Predictive validity of the Lacey Assessment of Preterm Infants for motor outcome at 2 years corrected age

The Lacey Assessment of Preterm Infants (LAPI) is a clinical tool used to assess neuromotor development in preterm infants at high risk of developmental problems. The aim of this study was to determine its predictive validity for estimating later motor outcome at 2 years of age, to ensure appropriate referral to early intervention and thus optimise the infant's outcome. LAPI outcomes (usual or monitor) for preterm infants born between January 2012–2017 at a single tertiary level neonatal intensive care unit in London, UK were retrospectively reviewed. Predictive validity for later “moderate/severe” motor delay was determined by comparing LAPI outcomes with locomotor scores estimated using the Griffiths Mental Development Scales-Extended Revised (GMDS-ER) or Griffiths III at 2 years corrected age. 118 infants were included (GMDS-ER = 87, Griffiths III = 31). Infants classified as usual on the LAPI showed significantly less motor delay on the GMDS-ER locomotor subset at 2 years, compared to infants in the monitor group (usual = 2.00 months, monitor = 6.00 months; p = 0.001). Sensitivity was found to be only 47.37%, with higher specificity of 84.85%. The LAPI shows high specificity but low sensitivity for prediction of later motor delay. It may therefore be useful for screening lower-risk infants, however on-going monitoring would be advised. Further studies investigating the reliability of the LAPI and use in conjunction with other predictive tools to improve sensitivity are recommended. •The LAPI demonstrates high specificity (85%) for prediction of 2-year motor outcome.•A ‘usual’ LAPI outcome is strongly predictive of later normal motor outcome.•However, the LAPI demonstrated lower sensitivity (47%).•The LAPI may be a useful tool for screening lower-risk infants.•Ongoing surveillance and monitoring for at-risk infants is strongly advised.