Concurrent validity of the ages and stages questionnaires with Bayley Scales of Infant Development-III at 2 years: Singapore cohort study
Concurrent validity of the ages and stages questionnaires with Bayley Scales of Infant Development-III at 2 years: Singapore cohort study
Background: With increasing acceptance of universal developmental screening in primary care, it is essential to evaluate the local validity and psychometric properties of commonly used questionnaires like the parent-completed Ages and Stages Questionnaires, 3rd Edition (ASQ-3) in identifying developmental delays. The aim of this study is to assess the convergent validity of the ASQ-3 with the Bayley Scales of Infant Development-3rd edition (Bayley-III) in identifying developmental delay in a low-risk term cohort in Singapore. Methods: ASQ-3 and Bayley-III data was collected prospectively with generation of ASQ-3 cut-off scores using three different criteria: 1-standard deviation (SD) (Criterion-I) or 2-SD (Criterion-II) below the mean, and using a Receiver Operator Curve (ROC) (Criterion-III). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. Correlations between the ASQ-3 and Bayley-III domains were evaluated using Pearson coefficients. Results: With all three criteria across different domains ASQ-3 showed high specificity (72–99%) and NPV (69–98%), but lower sensitivity (19–74%) and PPV (11–59%). Criterion-I identified 11–21% of children as “at-risk of developmental delay,” and was the most promising criterion measure, with high specificity (82–91%), NPV (69–74%) and overall agreement of 64–71%. Moderate-strong correlations were seen between ASQ-3 Communication and Bayley-III Language scales (r = 0.44–0.59, p < 0.01). The lowest sensitivities were seen in the motor domains. Conclusions: ASQ-3 is reliable in low-risk settings in identifying typically developing children not at risk of developmental delay, but it has modest sensitivity. Moderate-strong correlations seen in the communication domain are clinically important for early identification of language delay, which is one of the most prevalent areas of early childhood developmental delay.
ASQ-3, Bayley-III, cohort study, developmental screening, validity
Agarwal, Pratibha Keshav
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Huichao, Xie
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Rema, Anu Sathyan Sathyapalan
afd49b09-5df9-4e50-9bc6-01c0db9787ed
Meaney, Michael J.
5c6db45a-1f5b-4e1f-8c0b-07a8f7b29f66
Godfrey, Keith M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Rajadurai, Victor Samuel
fa198c7b-5d33-4ad8-bf07-8f26655572d3
Daniel, Lourdes Mary
8092af24-31fe-42e5-be16-eda563047752
Agarwal, Pratibha Keshav
5718be19-2e0f-4e16-b1e5-e202659c0de3
Huichao, Xie
9f47906d-a02e-4e09-8672-b76b7141a5f8
Rema, Anu Sathyan Sathyapalan
afd49b09-5df9-4e50-9bc6-01c0db9787ed
Meaney, Michael J.
5c6db45a-1f5b-4e1f-8c0b-07a8f7b29f66
Godfrey, Keith M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Rajadurai, Victor Samuel
fa198c7b-5d33-4ad8-bf07-8f26655572d3
Daniel, Lourdes Mary
8092af24-31fe-42e5-be16-eda563047752
Agarwal, Pratibha Keshav, Huichao, Xie, Rema, Anu Sathyan Sathyapalan, Meaney, Michael J., Godfrey, Keith M., Rajadurai, Victor Samuel and Daniel, Lourdes Mary
(2023)
Concurrent validity of the ages and stages questionnaires with Bayley Scales of Infant Development-III at 2 years: Singapore cohort study.
Pediatrics & Neonatology.
(doi:10.1016/j.pedneo.2023.03.013).
Abstract
Background: With increasing acceptance of universal developmental screening in primary care, it is essential to evaluate the local validity and psychometric properties of commonly used questionnaires like the parent-completed Ages and Stages Questionnaires, 3rd Edition (ASQ-3) in identifying developmental delays. The aim of this study is to assess the convergent validity of the ASQ-3 with the Bayley Scales of Infant Development-3rd edition (Bayley-III) in identifying developmental delay in a low-risk term cohort in Singapore. Methods: ASQ-3 and Bayley-III data was collected prospectively with generation of ASQ-3 cut-off scores using three different criteria: 1-standard deviation (SD) (Criterion-I) or 2-SD (Criterion-II) below the mean, and using a Receiver Operator Curve (ROC) (Criterion-III). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. Correlations between the ASQ-3 and Bayley-III domains were evaluated using Pearson coefficients. Results: With all three criteria across different domains ASQ-3 showed high specificity (72–99%) and NPV (69–98%), but lower sensitivity (19–74%) and PPV (11–59%). Criterion-I identified 11–21% of children as “at-risk of developmental delay,” and was the most promising criterion measure, with high specificity (82–91%), NPV (69–74%) and overall agreement of 64–71%. Moderate-strong correlations were seen between ASQ-3 Communication and Bayley-III Language scales (r = 0.44–0.59, p < 0.01). The lowest sensitivities were seen in the motor domains. Conclusions: ASQ-3 is reliable in low-risk settings in identifying typically developing children not at risk of developmental delay, but it has modest sensitivity. Moderate-strong correlations seen in the communication domain are clinically important for early identification of language delay, which is one of the most prevalent areas of early childhood developmental delay.
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Manuscript_Bayley ASQ GUSTO - 060223
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More information
Accepted/In Press date: 2 March 2023
e-pub ahead of print date: 18 July 2023
Additional Information:
Funding Information:
KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF–SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), the European Union (Erasmus + Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) and the British Heart Foundation (RG/15/17/3174, SP/F/21/150013).
Publisher Copyright:
© 2023 Taiwan Pediatric Association
Keywords:
ASQ-3, Bayley-III, cohort study, developmental screening, validity
Identifiers
Local EPrints ID: 480580
URI: http://eprints.soton.ac.uk/id/eprint/480580
ISSN: 1875-9572
PURE UUID: 501964d3-a4bf-4207-bb0a-95867fd6e9a0
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Date deposited: 07 Aug 2023 16:30
Last modified: 18 Mar 2024 02:38
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Contributors
Author:
Pratibha Keshav Agarwal
Author:
Xie Huichao
Author:
Anu Sathyan Sathyapalan Rema
Author:
Michael J. Meaney
Author:
Victor Samuel Rajadurai
Author:
Lourdes Mary Daniel
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