The transition scale : predicting neurological morbidity at the time of birth

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Authors
Strom, Dorothy A.
Advisor
Dean, Raymond S.
Issue Date
1988
Keyword
Degree
Thesis (Ph. D.)
Department
Department of Educational Psychology
Other Identifiers
Abstract

Advances in the field of neonatal-perinatal medicine and interventions of the 1960's have resulted in decreased mortality rates for infants suffering a variety of perinatal insults. However, it has been estimated that 25% of the survivors of high risk births will go on to have serious lifetime diabilities (Behrman, 1977). Resulting neurological morbidity may be expressed in major cognitive disabilities (i.e., cerebral palsy, mental retardation, learning disorders and the like). Early identification of these children seems Parmalee, Sigman, & Beckwith, 1982). However, the prediction of neurological outcomes remains problematic.Recognizing the psychometric concerns associated with. perinatal risk measures currently used (Crawford, 1965: Bobbin, 1963: Wenar, 1963), the Transition Scale was created as a potentially reliable measure of perinatal risks observed at the time of birth. With a sample of 116 newborn subjects, the present investigation evaluated the stability and underlying constructs of the newly created measure. In addition, comparisons were made with information obtained critical to prevention and early intervention (Cohen, from the medical chart (i.e., Apgar Score).The percentage of agreement between the two independent raters for individual items of the Transition Scale ranged from .95 to 1.00, with the overall interrater agreement calculated as .98. Similarly, an examination of the agreement between each individual rater's responses and the medical chart information revealed percentages ranging from .90 to 1.00, with overall percentages of .96 and .97. Furthermore, the results of a factor analysis indicated that the Transition Scale offers substantial construct validity.Overall, the present investigation recommends the Transition Scale as a reliable research instrument with potential clinical utility. In addition, an examination of the underlying constructs of the measure point to the potential of the Transition Scale as a valid predictor of neurological morbidity. Further research using a high risk sample of infants is recommended.