The ages and stages questionnaire: screening for developmental delay in the setting of a pediatric outpatient clinic

Kim, Eun Young; Sung, In Kyung

Abstract

PURPOSE: Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent-completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic.
METHODS
Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a fail, and children who failed in one or more domains tested were classified as screen-positive. Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II.
RESULTS
(1) The mean age of children was 16.4?7.4 months. Ten children (14.9%) were small-for-gestational age infants. The mean birth weight and gestational age were 3.10.6 kg and 38.81.4 weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was 13.62.4, and 31.3% had full-time jobs. The time for completing the ASQ was 10.23.0 minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%).
CONCLUSION
The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.