Psychometric properties and validation of Portuguese version of Ages & Stages Questionnaires (3rd edition): 9, 18 and 30 Questionnaires

The Influence of Perinatal Psychological Changes on Infant Neurodevelopment in Shanghai, China: A Longitudinal Group-based Trajectory Analysis

OBJECTIVE

This prospective cohort study, conducted at the Fenglin Community Health Service Center (FCHC) in Xuhui District, Shanghai, aimed to investigate the impact of maternal psychological status on offspring neurodevelopment.

METHODS

A total of 430 mother-child pairs were included, with pregnant women enrolled between February 18, 2020, and April 19, 2021. Face-to-face interviews and electronic data collection on demographic characteristics, health conditions and medical history were employed at various stages of pregnancy and postpartum. Maternal depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, while offspring neurodevelopment was measured at six months using the Ages and Stages Questionnaire 3rd Edition (ASQ-3). In statistical analyses, group-based trajectory modeling (GBTM) was employed to identify the latent groups for maternal psychological trajectories, including depression and anxiety, and logistic regression was used to explore associations between maternal psychological trajectories and offspring neurodevelopment, adjusting for potential confounders.

RESULTS

Five latent trajectory groups were identified for both depression and anxiety, exhibiting distinct patterns over time. Results indicated that maternal psychological trajectories were associated with various domains of offspring neurodevelopment, including communication, problem-solving, personal-social, and gross motor skills. Specifically, mothers in trajectory groups characterized by the highest level of depression or anxiety showed increased odds of offspring neurodevelopmental delays compared to reference groups.

CONCLUSION

Our findings underscore the importance of maternal mental health during the perinatal period and highlight the potential implications for offspring neurodevelopment. Further research is warranted to elucidate underlying mechanisms and inform targeted interventions to support maternal mental well-being and optimize offspring outcomes.

Lack of beneficiary effect of levothyroxine therapy of pregnant women with subclinical hypothyroidism in terms of neurodevelopment of their offspring

PURPOSE

Despite the beneficial effects of levothyroxine (LT4) therapy on pregnancy outcomes of women with subclinical hypothyroidism (SCH), its impact on the developmental status of offspring remains unclear. We aimed to assess the effects of LT4 therapy on the neurodevelopment of infants of SCH women in the first 3 years of life.

METHODS

A follow-up study was conducted on children born to SCH pregnant women who had participated in a single-blind randomized clinical trial (Tehran Thyroid and Pregnancy Study). In this follow-up study, 357 children of SCH mothers were randomly assigned to SCH + LT4 (treated with LT4 after the first prenatal visit and throughout pregnancy) and SCH-LT4 groups. Children born of euthyroid TPOAb-women served as the control group (n = 737). The neurodevelopment status of children was assessed in five domains (communication, gross motor, fine motor, problem-solving, and social-personal domains) using the Ages and Stages Questionnaires (ASQ) at the age of 3 years.

RESULTS

Pairwise comparisons of ASQ domains between euthyroid, SCH + LT4, and SCH-LT4 groups show no statistically significant difference between groups in the total score [median 25-75 total score: 265 (240-280); 270 (245-285); and 265 (245-285); P-value = 0.2, respectively]. The reanalyzing data using the TSH cutoff value of 4.0 mIU/L indicated no significant difference between groups in the score of ASQ in each domain or total score with TSH levels < 4.0 mIU/L, however, a statistically significant difference in the median score of the gross motor was observed between those SCH + LT4 with baseline TSH values ≥ 4.0 mIU/L and SCH-LT4 [60 (55-60) vs. 57.5 (50-60); P = 0.01].

CONCLUSIONS

Our study does not support the beneficiary effect of LT4 therapy for SCH pregnant women in terms of the neurological development of their offspring in the first three years of life.

No association between prenatal lead exposure and neurodevelopment during early childhood in the Japan Environment and Children's Study

Compared with the relatively well-investigated effects of childhood exposure to lead on neurocognitive deficits, those of prenatal exposure remain relatively inconclusive. We aimed to investigate the association between prenatal blood lead levels and neurodevelopmental delay during the first three years of life. From a prospective cohort of the Japan Environment and Children’s Study, we analyzed a total of 80,759 children. The exposure factors were prenatal lead concentrations measured from maternal whole blood in the second/third trimesters and umbilical cord blood at birth. Neurodevelopment was assessed at 6, 12, 18, 24, 30, and 36 months old using a screening tool, the Ages and Stages Questionnaires, third edition (ASQ). The outcome measures were any suspected neurodevelopmental delay (sNDD) identified via the ASQ during the first (sNDD-1Y), second (sNDD-2Y), and third (sNDD-3Y) years of life. sNDD-1Y, 2Y, and 3Y were identified in 18.0%, 16.2%, and 17.2% of children, respectively. The geometric means of blood lead concentration in this study were much lower (0.62 μg/dL in maternal blood and 0.50 μg/dL in cord blood) than previously investigated levels. Multivariable regression models revealed that there were no associations between maternal blood lead and sNDD-1Y and 2Y and between cord blood lead and sNDD-1Y, 2Y, and 3Y. Although a higher maternal blood lead was associated with a reduced risk of sNDD-3Y (adjusted relative risk: 0.84, 95% confidence interval 0.75–0.94, per 1 increase in common logarithm of lead concentration), there were no dose–response relationships in the analysis using quintiles of lead concentrations. Using a large-scale data set, the present study demonstrated no convincing evidence for an inverse association between levels of prenatal blood lead and neurodevelopment in early childhood. Longitudinal measurements of prenatal and postnatal lead levels are needed to understand the relationship between lead exposure and neurocognitive development.

Ages and Stages Questionnaires Brazil in monitoring development in early childhood education

In Brazil, the lack of specific instruments for monitoring child development is a problem given that the number of children at risk of delay is relatively high. Newly adapted to the Brazilian context, the Third Ages and Stages Questionnaires Edition - ASQ-3, has been referenced as an excellent instrument for tracking and monitoring child development. The present study aimed to outline the profile of the global development of children from 5 to 50 months through the ASQ-BR who attended the Municipal Centers of Early Childhood Education, as well as to verify the applicability of this instrument to preschool teachers. To this end, the preschool teachers applied the instrument to 392 children. The girls performed better than the boys in the Fine Motor and Personal-Social domains. The highest scores were obtained in the Gross Motor (79.44%), Communication (72.34%) and Problem-Solving (69.54%) domains and the lowest in the Personal-Social and Fine Motor domains. The two domains with the highest incidence of risk were the Personal-Social (22.08%) and the Fine Motor (19.03%), respectively. It can be concluded that although the ASQ-BR presents itself as a potential instrument in the screening of child development in daycare centers and preschools.

Physical growth and neurodevelopment during the first year of life: a cohort study of the Japan Environment and Children's Study

BACKGROUND

The association between a slower physical growth and poorer neurodevelopment has been established in infants born preterm or small for gestational age. However, this association is inconsistent in term-born infants, and detailed investigations in infancy, when intervention is most beneficial for improving outcomes, are lacking. We therefore examined this association separately by sex during the first year of life in term-born infants.

METHODS

Using data collected until children reached 12 months old in an ongoing prospective cohort of the Japan Environment and Children's Study, we analyzed 44,264 boys and 42,541 girls with singleton term-birth. The exposure variables were conditional variables that disentangle linear growth from weight gain relative to linear growth, calculated from the length and weight at birth and 4, 7 and 10 months old. Neurodevelopmental delay was identified using the Japanese-translated version of Ages & Stages Questionnaires, third edition.

RESULTS

A reduced risk of neurodevelopmental delay at 6 months old was observed in children with a higher birth weight (adjusted relative risks [aRRs]: 0.91 and 0.93, 95 % confidence intervals [95 % CIs]: 0.87-0.96 and 0.88-0.98 in boys and girls, respectively) and increased linear growth between 0 and 4 months old (aRRs: 0.85 and 0.87, 95 % CIs: 0.82-0.88 and 0.83-0.91 in boys and girls, respectively). A reduced risk at 12 months was found in children with an increased linear growth between 0 and 4 months (aRRs: 0.92 and 0.90, 95 % CIs: 0.87-0.98 and 0.84-0.96 in boys and girls, respectively), boys with an increased relative weight gain between 0 and 4 months (aRR: 0.90, 95 % CI: 0.84-0.97), and girls with a higher birth weight (aRR: 0.89, 95 % CI: 0.83-0.96).

CONCLUSIONS

These results suggest that a slow physical growth by four months old may be a predictor of neurodevelopmental delay during infancy.

Breast feeding and infant development in a cohort with sibling pair analysis: the Japan Environment and Children's Study

OBJECTIVES

To investigate the association between breast feeding and infant development during the first year of life using sibling comparison.

DESIGN

Nationwide prospective birth cohort study with sibling pair analysis.

SETTING

15 regional centres that participated in the Japan Environment and Children's Study.

PARTICIPANTS

This study included 77 119 children (singleton, term birth and no malformation/severe diseases) whose mothers were registered between January 2011 and March 2014, including 3521 duos or trios of siblings.

PRIMARY OUTCOME MEASURES

The primary outcome was developmental delay at 6 and 12 months of age, assessed using the Japanese translation of the Ages and Stages Questionnaires, third edition. Multivariable regression analyses adjusted for confounders were performed to estimate the risk ratios of delay associated with any or exclusive breast feeding. Pairs of siblings discordant for statuses were selected, and conditional regression analyses were conducted with a matched cohort design.

RESULTS

Developmental delay was identified in 6162 (8.4%) and 10 442 (14.6%) children at 6 and 12 months of age, respectively. Any breast feeding continued until 6 months or 12 months old was associated with reduced developmental delay at 12 months of age (adjusted risk ratio (95% CI): 0.81 (0.77 to 0.85) and 0.81 (0.78 to 0.84), respectively). Furthermore, exclusive breast feeding until 3 months was associated with reduced developmental delay at 12 months of age (adjusted risk ratio, 0.86 (95% CI 0.83 to 0.90)). In sibling pair analysis, the association between any breast feeding until 12 months and reduced developmental delay at 12 months of age persisted (adjusted risk ratio, 0.64 (95% CI 0.43 to 0.93)).

CONCLUSIONS

The present study demonstrated the association of continuous breast feeding with reduced developmental delay at 1 year of age using sibling pair analysis, in which unmeasured confounding factors are still present but less included. This may provide an argument to promote breastfeeding continuation.

Translation and Cultural Adaptation of the Ages and Stages Questionnaires (ASQ) Worldwide: A Scoping Review

OBJECTIVE

This scoping review aims to provide a data mapping and narrative synthesis of the available peer-reviewed scientific literature on the translation and cultural adaptation processes relative to the Ages and Stages Questionnaires (ASQ) as reported by the authors. It also seeks to paint an overall portrait of the implementation of the translated and culturally adapted ASQ worldwide.

METHODS

Articles published between 1995 and May 11, 2018, were identified via systematic searches of peer-reviewed literature carried out using CINAHL, Scopus, MEDLINE, Education Source, PsycINFO, and ERIC. The articles included in the qualitative synthesis were coded based on an extraction form developed for the study.

RESULTS

In the 46 articles surveyed, 37 different cultural adaptations were identified in 29 languages and 27 countries. Translations were included in 33 cultural adaptations, and language modifications were reported in 18 adaptations. The forward-backward translation method was reported in 25 cases. The authors declared having made cultural content, language, visual, and/or conceptual modifications in 26 adaptations. Cultural content modifications were reported in 24 adaptations. At least one method (pilot study, individual interview, survey or focus group with respondents) was reported in 24 adaptations.

CONCLUSION

Cultural modifications were relatively minor and were, in general, made to establish equivalence with the source version. As well, the processes used to translate and culturally adapt the ASQ varied widely based on the types of methods. Additional work should be conducted to document the process of this crucial phase.

Effects of in-hospital breast feeding on brain function development in preterm infants in China: study protocol for a prospective longitudinal cohort study

INTRODUCTION

Due to immature brain development, preterm infants are more likely to develop neurological developmental defects compared with full-term infants. Most preterm infants without neurodevelopmental damage can eventually reach the same scholastic level as their same-age peers; however, some show persistent impairment. Breast feeding (BF), which is an important public health measure, is of great significance for preterm infants. Various active substances in breast milk promote the development of the brain and central nervous system in premature infants. We present a protocol for a prospective longitudinal cohort study to explore the effect of in-hospital BF on brain development in preterm infants and possible influencing factors.

METHODS AND ANALYSIS

This study will enrol 247 Chinese preterm infants (gestational age: 30-34 weeks) delivered in Women's Hospital School of Medicine, Zhejiang University, and transferred to the neonatal intensive care unit. Demographic, clinical and in-hospital BF data will be collected through electronic medical records. Moreover, follow-up data will be obtained by telephone, interview or online. Measurements will be obtained using the Breastfeeding Self-Efficacy Scale-Short Form, neuroimaging with functional near-infrared spectroscopy, extrauterine growth restriction and the Ages and Stages Questionnaire. Follow-up will be performed at 3, 6 and 12 months after birth.

ETHICS AND DISSEMINATION

This study has been approved by the Women's Hospital School of Medicine Zhejiang University Medical Ethics Committee (2019-058). The study results are expected to be published in peer-reviewed journals and reported at relevant national and international conferences.

TRIAL REGISTRATION NUMBER

ChiCTR1900027648; Pre-results.

Comparison between Ages & Stages Questionnaire and Bayley Scales, to predict cognitive delay in school age

OBJECTIVE

To compare the predictive value of the Spanish Ages & Stages Questionnaire third edition adapted for Chilean population (ASQ-Cl) and the Bayley Scale of Infant and Toddler Development 3rd edition (Bayley-III) for cognitive delay at school age, and to identify the domain predictors.

METHODOLOGY

Data were collected from 306 term and preterm children of medium-high socio-economic level enrolled in a prospective cohort study. Developmental outcomes at 8, 18 and 30 months were assessed via the ASQ-Cl and Bayley-III; at 6-8 years cognitive development was assessed using the Wechsler Intelligence Scale for Children (WISC-III). The area under the curve (AUC), sensitivity, specificity and predictive values were calculated, and logistic regression analysis was used.

RESULTS

Of 227 children studied, 6.6% had cognitive delay. ASQ-Cl and Bayley-III generate equivalent AUC [0.77 and 0.80]. Sensitivity 67% and 53%; specificity of 72% and 88%, positive predictive value of 14% and 24%, negative predictive values of 97% and 96% respectively. Greater predictive validity was obtained at 30 months assessment. Deficit in the communication and gross motor skills and problem-solving domains of the ASQ-Cl and all the Bayley-III domains were significantly associated with cognitive delay.

CONCLUSIONS

ASQ-Cl can be used to identify children at risk for cognitive delay at 6-8 years of age, being comparable with the Bayley-III. Some domains of ASQ-Cl and all domains of Bayley-III were significant predictors for cognitive delay. These results support the use of ASQ-Cl as a screening tool for developmental delay.

Psychometric profile of the Ages and Stages Questionnaires, Japanese translation

BACKGROUND

This study assessed the psychometric profile of 10 questionnaires (every 6 months, from 6 to 60 months) from the Japanese translation of the Ages and Stages Questionnaires, third edition (J-ASQ-3).

METHODS

Data from 439 children in a birth cohort were used to identify the J-ASQ-3 score distribution, establish cut-off scores, and calculate the instrument's internal consistency. Data were also collected from 491 outpatients to examine J-ASQ-3 test-retest reliability and concurrent validity, which was examined using the Kyoto Scale of Psychological Development (KSPD) and the Japanese version of the Denver Developmental Screening Test II (J-Denver II). Both the original and the alternative screening criteria of the ASQ-3 were used (failure in at least one and at least two domains, respectively).

RESULTS

Cronbach's alpha for each J-ASQ-3 subscale on each questionnaire ranged from 0.45 to 0.89. Test-retest reliability was >0.75 for the subscales on almost all questionnaires. Concurrent validity was also adequate. In comparison with the screening results of the KSPD, the overall sensitivity and specificity were 96.0% and 48.8%, respectively, when the ASQ-3 original criterion was used, and 92.1% and 74.9%, respectively, when the alternative criterion was used. In comparison with the screening results of the J-Denver II, the overall sensitivity and specificity were 75.6% and 74.7%, respectively, when the ASQ-3 original criterion was used, and 56.3% and 93.0%, respectively, when the alternative criterion was used.

CONCLUSIONS

This study quantified the psychometric profiles of the Japanese translations of 10 ASQ-3 questionnaires. We demonstrated the validity of the J-ASQ-3 and determined new cut-off scores. Further studies with larger samples from a greater range of locations are required to clarify the suitability of this tool for all Japanese children.

The psychometric properties of the Ages and Stages Questionnaires-3 in Arabic: Cross-sectional observational study

BACKGROUND

Screening for developmental delay is recommended for pediatricians, yet validated screening tools in Arabic are scarce.

AIMS

Assess the reliability, validity, sensitivity and specificity of the Arabic ASQ-3 in detecting developmental delays in children aged 4-33 months.

STUDY DESIGN

Cross-sectional observational study.

SUBJECTS

A sample of 491 children from all Lebanese governorates from five age groups (4, 10, 18, 27 and 33 months).

OUTCOME MEASURES

Internal consistency using Cronbach's alpha (Cα), convergent construct validity using Pearson Correlation Coefficient (CC) comparing ASQ-3 in Arabic (A-ASQ-3) to Bayley scale for infant development (BSID-III) scores were computed. A subset sample (n = 35) underwent assessment with BSID-III for convergent validity, and sensitivity and specificity. A-ASQ-3 scores were compared to the US mean cutoff scores.

RESULTS

Subjects' mean age was 17.75 ± 10.6 months. Cα was 0.85; Pearson CC showed positive moderate correlation between A-ASQ-3 gross and fine motor scores and BSID-III composite motor scores (r = 0.42, p = 0.002; r = 0.39, p = 0.004, respectively); and positive moderate correlation between A-ASQ-3 problem solving and BSID-III cognitive scores (r = 0.43, p = 0.001). A-ASQ-3 had 100% sensitivity and 50% specificity for cognitive scores; 60% sensitivity and 70% specificity for motor scores.

CONCLUSION

A-ASQ-3 has adequate reliability and validity for the tested age groups. It is plausible that this would hold true for the rest of the questionnaires. Further testing is needed to make the five clusters more aligned with the US sample scores and to improve the sensitivity and specificity.

Reliability and agreement of ages and stages questionnaires®: Results in late preterm and term-born infants at 24 and 48 months

AIM

To evaluate the reliability of the Ages and Stages Questionnaires (ASQ-3) 24 and 48 month intervals translated to Spanish by Brookes Publishing, and the agreement between both questionnaires, comparing late preterm (LPI) and term-born infants (terms).

METHODS

Two cohort samples of healthy LPI and terms that were born in a private hospital in Barcelona, Spain. Internal consistency was analyzed by Cronbach's alpha scores and Pearson product- moment correlation between the domain scores and the overall score. The agreement was analyzed using Pearson's correlations between the two questionnaires, and the odds ratio (OR) for positive screening at 48 months, given a positive screen in 24 month assessment.

RESULTS

A total of 473 evaluations were analyzed, representing 331 children. Cronbach's alpha scores for the motor domains on both intervals were low, but acceptable compared with the overall score; a strong positive correlation between the domain and overall score were obtained in the majority of the domains. The correlation between the 24 and 48 month total scores were positive, especially for LPI. Having at least 2 domains in the referral zone at 24 months was associated with an OR of 140 [95% CI 14.85; 3575.65] for positive screen at 48 months.

CONCLUSION

The Spanish ASQ-3 24 and 48 month intervals appear to be a reliable for developmental screening and for the follow-up of children, especially for LPI. Having two or more domains in the referral zone at 24 months screening is a significant predictor of developmental delay risk at 48-month questionnaire.

Preliminary Results of the Macedonian-Adapted Version of Ages and Stages Developmental Questionnaires

Context:

Early detection of developmental problems is critical, and interventions are more effective when they are carried out early in a child's life. In Macedonia, there are only four centers providing early intervention services.

Aims:

In this research, we determined the reliability of the translation and adaptation of Ages and Stages Questionnaires 3^rd edition (ASQ-3-M) for assessment of children aged 3–5 years old in Macedonia, and reported preliminary results of the gender differences in the development.

Materials and Methods:

ASQ-3-M was completed by 165 parents and 40 educators in seven kindergarten classrooms. Children were 3–5 years old.

Statistical Analysis Used:

Cronbach's alpha, Intraclass Correlation coefficient (ICC), and interrater reliability (IRR) were used to assess ASQ-3-M psychometric properties. The Bayesian t-test was performed to estimate the difference in means between males and females.

Results:

The Cronbach's alpha ranged from 0.65 to 0.87. The overall ICC was 0.89 (ranged from 0.8 to 0.95), which indicates a strong to almost perfect strength of agreement between test-retest. IRR correlation revealed an average of 0.88 (ranged from 0.74 to 0.95), suggesting that ASQ-3-M is reliable and stable.

Conclusions:

The results from the comparison between males and females on all dimensions of ASQ-3-M were not statistically significant (BF10 <3), indicating no significant gender difference. That said, the ASQ-3 is recommended for routine use in screening children aged 3–5 years old.

Perceção de profissionais e de pais acerca do Ages & Stages Questionnaires (ASQ-PT)

Em Portugal, o Ages & Stages Questionnaires já se encontra aferido e adaptado para a população infantil e denomina-se ASQ-PT. A finalidade da nossa investigação é a realização de um estudo qualitativo para conhecer as perceções de profissionais de Intervenção Precoce, de saúde e de educação e de pais sobre a utilização do ASQ-PT para o rastreio e sobre a colaboração dos pais neste processo. Pretende-se sensibilizar os profissionais para a utilização deste instrumento, para colaborarem com as famílias no rastreio de desenvolvimento e perceber o impacto do preenchimento do ASQ-PT pelos pais no conhecimento acerca da sua criança.

The Ages and Stages Questionnaire: Latent factor structure and growth of latent mean scores over time

BACKGROUND

Very little research exists that looks at the Ages and Stages Questionnaire simultaneously from a modern latent variable point of view and by looking at its psychometric properties over time.

AIMS

To explore the latent factor structure of the ASQ using Exploratory Structural Equation Modeling techniques for ordinal data and investigate its change over time using the method of vertical scaling from multidimensional Item Response Theory.

STUDY DESIGN

Longitudinal, with the same children being assessed at multiple timepoints.

SUBJECTS

Children measured using the 12, 14, 16, 18, 20, 22, 24, 27, 30, 33, 36, 42, 48month questionnaires of the ASQ. Initial sample (12months) consisted of 2219 children and final sample (48months), 892 children due to drop-out.

OUTCOME MEASURES

Ages and Stages Questionnaire, 3rd version (ASQ-3).

RESULTS

Results indicate that all ASQ-3 age questionnaires examined showed the proposed 5-factor structure (except the 12-month version) but with different patterns over time. The Gross Motor domain had the fewest misfitting items, from 12months onwards. The Personal-Social domain and the Problem Solving domain had larger numbers of misfitting items. Results from the vertical scaling analysis showed that both the Problem-Solving and Personal-Social dimensions also exhibited the most complex patterns of change over time.

CONCLUSIONS

The psychometric properties of the ASQ-3 seem to be both time-dependent and domain-dependent. Earlier questionnaires reflect a latent structure that was not as well-defined as for later versions. Also, domains such as Communication and Gross Motor appear to be much more reliably measured than others, such as Problem-Solving and Personal-Social.

Validation of a culturally adapted developmental screening tool for Australian Aboriginal children: Early findings and next steps

BACKGROUND

Early detection of developmental problems is important for facilitating access to targeted intervention and maximising its positive effects. The later problems are identified, the more likely that they will become increasingly difficult to ameliorate. Standardised developmental screening tools are known to improve detection rates of developmental problems compared to clinical judgement alone and are widely recommended for use with all children. The Ages and Stages Questionnaire (ASQ-3) is a tool that is widely used in Australia. However, mainstream screening tools may not be appropriate for remote-dwelling Australian Aboriginal children. While Australian Aboriginal children face multiple developmental risk factors, there are no developmental screening tools that have been validated for use in this population.

AIMS

To determine the concurrent validity of the culturally adapted ASQ-3 - the ASQ-TRAK - for Australian Aboriginal children compared to the Bayley Scales of Infant and Toddler Development (Bayley-III), a standardised, professionally administered developmental assessment.

SUBJECTS

The ASQ-TRAK and Bayley-III were administered cross-sectionally to 67 Central Australian Aboriginal children between 2 and 36months of age.

RESULTS

The ASQ-TRAK communication, gross motor, fine motor and problem-solving domains and the corresponding domains on the Bayley-III were moderately correlated. Overall sensitivity for the ASQ-TRAK was 71% (95% CI 29-96) and specificity was 92% (95% CI 88-99). Percentage agreement between the ASQ-TRAK and the Bayley-III was 90%.

CONCLUSIONS

The ASQ-TRAK shows promise as a tool that can be used to improve developmental monitoring for remote dwelling Australian Aboriginal children. Further research is necessary to build on the current findings.