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The accuracy of parental concern expressed in the Ages and Stages Questionnaire to predict developmental delay
Nicole Deakin-Bell1, Karen Walker, Nadia Badawi
1School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia. n.deakinbell@gmail.com
Insights
Parental concerns on the Ages and Stages Questionnaire (ASQ) can predict infant development. However, ASQ comments alone do not meet guidelines for screening developmental delay.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Health Services Research
Background:
- The Ages and Stages Questionnaire (ASQ) is a widely used developmental screening tool.
- Limited research exists on the predictive value of the ASQ's free-text comments section.
- Parental input is crucial in identifying potential developmental concerns in infants.
Purpose of the Study:
- To evaluate if parental concerns in the ASQ free-text comments can predict infant development.
- To compare ASQ free-text comments with gold-standard developmental assessments.
- To analyze the predictive accuracy of different types of parental concerns.
Main Methods:
- Post hoc analysis of data from the Development After Infant Surgery study.
- Qualitative thematic analysis of ASQ free-text comments.
- Quantitative comparison of ASQ comments with the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III).
- Analysis of infants who underwent cardiac surgery, non-cardiac surgery, and a control group.
Main Results:
- Parental concern on ASQ collectively predicted lower BSID-III scores.
- Medical and developmental concerns predicted child development.
- Global and behavioral concerns were not predictive of development.
- Sensitivity for predicting BSID-III subscale scores < 8 ranged from 22% to 48%; specificity ranged from 73% to 88%.
Conclusions:
- Parental concern expressed in ASQ comments is associated with infant developmental outcomes.
- ASQ comments alone do not meet psychometric property guidelines for screening developmental delay.
- The qualitative information from ASQ comments warrants attention for understanding child development.
Aim:
Whilst there have been comparisons of the Ages and Stages Questionnaire (ASQ) with other gold standard developmental assessments, research concerning the free-text comments section of the questionnaire has been limited. The objective of this paper is to assess whether parental concerns expressed in the free-text comments section of the ASQ can accurately predict infant development.
Method:
Data from the Development After Infant Surgery study was analysed post hoc. Free-text comments from the ASQ were analysed qualitatively by thematic analysis and quantitatively in comparison to the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Infants who underwent cardiac surgery (97), non-cardiac surgery (131) and no surgery (controls; 166) were analysed.
Results:
Parental concern expressed on the ASQ predicted a lower mean BSID-III score when groups were analysed collectively. Medical concern and developmental concern were shown to be predictors of child development, whilst global concerns and behavioural concerns were unrelated to child development. The presence of carer concern was assessed for its value in predicting a BSID-III subscale score less than 8 in all groups. Sensitivity ranged from 22% to 48%, and specificity ranged from 73% to 88%.
Conclusions:
Parental concern was found to predict a lower BSID-III when all groups were analysed collectively. Despite this, parental concern as a screening test for developmental delay failed to meet the National Health and Medical Research Council guidelines for adequate psychometric properties. The findings from this study suggest that there is value in attending to the comments written by carers on the ASQ.
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