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Validity of the ages and stages questionnaires in term and preterm infants
Luisa Schonhaut1, Iván Armijo, Marianne Schönstedt
1Department of Pediatrics, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile. lschonhaut@alemana.cl
Insights
The Ages and Stages Questionnaires, Third Edition (ASQ-3) demonstrates adequate validity for screening developmental delays in children. It is recommended for routine screening and follow-up programs, especially for preterm infants.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Screening Tools Validation
Background:
- Assessing the concurrent validity of the Ages and Stages Questionnaires, Third Edition (ASQ-3) against the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).
- Study population included term, late preterm, and extremely preterm infants at 8, 18, and 30 months corrected gestational age (CGA).
Purpose of the Study:
- To evaluate the ASQ-3's accuracy in identifying developmental delays compared to a gold-standard measure.
- To determine the ASQ-3's suitability for routine developmental screening in diverse infant populations.
Main Methods:
- 306 infants (term and preterm) aged 8, 18, and 30 months CGA participated.
- Parents completed ASQ-3 at home; trained professionals administered Bayley-III in clinic.
- ASQ-3 positive screen: any domain <2 SDs below mean. Bayley-III delay: score ≤1 SD.
Main Results:
- ASQ-3 exhibited adequate psychometric properties: 75% sensitivity and 81% specificity.
- Modest agreement between ASQ-3 and Bayley-III (r = 0.56).
- Sensitivity, specificity, and correlations improved with age and in extremely preterm infants.
Conclusions:
- ASQ-3 is recommended for routine screening of low-risk children at 8, 18, and 30 months' CGA.
- ASQ-3 inclusion in follow-up programs for preterm infants is advisable.
- The measure shows good utility for developmental surveillance in clinical settings.
Background:
This study assessed the concurrent validity of the parent-completed developmental screening measure Ages and Stages Questionnaires, Third Edition (ASQ-3) compared with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) in children born term, late preterm, or extremely preterm at 8, 18, or 30 months of corrected gestational ages (CGA).
Methods:
Data were collected from 306 term and preterm children ages 8, 18, and 30 months' CGA recruited from an ambulatory well-child clinic in Santiago, Chile. Parents completed the ASQ-3 in their homes, and afterward a trained professional administered the Bayley-III in a clinic setting. On the ASQ-3, the presence of any domain screened <2 SDs below the mean area score was considered a positive screen (indicating failure or delay). A Bayley-III score less than ≤1 SD indicated mild or severe delay.
Results:
ASQ-3 showed adequate psychometric properties (75% sensitivity and 81% specificity) and modest agreement with the Bayley-III (r = 0.56). Sensitivity, specificity, and correlations between measures improved with testing age and in children who were born extremely preterm.
Conclusions:
Considering its psychometric properties, the ASQ-3 can be recommended for routine use in screening low-risk children at 8, 18, and 30 months' CGA and is advisable to be included in follow-up programs for children with biological risk factors such as those born preterm.
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