley-Ⅲ의 민감도와 특이도를 분석하고 Bayley-Ⅲ의 임상적 절단점을 탐색한 결과, Bayley-Ⅲ의 하위 척도 모두 우수한 수준의 변별정확도를 나타냈으나, 미국 규준 적용시 절단점은 더 높게 나타났다. 본 연구는 미국 규준을 사용하여 Bayley-Ⅲ를 임상 현장에 적용할 때 점수 해석의 주의를 알리는 실증적인 자료로서, 한국 규준 마련시 표집 문제와 관련된 논의를 제공하였다.

keywords: Bayley scales of Infant and Toddler Development-Third Edition, clinical utility, preterm infants, 베일리 영유아 발달검사 3판(Bayley-Ⅲ), 미숙아, 규준, 임상적 유용성

Abstract

The study aims to investigate the clinical utility of Bayley-Ⅲ using US norm in Korea. A total of 98 preterm infants and 93 term infants were assessed with the K-Bayley-Ⅲ. The performance pattern of preterm infants was analyzed with mixed design ANOVA which examined the differences of scaled scores and composite scores of Bayley-Ⅲ between full term- and preterm- infant group and within preterm infants group. Then, We have investigated agreement between classifications of delay made using the BSID-II and Bayley-III. In addition, ROC plots were constructed to identify a Bayley-Ⅲ cut-off score with optimum diagnostic utility in this sample. The results were as follows. (1) Preterm infants have significantly lower function levels in areas of 5 scaled scores and 3 developmental indexes compared with infants born at term. Significant differences among scores within preterm infant group were also found. (2) Bayley-Ⅲ had the higher scores of the Mental Development Index and Psychomotor Developmental Index comparing to the scores of K-BSID-Ⅱ, and had the lower rates of developmental delay. (3) All scales of Bayley-Ⅲ, Cognitive, Language and Motor scale had the appropriate level of discrimination, but the cut-off composite scores of Bayley-Ⅲ were adjusted 13~28 points higher than 69 for prediction of delay, as defined by the K-BSID-Ⅱ. It explains the lower rates of developmental delay using the standard of two standard deviation. This study has provided empirical data to inform that we must careful when interpreting the score for clinical applications, identified the discriminating power, and proposed more appropriate cut-off scores. In addition, discussion about the sampling for making the Korean norm of Bayley-Ⅲ was provided. It is preferable that infants in Korea should use our own validated norms. The standardization process to get Korean normative data must be performed carefully.

keywords: Bayley scales of Infant and Toddler Development-Third Edition, clinical utility, preterm infants, 베일리 영유아 발달검사 3판(Bayley-Ⅲ), 미숙아, 규준, 임상적 유용성

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Vol.36 No.1

베일리영유아발달검사 제3판(Bayley-Ⅲ)의 미국 규준 적용의 문제: 미숙아 집단을 대상으로

The Clinical Utility of Korean Bayley Scales of Infant and Toddler Development-Ⅲ -Focusing on using of the US norm-

초록

Abstract

참고문헌

한국심리학회지: 일반