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Published on: August 25, 2014
Prospective evaluation of the Ages and Stages Questionnaire 3rd Edition in very-low-birthweight infants
Pratibha K Agarwal1, Luming Shi2, Lourdes M Daniel3
1Department of Neonatology, KK Women's and Children's Hospital, Singapore.
Insights
The Ages and Stages Questionnaire (ASQ-3) accurately screens preterm infants for developmental delays. Early screening with ASQ-3 can reduce the need for further assessments in healthy preterm and very-low-birthweight infants.
Area of Science:
- Neonatal development
- Developmental screening tools
- Pediatric neurodevelopment
Background:
- Preterm and very-low-birthweight (PT/VLBW) infants are at higher risk for developmental delays.
- Accurate and timely developmental screening is crucial for early intervention.
- The Ages and Stages Questionnaire 3rd Edition (ASQ-3) is a widely used developmental screening tool.
Purpose of the Study:
- To evaluate the predictive and concurrent diagnostic agreement of the ASQ-3 with the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III).
- To assess the ASQ-3's utility in identifying developmental delays in PT/VLBW infants.
Main Methods:
- 141 PT/VLBW infants were assessed using ASQ-3 at 9, 12, 18, and 24 months corrected age.
- Bayley-III was administered at 24 months corrected age for comparison.
- Receiver operating characteristic curves were used to determine ASQ-3 cut-offs.
Main Results:
- 43% of infants failed at least one ASQ-3 domain, while 18% failed at least one Bayley-III domain.
- ASQ-3 achieved a negative predictive value (NPV) >98% for motor development from 9 months.
- ASQ-3 demonstrated >90% NPV for communication and overall results at 24 months.
Conclusions:
- ASQ-3 screening at 24 months can effectively reduce unnecessary psychometric assessments in PT/VLBW infants with normal development.
- Clinicians can trust ASQ-3 results for normal motor development at 9 months.
- Continued screening across all domains is recommended for comprehensive developmental surveillance.
Aim:
To evaluate the predictive and concurrent diagnostic agreement of the Ages and Stages Questionnaire 3rd Edition (ASQ-3) with the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) in infants born preterm and very-low-birthweight (PT/VLBW; ≤1250g).
Method:
We evaluated 141 PT/VLBW infants (68 males, 73 females) born at the KK Women's and Children's Hospital between January 2010 and December 2011, to determine predictive and concurrent diagnostic agreement between the ASQ-3 at 9, 12, 18, and 24 months corrected age and Bayley-III at 24 months. Cut-offs on the ASQ-3 at 24 months were estimated by receiver operating characteristic curves.
Results:
Sixty (43%) and 25 (18%) failed in any domain of the ASQ-3 and Bayley-III (<70) respectively. A negative predictive value (NPV) >98% was achieved for the motor domain from 9 months, and >90% for the communication domain and the overall results at 24 months. Optimal referral ASQ-3 score at 24 months to achieve 100% NPV was 243.
Interpretation:
In PT/VLBW infants, ASQ-3 screening at 24 months can reduce the need for costly psychometric assessments in children with normal results. Clinicians can be assured of normal motor development at 9 months using the ASQ-3, but should continue to screen children on other domains.
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