Agarwal PK, Xie H, Sathyapalan Rema AS, Rajadurai VS, Lim SB, Meaney M, Daniel LM. Evaluation of the Ages and Stages Questionnaire (ASQ 3) as a developmental screener at 9, 18, and 24 months.
Early Hum Dev 2020;
147:105081. [PMID:
32502946 DOI:
10.1016/j.earlhumdev.2020.105081]
[Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND
Without the use of standardized screening tools, only 30% of the estimated 5-15% of children with developmental delay can be identified, potentially delaying intervention.
AIM
1)To evaluate the ASQ-3's reliability and validity at 9, 18, and 24 months and to compare the results with normative USA data. 2)To determine the risk factors for a screen positive result, which requires further evaluation.
METHODS
Study of 649 low-risk children was part of a larger longitudinal cohort study, the GUSTO project. Socio-demographic and ASQ3 data were analyzed to estimate reliability, validity, mean ASQ scores, and cut-off scores.
RESULTS
ASQ-3 showed an acceptable to good internal consistency (0.49-0.83) and a medium level of correlations (0.22-0.59) between the five domains but differed significantly compared to normative USA data. Using local cut-off scores, 12.6-13.6% of the cohort had a positive screen in ≥ 1 domain at 9, 18, or 24 months. ASQ-3 screening categorization was consistent, with only 3-11% of children showing change in categorization longitudinally. On regression, lower family income (OR 3.3-9.42) and maternal education (OR2.65-3.03) were predictive of a positive screen across domains and age intervals.
INTERPRETATION
ASQ-3 is a useful, valid screening tool in Singapore. Further research is needed to investigate item functioning and to assess its concurrent validity with a criterion standard tool for culturally sensitive developmental screening.
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