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

Luisa Schonhaut,Andres Maturana,Pamela Serón,Olenkha Cepeda

doi:10.3389/fped.2021.698549

Abstract

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.

Highlights

It is estimated that one in six children has a developmental disability, defined by problems in cognitive, behavioral, language, learning, or physical performance, which are often more prevalent in children with biological risk factors such as prematurity [1,2,3]
No cohorts conducted with Survey of Well-being of Young Children (SWYC) were identified
Associations between ASQ and cognitive achievement and/or school performance (CA/SP) were extracted for eight cohorts

Summary

Introduction

It is estimated that one in six children has a developmental disability, defined by problems in cognitive, behavioral, language, learning, or physical performance, which are often more prevalent in children with biological risk factors such as prematurity [1,2,3]. Considering that development is a continuum and that the first 5 years of life are recognized as a critical period for subsequent cognitive performance and school success, it is accepted that these disabilities begin in early childhood, under the definition of developmental delay (DD) [4]. Detection of DD allows for timely and effective interventions [5, 6]. For this reason, early screening and referral of developmental difficulties are a critical element in the routine health supervision of children to guarantee that children have adequate conditions for optimal learning [7, 8]. The Bayley Scale of Infant and Toddler Development is currently one of the most used tools with this purpose

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