Comparative Accuracy of Developmental Screening Questionnaires.

Area of Science:

• Pediatric developmental screening
• Diagnostic accuracy studies
• Child health assessment

Background:

• Universal developmental screening is recommended but accuracy studies show mixed results.
• Previous comparisons of screening instruments have methodological limitations.

Purpose of the Study:

• To compare the diagnostic accuracy of three common developmental screening instruments.
• Evaluate the Ages & Stages Questionnaire (ASQ-3), Parents' Evaluation of Developmental Status (PEDS), and Survey of Well-being of Young Children (SWYC): Milestones.

Main Methods:

• Cross-sectional diagnostic accuracy study in 10 pediatric primary care offices.
• 1495 families of children aged 9 months to 5.5 years participated.
• Compared ASQ-3, PEDS, and SWYC Milestones against standardized developmental tests (Bayley Scales, Differential Ability Scales).

Main Results:

• All three questionnaires demonstrated adequate specificity but modest sensitivity for detecting developmental delays.
• Specificity was higher for ASQ-3 and SWYC Milestones in younger children, and ASQ-3 in older children.
• Sensitivity varied by questionnaire and age group, with higher sensitivity for severe delays and when parent concerns were addressed.

Conclusions:

• The three widely used developmental screening questionnaires have trade-offs in sensitivity and specificity.
• No single instrument was superior overall for developmental delay screening.
• Parental concerns significantly enhanced the sensitivity of all tested questionnaires.