Developmental screening in children with CHD: Ages and Stages Questionnaires

Area of Science:

• Pediatric Cardiology
• Developmental Pediatrics
• Screening Tools

Background:

• Standardized developmental screening is crucial for children with congenital heart disease (CHD).
• The psychometric properties and clinical utility of screening tools like the Ages & Stages Questionnaires, Third Edition (ASQ-3) have not been well-established in the CHD population.
• This study aimed to evaluate the ASQ-3's usefulness in this specific group.

Purpose of the Study:

• To assess the clinical utility and psychometric properties of the ASQ-3 for developmental screening in children with CHD.
• To determine if the ASQ-3 can accurately identify developmental delays in children with CHD compared to established developmental assessments.

Main Methods:

• Compared ASQ-3 developmental classifications with concurrent Bayley Scales of Infant and Toddler Development, Third Edition testing.
• Analyzed data from 163 children with CHD at ages 6, 12, 24, and 36 months.
• Evaluated ASQ-3 performance using different thresholds (≥1 SD and ≥2 SD below the normative mean).

Main Results:

• High specificity (≥81.9%) and negative predictive value (≥81.0%) were observed when screening failure was defined as ≥1 SD below the mean.
• Sensitivity varied by developmental area and age, being high for gross motor skills (79.6%) and improving with age for communication.
• The ASQ-3 demonstrated improved accuracy in predicting delays compared to clinical risk factors alone.

Conclusions:

• The ASQ-3 is a clinically useful tool for screening development in children with CHD, though its utility differs across developmental domains and age points.
• Clinicians should consider referring children scoring ≥1 SD below the normative mean on any ASQ-3 area for formal developmental evaluation.
• The ASQ-3 aids in early identification and management of developmental disorders in children with CHD.