Development of a Structured Neurodevelopmental History Tool (ASNE/SNHQ): Delphi-based content validation and...

Neurodevelopmental disorders (NDDs) frequently present as complex, transdiagnostic clinical profiles characterised by overlapping developmental symptoms, heterogeneous trajectories and frequent psychiatric, medical and learning comorbidities. In this context, the quality and completeness of the developmental history are critical determinants of diagnostic reasoning and multidisciplinary care planning. In France, Coordination and Orientation Platforms (PCO) have strengthened early identification and referral, but existing tools primarily support screening and orientation rather than providing a structured, consultation-ready clinical history.

To describe the development and content validation of the Structured Neurodevelopmental History Tool (ASNE; Structured Neurodevelopmental History Questionnaire, SNHQ, in English), designed to be completed by families prior to specialist consultation, and to position this tool within the French neurodevelopmental care pathway.

ASNE was developed from an existing French parental questionnaire and refined through a three-round Delphi consensus involving a multidisciplinary panel of 40 experts in neurodevelopmental disorders. Consensus was established using the formalized consensus method of the French National Authority for Health (HAS), based on the median and dispersion of expert ratings rather than percentage agreement. The study was conducted and reported in accordance with the ACCORD reporting guideline. The Delphi process aimed to establish content and usability validity rather than psychometric performance.

The Delphi process resulted in a structured questionnaire comprising 102 consensus items organised into 18 domains covering developmental history, functional abilities, schooling, emotional and behavioural functioning, daily life, somatic history, and previous care pathways. Three items reached immediate consensus during Round 1, 84 during Round 2 and 15 during Round 3. Expert participation decreased from 40 to 22 and 20 panellists across successive rounds while preserving multidisciplinary representation. The final questionnaire was intended to standardise developmental history-taking prior to consultation and to support diagnostic preparation and multidisciplinary clinical reasoning.

ASNE fills an important gap between screening instruments and standardised assessment tools by providing a structured, parent-completed developmental history that is immediately usable during specialist consultations. It supports more comprehensive and standardised information collection within French neurodevelopmental care pathways. Future studies should evaluate its feasibility, acceptability and psychometric properties in routine clinical practice.