BAYLEY SCALES

Definition
The Bayley Scales of Infant Development (BSID) measure the mental and motor
development and test the behavior of infants from one to 42 months of age.
Purpose
The BSID are used to describe the current developmental functioning of infants and to assist
in diagnosis and treatment planning for infants with developmental delays or disabilities. The
test is intended to measure a child's level of development in three domains: cognitive, motor,
and behavioral.
Cognitive development
Cognition can be defined as a process by which knowledge is gained from perceptions or
ideas. Cognitive development refers to how an infant perceives, thinks, and gains an
understanding of the world. Within the history of developmental psychology, the work of
Jean Piaget (18961980), the Swiss psychologist, has had the greatest impact on the study of
cognitive development. Piaget's theory is focused on the processes of cognitive development
and states that the child is born with an innate curiosity to interact with and understand
his/her environment. It is through interaction with others that the child actively constructs
his/her development.
Motor development
During the first two years of life, infants grow and develop in many ways. Two types of
motor development occur at this stage. Cephalocaudal development occurs in the following
sequence: head before arms and trunk and arms and trunk before legs. Proximodistal
development occurs as follows: head, trunk, arms before hands and fingers. Motor
development has a powerful impact on the social relationships, thinking, and language of
infants. Large motor development allows infants to have more control over actions that help
them move around their environment, while small motor development gives them more
control over movements that allow them to reach, grasp, and handle objects. The sequence of
these developments is similar in most children; however, the rate of growth and development
varies by individual.
Behavioral development
Temperament is the set of genetically determined traits that organize the child's approach to
the world. They are instrumental in the development of the child's distinct personality and
behavior. This behavioral style appears very early in lifewithin the first two months after
birthand undergoes development, centered on features such as intensity, activity,
persistence, or emotionality.
Besides measuring normal cognitive, motor, and behavioral developmental levels, the BSID
are also used in cases in which there are significant delays in acquiring certain skills or

performing key activities in order to qualify a child for special interventions. Specifically,
they are also used to do the following:

identify children who are developmentally delayed

chart a child's progress after the initiation of an intervention progrlim
teach parents about their infant's development
conduct research in developmental psychology

Description
The BSID were first published by Nancy Bayley in The Bayley Scales of Infant Development
(1969) and in a second edition (1993). The scales have been used extensively worldwide to
assess the development of infants. The test is given on an individual basis and takes 4560
minutes to complete. It is administered by examiners who are experienced clinicians
specifically trained in BSID test procedures. The examiner presents a series of test materials
to the child and observes the child's responses and behaviors. The test contains items
designed to identify young children at risk for developmental delay . BSID evaluates
individuals along three scales:
1. Mental scale: This part of the evaluation, which yields a score called the mental
development index, evaluates several types of abilities: sensory/perceptual acuities,
discriminations, and response; acquisition of object constancy; memory learning and
problem solving; vocalization and beginning of verbal communication; basis of
abstract thinking; habituation; mental mapping; complex language; and mathematical
concept formation.
2. Motor scale: This part of the BSID assesses the degree of body control, large muscle
coordination, finer manipulatory skills of the hands and fingers, dynamic movement,
postural imitation, and the ability to recognize objects by sense of touch
(stereognosis).
3. Behavior rating scale: This scale provides information that can be used to supplement
information gained from the mental and motor scales. This 30-item scale rates the
child's relevant behaviors and measures attention/arousal, orientation/engagement,
emotional regulation, and motor quality.
The mean score is 100 (SD _ 16) with 50 being the lowest MDI or PDI. The MDI assesses
perceptual abilities, object permanence, memory, problem-solving skills, imitative abilities,
and early symbolic thinking (Aylward, 1994). The PDI provides evaluation of gross and fine
motor development; whereas the IBR includes a general assessment of social, behavioral, and
emotional functioning. The BSID was revised and is now the Bayley Scales of Infant
Development-II (Bayley, 1993). It continues to be the premier developmental assessment
instrument. The revision was due in part to the fact that there had been an upward drift of
approximately 11 points on the MDI and 10 points on the PDI, this pattern being referred to
as the Flynn effect (1999). As a result, scores on the BSID-II are 12 points lower on the MDI
and 10 points lower on the PDI when compared to the original BSID (Bayley, 1993; Black &
Matula, 2000). Therefore, if a child had been given the BSID and subsequently the BSID-II,
scores would be lower, but this decline would not necessarily reflect a worsening of
developmental function. The BSID-II maintains the same structure as the original Bayley;
however, the Behavior Rating Scale replaced the IBR. Overall, approximately 30% of the
original items were dropped, and roughly 50% of the items are new, designed to improve

content coverage, although the theoretical foundation continues to be eclectic. Many new
items represent higher order cognitive processes that involve reasoning, memory, and process
integration (Aylward, 1997a; Black et al., 2000). On the MDI, there was an increase in
language items, and addition of early number concepts, prewriting skills, visual perception,
and perceptual-motor integration items. The PDI was also expanded to include muscle tone,
dynamic and static balance, and perceptual motor development. The age range of the BSID-II
is 142 months, and the SD was changed to 15.
The Behavior Rating Scale (BRS) enables assessment of the infants state, orientation toward
the environment, motivation, and engagement with people (Black et al., 2000). These aspects
of testing are critical with regard to test performance, as indicated in the earlier discussion.
The first two items represent the caregivers interpretation of the infants performance,
namely, how typical the infants behaviour was and whether the test results accurately
portrayed the infants abilities (as per caretaker report). BRS items were factor analyzed with
factor structures differing for the three age groups (15 months, 612 months, and 1342
months). Examples of these factors are Attention/Arousal, Motor Quality,
Orientation/Engagement, and Emotional Regulation. The enhanced psychometric properties
of the BRS in comparison to the former IBR enable a broader evaluation of the infants
overall functioning.The BSID-II has specified item sets (22) and changes in basal and ceiling
rules that differ from the original BSID. Each item set includes scores that are roughly _ 1 SD
from the mean (78122). However, there is controversy surrounding the BSID-II regarding
whether to begin the item set corresponding to the childs corrected or chronological age (in
the case of premature infants) or at lower item sets for children suspected of having
developmental delays. More specifically, if correction is used to determine the item set to
begin administration or if an earlier item set is employed because of developmental problems,
scores tend to be somewhat lower, because the child is not automatically given credit for
passing the lower item set.
Although the BSID-II incorporates facet scores to identify strengths and weaknesses
(cognitive, language, social, and motor), it would be helpful to provide area scores
compatible with Individuals with Disabilities Education Act (IDEA), namely, cognitive,
motor, communication, social, and adaptive (Black et al., 2000). Several other testing
concerns are applicable to the BSID-II as well as other developmental assessment
instruments. Standardized materials and standardized administration are critical for making
comparisons to established norms; and deviation vitiates such a comparison. Similarly, it is
critical to determine whether the infants success on an item is purposeful/intentional rather
than serendipitous (e.g., trial-and-error form-board approach versus looking at the form and
placing it in the proper hole). The examiners effort to obtain a response (too many attempts
facilitates teaching to task), patterns of refusals, and use of testing of limits in the case of
splinter skills is helpful. Similarly, differences between cognitive and motor scores should not
be overlooked (sometimes called cognitive referencing), as these differences have diagnostic
utility (Aylward et al.,1995)
The BSID are known to have high reliability and validity. The mental and motor scales have
high correlation coefficients (.83 and .77 respectively) for test-retest reliability.
The BayleyIII has three major parts that are tested with the child: Cognitive,
Language, and Motor. The Questionnaire that you completed looks at your childs
Social-Emotional and Adaptive Behavior development.

The Cognitive Scale (Cog) looks at how your child thinks, reacts, and learns
about the world around him or her.

* Infants are given tasks that measure their interest in new things, their attention to familiar
and unfamiliar objects, and how they play with different kinds of toys. * Toddlers are given
items that examine how they explore new toys and experiences, how they solve problems,
and their ability to complete puzzles.
* Preschool-age children are given items that measure pretend play and activities such as
building with blocks, color matching, counting, and solving more complex puzzles.

The Language Scale (Lang) has two parts.

* The Receptive Communication (RC) part looks at how well your child recognizes sounds
and how much your child understands spoken words and directions.
* Infants are given items that measure his or her recognition of sounds, objects, and people in
the environment.
* Toddlers are given items that ask them to identify pictures and objects, follow simple
directions, and perform social routines such as wave bye-bye or play peek-a-boo.
* Preschool age children are asked to follow more complex directions, identify action
pictures, and are given items that measure his or her understanding of basic grammar.
* The Expressive Communication (EC) part looks at how well your child communicates
using sounds, gestures, or words.
* Infants are observed throughout the assessment for various forms of non-verbal expressions
such as smiling, jabbering expressively, and laughing.
* Toddlers are given opportunities to use words by naming objects or pictures and answering
questions.
* Preschool age children are also given the opportunity to use words and to answer more
complex questions.

The Motor Scale (Mot) has two parts.

* The Fine Motor (FM) part looks at how well your child can use his or her hands and fingers
to make things happen.
* Infants are assessed for muscle control such as following movement with their eyes,
bringing a hand to their mouth, and reaching and/or grasping an object.
* Toddlers are given the opportunity to demonstrate their ability to perform such tasks as
stacking blocks, drawing simple shapes, and placing small objects such as coins in a slot.

* Preschool age children are asked to draw more complex shapes, build simple structures
using blocks, and use scissors to cut paper.
* The Gross Motor (GM) part looks at how well your child can move his or her body.
* Infants are assessed for head control and their performance on activities such as rolling
from side to side, sitting upright, and crawling motions.
* Toddlers are given items that measure their ability to crawl, make stepping motions, support
their own weight, stand, and walk without assistance.
* Preschoolers age children are given a chance to demonstrate their ability to climb stairs,
run, maintain balance, kick a ball, and other activities requiring full body control or
coordination.

The Social-Emotional (SE) portion of the Social-Emotional and Adaptive

Behavior Questionnaire

Measures development in infants and young children by identifying social-emotional

milestones that are normally achieved by certain ages.
* Caregivers of infants are asked to give feedback on their childs level of interest in colorful
or bright things, ease of getting the childs attention, ease of calming the child, and how often
the child responds to others by making sounds or changing facial expression.
* Caregivers of toddlers are asked to respond to items that assess their childs ability to take
action to get their needs met, ability to imitate others in play, the childs use of imagination in
play, and how the child uses words to communicate.
* Caregivers of preschool children are asked about their childs interactions with peers and
adults, ability to explain what they need and why, ability to describe how they feel, and
ability to use emotions in an interactive, purposeful manner.

The Adaptive Behavior portion of the Questionnaire

Asks caregivers to respond to items that assess their childs ability to adapt to various
demands of normal daily living. Depending on the childs age, children are measured on
some or all of the following areas:
* Communication (Com): speech, language, listening, and nonverbal communication skills
* Functional Pre-Academics (FA): skills such as letter recognition and counting
* Self-Direction (SD): skills such as self-control, following directions, and making choices
* Leisure (LS): activities such as playing and following rules
* Social (Soc): getting along with other people, including skills such as using manners,
assisting others, and recognizing emotions

* Community Use (CU): interest in activities outside the home

* Home Living (HL): helping adults with household tasks and taking care of personal
possessions
* Health and Safety (HS): knowledge of basic health activities (wearing coat when cold
outside) and physical dangers (hot stove)
* Self-Care (SC): activities such as eating, toileting, and bathing * Motor (MO): locomotion
and manipulation of objects
The scores indicate how well your child performed compared to a group of children within
the same age range from across the United States.
* The highest possible score on a subtest is 19, and the lowest possible score is 1.
* Scores from 8 to 12 are considered average.