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

Early stimulation and responsive care: A mediator of caregivers' depression on the suspected developmental delay of left-behind children in China

BACKGROUND

Due to multiple factors, left-behind children in rural areas suffer from neurodevelopment delay and their caregivers suffer from depressive symptoms. This study aimed to analyze the effect of caregivers' depressive symptoms on left-behind children's neurodevelopment, with early stimulation and responsive care mediating.

METHODS

We conducted a cross-sectional survey in five counties in China. A total of 904 left-behind children aged 0-3 and their primary caregivers were enrolled. The Zung Self-rating Depression Scale (ZSDS) was used to measure caregivers' depressive symptoms. The Ages and Stages questionnaires-third edition (ASQ-3), which contains five domains: communication (CM), gross motor (GM), fine motor (FM), problem-solving (CG), and personal social (PS), was used to screen children for suspected developmental delay (SDD).

RESULTS

31.4 % of left-behind children suffered from SDD, while 39.7 % of left-behind children's caregivers experienced depressive symptoms. Caregivers' ZSDS scores were positively correlated with the SDD on four domains (FM, GM, CG, and PS), while Early stimulation and responsive care was negatively correlated with the SDD on four domains (CM, FM, CG, and PS).

LIMITATIONS

The cross-sectional design limited the ability to ascertain causal relations. Besides, the findings may not be generalized to all regions of China due to the heterogeneity of the study population.

CONCLUSIONS

Left-behind children under three years old in rural China were at high risk of SDD, while a substantial proportion of their caregivers had depressive symptoms. Caregivers' depressive symptoms may negatively affect the SDD of left-behind children through caregivers providing less early stimulation and responsive care.

A realist review of digitally delivered child development assessment and screening tools: Psychometrics and considerations for future use

BACKGROUND

Developmental screening improves the detection of developmental concerns, yet numerous children are not screened/assessed. Remote child developmental tool administration has been utilized to increase screening and assessment accessibility.

METHOD

We conducted a realist review to: (1) identify existing multi-domain child development assessment and screening tools for children 0-5 years; (2) review psychometric data on their digital (i.e., only administered remotely) administration; and (3) explore contextual factors relevant to their digital administration. We searched APA PsycInfo, MEDLINE, CINAHL, and ERIC to identify tools and papers on their psychometrics. We reference-searched included articles and searched Google for relevant grey literature.

RESULTS

Of 33 multi-domain child development tools identified in objective one, five tools (in five studies) were delivered digitally and compared to traditional (e.g., paper) delivery (i.e., objective two). Studies evaluated within-group equivalence reliability (k = 2) and between-group equivalence (k = 3). Within-group equivalence reliability was established for the Vineland Adaptive Behavior Scales, and domains (e.g., gross motor) of the Ages and Stages Questionnaires 2nd edition (ASQ-2) and Revised Prescreening Denver Questionnaire (R-PDQ). Between group equivalence was demonstrated for Developmental Neuropsychological Assessment, 2nd Edition (NEPSY-II) subtests and Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3) items. In another between group evaluation, web-based and paper versions of the ASQ-2 were deemed generally equivalent. Digital Bayley-3 inter-observer reliability ranged from 0.82 to 1.0. Examiner support, time, tool modifications, family resources, and comfort promotion supported digital administration.

CONCLUSION

Digitally delivered ASQ-2, R-PDQ, Vineland, and Bayley-3 and NEPSY-II components show promise for equivalence with traditional administration.

A multiphased cultural and contextual adaptation of the Parents' Evaluation of Developmental Status tools for a low-income community: A South African case study

INTRODUCTION

Culturally relevant developmental screening is one of the best ways to appropriately identify developmental delays and disabilities in children as early as possible across diverse cultural backgrounds. This study aimed to adapt the Parents' Evaluation of Developmental Status (PEDS) tools for a low-income community in South Africa by using a detailed multiphased cultural and contextual adaption process.

METHOD AND RESULTS

A three-phase mixed-method design relying on triangulation of data was used. Data were collected at an immunization clinic in a low-income community in Mamelodi, South Africa. Phase 1 was a focus group discussion with 11 community participants. The topics explored the possible changes to the PEDS tools to make them more relevant to the community. Phase 1 informed Phase 2 where 12 early childhood development experts achieved consensus through a two-round survey on a modified Delphi method. In Phase 3, a draft of the PEDS tools-SA was presented to the authors of the PEDS tools for final approval. Of 55 questions that were adapted for the PEDS tools-SA, two original questions (3.6%), 14 questions from the expert suggestions (25.4%) and 39 from the community participant's suggestions (71%) were included. A final version of the PEDS tools-SA was created.

CONCLUSION

This study used a systematic method to adapt the PEDS tools to create the culturally appropriate PEDS tool-SA for a low-income community in South Africa, informed by community stakeholders' views from the first step. This resulted in a high-quality adaptation process that is more likely to result in a tool that is more acceptable to caregivers from a low-income South African community.

Predictive Validity of Developmental Screening Questionnaires for Identifying Children With Later Cognitive or Educational Difficulties: A Systematic Review

Context: Parent/caregiver completing developmental screening questionnaires (DSQs) for children before 5 years of age is currently recommended. The DSQs recommended by the American Academy of Pediatrics (AAP) are the Ages and Stages Questionnaires (ASQ), Parents' Evaluation of Developmental Status (PEDS), and the Survey of Well-being of Young Children (SWYC). Nevertheless, their predictive validity has not been well-established. Objective: To assess in the current literature, the value of AAP-recommended DSQs (ASQ, PEDS, SWYC) administered between 0 and 5 years of age, for predicting long-term cognitive achievement and/or school performance (CA/SP), after 1 year or more of evaluation and at/or after age 5 years, in the general population. Data Sources: Cochrane, MEDLINE PubMed, CINAHL, EMBASE, Web of Science, Scielo, and Scopus databases (until March 2021). Study Selection: Two authors selected the studies. Forward and backward citation follow-up was done; authors of DSQ were contacted to identify additional studies. Data Extraction: Cohorts were identified, and authors of selected studies were contacted to corroborate and complete extracted data. Results: Thirty-two publications, corresponding to 10 cohorts, were included. All cohorts used ASQ. Only cohort using PEDS was identified but did not meet the inclusion criteria. No cohorts conducted with SWYC were identified. Associations between ASQ and CA/SP were extracted for eight cohorts. The odds ratios were >3, and the area under the curve was 0.66-0.87. A trade-off between sensitivity and specificity was observed. Limitations: Heterogeneity in population characteristics and in DSQ adaptations. Conclusions: A positive association between ASQ and later CA/SP was found in different social, cultural, and economic settings. Additional studies are necessary to determine the impact factors in the predictive capacity of DSQs. Systematic Review Registration: PROSPERO, identifier: CRD42020183883.