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The Ages and Stages Questionnaires: feasibility of use as a screening tool for children in Canada
Jorina Elbers1, Andrew Macnab, Elaine McLeod
1Department of Pediatrics, University of British Columbia, Vancouver, BC.
Insights
The Ages and Stages Questionnaires (ASQ) effectively screens for developmental delays in children, showing high accuracy and feasibility for both at-risk and community populations. Parents found the tool easy to use and valuable for monitoring child development.
Area of Science:
- Pediatric developmental screening
- Child health monitoring
- Clinical assessment tools
Background:
- Early identification of developmental problems is crucial for timely intervention.
- Existing screening methods may have limitations in accessibility or parent engagement.
- Monitoring tools for at-risk and community children require validation for accuracy and feasibility.
Purpose of the Study:
- To evaluate the accuracy and feasibility of the Ages and Stages Questionnaires (ASQ) for developmental screening.
- To assess the ASQ's utility in identifying developmental delays in infants and children.
- To determine parental acceptance and willingness to use the ASQ tool.
Main Methods:
- Prospective assessment of 43 post-cardiac surgery and 68 community children (4-36 months) using the ASQ.
- Follow-up at 5-6 years via parent and physician interviews to confirm developmental delays.
- Comparison of ASQ results with physician-documented developmental assessments.
Main Results:
- The ASQ demonstrated high sensitivity (75% at-risk, 100% community) and specificity (95% at-risk, 90% community).
- Parents were unanimously willing to complete the ASQ assessments.
- The tool identified developmental delays in both at-risk and community groups, with high concordance with specialist assessments.
Conclusions:
- The Ages and Stages Questionnaires (ASQ) is a feasible, inexpensive, and user-friendly tool for developmental monitoring.
- The ASQ is a sensitive and specific screening method suitable for cardiac and community child health programs.
- The ASQ can rationalize access to specialist services but should complement, not replace, clinical assessment.
Objective:
To determine the accuracy and feasibility of a monitoring tool completed by parents for screening at-risk and community infants and children for developmental problems.
Methods:
We assessed 43 children following open-heart surgery and 68 community children (aged 4-36 mo) at prescribed intervals using the Ages and Stages Questionnaires (ASQ). Subjects were followed 3 years later (at age 5-6 yr) via telephone interview with their parents concerning developmental delay identified by physicians. Responses were confirmed by telephone interviews with family physicians. We then compared the results of the ASQ with the physician assessments.
Results:
Nine at-risk and 9 community children were lost to follow-up. The ASQ identified 4 of the 25 at-risk children as having developmental delay, while 2 of the 6 children assessed by a neurologist were identified as having developmental delay. The ASQ identified 2 of the 59 community children as having developmental delay, 1 of whom was assessed by a neurologist as having developmental delay. The ASQ had sensitivities of 75% in the at-risk group and 100% in the community group, and specificities of 95% and 90%, respectively. The parents were unanimous in their willingness to complete the assessments.
Conclusion:
The ASQ is feasible, inexpensive, easy to use, and was appreciated by the parents. It is a sufficiently sensitive and specific monitoring tool that its use in cardiac follow-up programs and in community programs for healthy children is warranted. Although this tool should not be used to replace clinical assessment, it can be used to rationalize access to specialist developmental assessment services.
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