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R Christopher Sheldrick1, Susan Marakovitz2, Daryl Garfinkel2

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Summary
This summary is machine-generated.

Three common developmental screening tools show good specificity but moderate sensitivity for identifying developmental delays in young children. No single questionnaire was found to be superior overall, indicating trade-offs in their performance.

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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.