Ages And Stages Questionnaire Research Articles

Validity of the Fine Motor Area of the 12-Month Ages and Stages Questionnaire in Infants Following Major Surgery

ABSTRACTThe Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The ASQ2-FM was completed by caregivers of 74 infants who had cardiac surgery in the first 90 days of life, 104 infants who had noncardiac surgery in the first 90 days of life, and a control group of 154 infants. The Rasch item response analysis revealed that the ASQ2-FM had poor ability to discriminate among levels of fine motor ability. Sensitivity was poor (20%) and specificity was good (98%) when compared with the scores for the fine motor subscale of the Bayley Scales of Infant and Toddler Development. The ASQ2-FM under-identified infants at risk for fine motor delay; internal reliability and construct validity do not support use as a screening tool of fine motor development of infants aged 12 months who have undergone major surgery.

Deformational Plagiocephaly Follow-up at 3 & 4 Years

Research Article| July 01 2011 Deformational Plagiocephaly Follow-up at 3 & 4 Years AAP Grand Rounds (2011) 26 (1): 6. https://doi.org/10.1542/gr.26-1-6 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Deformational Plagiocephaly Follow-up at 3 & 4 Years. AAP Grand Rounds July 2011; 26 (1): 6. https://doi.org/10.1542/gr.26-1-6 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: plagiocephaly, nonsynostotic Source: Hutchison BL, Stewart AE, Mitchell EA. Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years. Arch Dis Child. 2011; 96(1): 85– 90; doi: https://doi.org/10.1136/adc.2010.190934Google Scholar Investigators from the University of Auckland, New Zealand, performed a longitudinal cohort study of children with positional deformations of the occipital skull to compare head shape measurements at 3 or 4 years of age with those from infancy, examine factors common to children whose head shapes had not improved, and evaluate the level of parental concern regarding the child’s head shape. All enrolled children were diagnosed with deformational plagiocephaly or brachycephaly in the only dedicated plagiocephaly clinic in the Auckland region and were at least 3.25 years of age during the followup period. Parents were counseled regarding positioning, and infants referred for physical therapy if indicated for torticollis; no child in the cohort was treated with banding/helmet therapy. Developmental outcomes were assessed using the Ages and Stages Questionnaire (ASQ), parental concern outcomes were based on a Likert scale, and cranial shape was assessed using the Cranial Index (CI) for brachycephaly deformation (bilateral occipital flattening) and Oblique Craniofacial Length Ratio (OCLR) for plagiocephaly (unilateral occipital flattening). The authors used a previously reported photographic and mathematical protocol1 to objectively evaluate head shape (“Heads Up”). Among the age-eligible patients followed at the clinic (n=220), 161 were study-eligible, and 129 (80% of study-eligible) were available for follow-up. Overall, 87% of patients showed substantial improvement. At initial presentation deformations were classified as 47% severe, 31% moderate, 22% mild, and 0% normal. At reevaluation, deformations were classified as 4% severe, 7% moderate, 28% mild, and 61% normal. Reductions in severity occurred in all groups, including some children with severe deformation who moved into the normal range. Only 6% of children had residual frontal/facial asymmetry. No child had residual torticollis. Children (n=10) who failed to progress at all or were worse at follow-up had unilateral occipital deformations (plagiocephaly rather than brachycephaly) with significantly higher OCLR measurements (x=109.2, SD=1.8, P=.02). Age-appropriate development was assessed with the ASQ which evaluates gross motor, fine motor, problem solving, personal-social, and communications skills. The cohort had significantly higher delays than expected at presentation and had reverted to the expected number of delays by follow-up. There was no difference in ASQ scores between the good and poor improvement groups at initial involvement, but at follow-up 29% of the poor improvement group exhibited delays as compared to only 8% in the good improvement group. These delays were primarily found on the communication domain of the ASQ. Parental concern decreased over the time interval. At presentation, 85% of parents were very concerned to somewhat concerned. At follow-up, 13% were concerned and 87% were not very or not at all concerned. The authors conclude that 87% of children with positional deformations of the occiput experienced improvement in the severity of deformation by treating with repositioning and physiotherapy. At... You do not currently have access to this content.

Ages and stages questionnaires: Feasibility of postal surveys for child follow-up

Background The Ages and Stages Questionnaire (ASQ), completed by parents and caregivers, has been shown to be an accurate tool for screening children who need further developmental assessment. Aims To assess the feasibility of using the French Canadian translation of the ASQ in an epidemiological cohort of children from the French general population. Study design Follow-up study by postal questionnaire at 12 and 36 months, using the ASQ. Subjects: 339 French families recruited at the birth of their child in 2006 in two hospitals in the Paris suburbs. Outcome measure Response rates and French ASQ results at 12 and 36 months. The ASQ was scored as indicated in the manual. Results A high response rate of 79% was observed at the children's 1st and 3rd birthdays. Parents were enthusiastic about participating; half of them wrote comments on the questionnaires, most of them positive. Low scores at the 12-month assessment were associated with birth characteristics such as prematurity and transfer to the neonatology unit after birth, whereas at 36 months they tended to be associated with both birth and family socio-demographic characteristics. Conclusions Use of the French ASQ in a research cohort appears feasible as response rates were high. Moreover, known links between child development measured by ASQ and birth and social characteristics were observed. However, further French studies are needed to understand differences observed in 12-month ASQ gross motor scores compared with US norms. For research purposes, further analysis of the ASQ in innovative, quantitative approaches, is needed.

Parent-Completed Developmental Screening in Premature Children: A Valid Tool for Follow-Up Programs

Our goals were to (1) validate the parental Ages and Stages Questionnaires (ASQ) as a screening tool for psychomotor development among a cohort of ex-premature infants reaching 2 years, and (2) analyse the influence of parental socio-economic status and maternal education on the efficacy of the questionnaire. A regional population of 703 very preterm infants (<35 weeks gestational age) born between 2003 and 2006 were evaluated at 2 years by their parents who completed the ASQ, by a pediatric clinical examination, and by the revised Brunet Lezine psychometric test with establishment of a DQ score. Detailed information regarding parental socio-economic status was available for 419 infants. At 2 years corrected age, 630 infants (89.6%) had an optimal neuromotor examination. Overall ASQ scores for predicting a DQ score ≤85 produced an area under the receiver operator curve value of 0.85 (95% Confidence Interval:0.82–0.87). An ASQ cut-off score of ≤220 had optimal discriminatory power for identifying a DQ score ≤85 with a sensitivity of 0.85 (95%CI:0.75–0.91), a specificity of 0.72 (95%CI:0.69–0.75), a positive likelihood ratio of 3, and a negative likelihood ratio of 0.21. The median value for ASQ was not significantly associated with socio-economic level or maternal education. ASQ is an easy and reliable tool regardless of the socio-economic status of the family to predict normal neurologic outcome in ex-premature infants at 2 years of age. ASQ may be beneficial with a low-cost impact to some follow-up programs, and helps to establish a genuine sense of parental involvement.

Directions for developmental screening in child welfare based on the ages and stages questionnaires

Many young children investigated for maltreatment have developmental problems qualifying them for early intervention services, yet only a portion of these children receive such services. To address this gap, all children ages 0–3 with child welfare (CW) substantiated maltreatment in Pennsylvania are screened for developmental and socioemotional problems using the Ages and Stages Questionnaires (ASQ). This study views screening results for over 500 children to address whether children's substantiation status, living situation, and administering worker as CW or early intervention (EI) predicts screening rates. Bivariate and logistic regression analyses were used. Results showed that 22% of children scored in the problem-range of at least one developmental area and 18% scored in the problem-range of social–emotional concerns warranting EI referral. Results of bivariate analyses showed that children who spent time in the NICU were more likely to have developmental concerns. Socioemotional concerns were related to child race, foster care living situation, child as the subject of the referral, and physical neglect. Older children and children whose referral involved lacking basic needs showed both developmental and socioemotional concerns. There were no significant differences in screening results of children with substantiated versus unsubstantiated maltreatment. Children whose screening was conducted by EI were more than three times as likely to show developmental concerns compared with those screened by CW. Child welfare workers need more support when conducting developmental screening, and policies that limit screening to children with substantiated maltreatment or to children in out-of-home care should be reconsidered.

Developmental Delay in Moderately Preterm-Born Children at School Entry

To determine the prevalence and nature of developmental delay at preschool age in infants born moderately preterm compared with those born full-term and early preterm. Parents of 927 moderate preterm infants (32-35(+6) weeks gestation), 512 early preterm infants (<32 weeks gestation) and 544 full-term infants (38-41(+6) weeks gestation) completed the Ages and Stages Questionnaire (ASQ) when the child was aged 43-49 months. We analyzed rates of abnormal ASQ scores and odds ratios for abnormal ASQ scores in both preterm groups compared with the full-term group. We repeated the analyses after adjustment for socioeconomic status, sex, being part of a multiple birth, and small for gestational age status. Abnormal (ie, >2 SDs below the mean) ASQ total scores were noted in 8.3% of moderate preterm infants, in 4.2% of full-term infants, and in 14.9% of early preterm infants. ORs of abnormal ASQ total scores were 2.1 (95% CI, 1.3-3.4) for moderate preterm infants and 4.0 (95% CI, 2.4-6.5) for early preterm infants. Both moderate and early preterm infants had more frequent problems with fine motor, communication, and personal-social functioning compared with full-term infants. Compared with full-term infants, moderate preterm infants did not have a greater prevalence of problems with gross motor functioning and problem solving, whereas early preterms did. Socioeconomic status, small for gestational age status, and sex were associated with abnormal ASQ scores in moderate preterm infants. At preschool age, the prevalence of developmental delay in moderate preterm infants was 2-fold of that in full-term infants and one-half of that in early preterm infants.

Use of the Ages and Stages Questionnaire and Bayley Scales of Infant Development-II in neurodevelopmental follow-up of extremely low birth weight infants

ObjectivesFor infants born extremely low birth weight (ELBW), we examined the 1) correlation between results on the Ages and Stages Questionnaire (ASQ), and the Bayley Scales of Infant Development II (BSID-II) at 18-22 months corrected age; 2) degree to which earlier ASQ assessments predict later BSID-II results; 3) impact of ASQ use on follow-up study return rates.Study DesignASQ data were collected at 4, 8, 12, and 18-22 months corrected age. The BSID-II was completed at 18-22 months corrected age. ASQ and BSID-II 18 – 22 month sensitivity and specificity were examined. Ability of earlier ASQs to predict later BSID-II scores was examined through linear regression analyses.ResultsASQ sensitivity and specificity at 18-22 months were 73% and 65%, respectively. Moderate correlation existed between earlier ASQ and later BSID-II results.ConclusionsFor ELBW infant assessment, the ASQ cannot substitute for the BSID-II, but appears to improve tracking success.

Developmental status of 5-year-old moderate low birth weight children

Background: Low birth weight (LBW or birth weight < 2500 g) is one of the most serious children problems in today’s world. The purpose of this study was to evaluate and compare developmental status of moderately LBW (birth weight: 1500–2499 g) children at the age of five to that of normal birth weight (NBW: birth weight: 2500–4000 g) ones. Methods: In a case-control study, developmental status of five year old children referred for vaccination between December 2008 and June 2009 in Yazd-Iran, evaluated via Persian version of 60-month Ages and Stages Questionnaires (ASQ). NBW and MLBW children were selected as control and case groups, respectively. Results: Frequency of developmental delay in gross motor, fine motor and problem solving domains were significantly higher in MLBW group and mean score in all developmental domains was statistically significant lower in case group. Conclusion: LBW is one of risk factors for developmental delay. So, evaluation and monitoring of development status of LBW should be emphasized for early and timely diagnosis, investigation, management and also rehabilitation.

DEVELOPMENTAL STATUS OF NICU ADMITTED LOW BIRTH WEIGHT PRETERM NEONATES AT 6 AND 12 MONTHS OF AGE USING AGES AND STAGES QUESTIONNAIRE

Objective Low birth weight (birth weight 2500 g) can be one of the serious problems in children. The purpose of this study was to evaluate the developmental status of LBW preterm neonates admited at neonatal intensive care unit (NICU) at the corrected ages of six and 12 months via the Persian version of Ages and Stages Questionnaires (ASQ). Materials & Methods In a follow up study, fifty LBW preterm neonates admitted to Shahid Sadoughi Hospital NICU in 2008 were evaluated for developmental status at 6 and 12 months of age using ASQ. Results Twenty four boys and 26 girls with a mean gestational age of 31 . 3 ± 2 . 7 weeks and a mean birth weight of 1480 . 3 ± 422 . 8 grams were evaluated. Developmental delay in gross motor and personal social skills domains were the most prevalent abnormal developmental status at 6 and 12 months of age. Mean score in gross motor skills, personal social skills and porblem solving domains at 12 months of age were significantly higher in neonates with birth weight 1500 grams. Mean score in fine motor skills, communication and problem solving domains at 12 months of age were significantly higher in neonates who were exclusively breast fed. Conclusion LBW and preterm infants admitted to the NICU showed degrees of developmental delay at the ages of 6 and 12 months, especially in the gross motor and personal-social developmental domains on the ASQ. So, evaluation and monitoring of development status of LBW should be emphasized for early and timely diagnosis, investigation, and management.

Comparación de la Evaluación Tradicional del Desarrollo Psicomotor versus una Prueba Autoadministrada

Introduction: The purpose of this study is to evaluate the applicability of a self-administered questionnaire in the screening of psychomotor development (PD) in a primary care setting (PC). For that purpose, the degree of concordance between the Ages and Stages Questionnaire (ASQ) and a Psychomotor Development Evaluation Scale (Escala de Evaluacion del Desarrollo Psicomotor-EEDP) currently utilized in PC was tested. In addition, perceptions and value judgment by professionals who participated in the study were explored. Methodology: This semi-quantitative study was performed between November 2008 and December 2009 in two PC centers of the Metropolitan Area of Chile on full-term newborns of the well-baby clinic. At age 8 and 18 months, parents or primary caretakers were asked to fill out the ASQ, and a PC professional completed the EEDP. Correlation and concordance between both tests was measured. Interviews and mini-focus groups were con-ducted with the participating professionals. Results: Three hundred and thirty newborns were recruited in the study. PD deficits were found on 8.79% of patients through the use of EEDP and in 12.73% through the use of ASQ (p = 0,05). Correlation between both evaluations was acceptable (r 0,5) as was concordance in deficit detection (kappa 0.576). The qualitative analysis showed appreciation of ASQ as a measuring tool as well as promoting awareness of PD. Staff of the PC settings utilized various strategies to overcome deficiencies of a self-administered test in populations of higher socio-educational and cultural risk. Conclusions: ASQ picked up significantly more PM deficits than EEDP, while correlation and concordance indices between both tests were adequate. Considering the subjective advantages expressed by staff in favor of ASQ, it is proposed that those PC centers that wish to implement the ASQ do so by progressively incorporating parents and caretakers into the observation of their children's development.

Maternal Transdermal Nitroglycerin Use and Early Childhood Development

ObjectiveOur randomized, double-blind, placebo-controlled trial of transdermal nitroglycerin (GTN) for preterm labour demonstrated a significant reduction in neonatal morbidity and mortality. The objective of this study was to evaluate developmental performance in the children born to women who participated in the GTN trial after one year and two years of follow-up. MethodsThe Ages and Stages Questionnaires (ASQ) were used for the assessments, and five domains of child development (communication, gross motor skills, fine motor skills, problem-solving, and personal social skills) were evaluated. Supplementary analyses were performed after stratifying study subjects by gestational age at birth (<28, 28 to 32, 33 to 36, ≥ 37 weeks) or by defining study subjects as normal or abnormal using standard cut-offs. ResultsA total of 153 infants born to women who participated in the GTN trial were included in the initial follow-up. Among them, 111 (72.5%) children (55 in the GTN arm and 56 in the placebo arm) at 12 months of age and 83 (54.2%) children (42 in the GTN arm and 41 in the placebo arm) at 24 months of age completed the full ASQ. There were no differences in ASQ total score and five subscores between the GTN arm and the placebo arm at the one-year and two-year follow-up evaluations, in overall study subjects, or after stratifying study subjects by gestational age. A trend towards reduced abnormalities in the GTN arm at the two-year follow-up was observed, although there was no statistical significance. ConclusionMaternal GTN use for preterm labour had no impact on children’s long-term development, but larger studies are needed to confirm the preliminary findings of this study.

Editorial: Early prevention and intervention – the Five W (and one H) questions

Editorial: Early prevention and intervention – the Five W (and one H) questions

565 Follow-Up of Neonatal Nonhaemolytic Hyperbilirubinemia in Danish Term and Near-Term Infants with Total Serum Bilirubin Level ≥ 420 Umol/L

Background: It is well described that infants with severe non-haemolytic hyperbilirubinemia in the neonatal period, who present with acute encephalopathy may suffer from permanent brain damage, kernicterus. Whether the infants with severe hyperbilirubinemia presenting with minor or no neurological symptoms in the neonatal period may sustain more subtle brain injury resulting in developmental delay remain controversial.Objective: To study if severe non-haemolytic hyperbilirubinemia in infants with minor or no neurological symptoms in the neonatal period affects the childrens development at the age of 1-5 years.Design/Methods: A controlled descriptive study evaluating all infants born in Denmark 2004-2007 with a gestational age 35 weeks and severe neonatal non-haemolytic hyperbilirubinemia with total serum bilirubin (TSB) ≥ 420 umol/l. Total births those years were approximately 240.000. The study group of 211 (0.9 per 1000) children was identified by linking electronically stored laboratory data with the Danish personal identification number and next medical records of all children with TSB ≥ 420 umol/l was found. A control group of 208 children matched to the study group on sex, age, GA and municipality of residence was found through the Danish birth registry. The families to the children were mailed the Ages and Stages Questionnaire (ASQ), which is a parent completed questionnaire evaluating the childs development.Results: The response rate was 79% for the study group and 70% for the control group. There were no differences in ASQ score between the groups.Conclusions: We found no evidence of developmental delay in children with severe neonatal non-haemolytic hyperbilirubinemia.

Long-term developmental follow-up of infants who participated in a randomized clinical trial of amniocentesis vs laser photocoagulation for the treatment of twin-to-twin transfusion syndrome

We sought to assess long-term neurodevelopment of children who were treated prenatally as part of the Eurofoetus randomized controlled trial. The study population was composed of 128 cases of twin-to-twin transfusion syndrome (TTTS) included and followed up in France. Survivors were evaluated by standardized neurological examination and by Ages and Stages Questionnaires (ASQ). Primary outcome was a composite of death and major neurological impairment. A total of 120 children (47%) were alive at the age of 6 months and were followed up to the age of 6 years. At the time of diagnosis, only treatment and Quintero stage were predictors of a poor outcome (hazard ratio, 0.61; 95% confidence interval, 0.41-0.90; P = .01 and hazard ratio, 3.23; 95% confidence interval, 2.19-4.76; P < .001, respectively). Children treated by fetoscopic selective laser coagulation (FSLC) had higher ASQ scores at the end of follow-up (P = .04). FSLC was significantly associated with a reduction of the risk of death or long-term major neurological impairment at the time of diagnosis and treatment.

Identification of social‐emotional problems among young children in foster care

Little is known about how best to implement behavioral screening recommendations in practice, especially for children in foster care, who are at risk for having social-emotional problems. Two validated screening tools are recommended for use with young children: the Ages and Stages Questionnaire: Social Emotional (ASQ-SE) identifies emotional problems, and the Ages and Stages Questionnaire (ASQ) identifies general developmental delays in five domains, including personal-social problems. The current study examined: (1) whether systematic use of a social-emotional screening tool improves the detection rate of social-emotional problems, compared to reliance on clinical judgment; (2) the relative effectiveness of two validated instruments to screen for social-emotional problems; and (3) the patterns of social-emotional problems among children in foster care. We used retrospective chart review of children in foster care ages 6 months to 5.5 years: 192 children before and 159 after screening implementation, to measure detection rates for social-emotional problems among children. The ASQ-SE and the ASQ were used in multivariable logistic regression analyses to examine associations between children with social-emotional problems. Use of the screening tool identified 24% of the children as having a social-emotional problem, while provider surveillance detected 4%. We identified significantly more children with social-emotional problems using the ASQ-SE than using the ASQ, and agreement between the instruments ranged from 56% to 75%, when data were stratified by age group. Multivariable modeling showed that preschool children were more likely to have a social-emotional problem than toddlers and infants (aOR = 3.4, 95% CI = 1.1-10.8). Systematic screening using the ASQ-SE increased the detection rate for social-emotional problems among young children in foster care, compared to provider surveillance and the ASQ. A specific social-emotional screening tool appears to detect children with psychosocial concerns who would not be detected with a broader developmental screening tool.

Do motor skills in infancy and early childhood predict anxious and depressive symptomatology at school age?

Research has identified a relationship between social–emotional problems and motor impairment in both pre-school and school-age children. The aim of the current study was to determine how motor performance in infancy and early childhood is related to levels of anxious and depressive symptomatology at age 6–12 years. Fifty participants were assessed by their parents 11 times between the ages of 4 months and 4 years using the Ages and Stages Questionnaire (ASQ), and once between the age of 6 and 12 years using the Child Behavior Checklist (CBCL). The ASQ scores were used to obtain the stability (variance) of fine and gross motor performance. Once gestational age, sex and age of testing were taken into account, the stability of gross motor scores predicted both the anxiety/depression measure and the anxious score from the CBCL. It appears that how variable a young child’s gross motor development is from 4 months to 4 years predicts the level of anxious/depressive symptoms at school age. These findings may assist in the early identification of children at risk of anxiety disorders and depression at school age.

Lessons from SARS: A retrospective study of outpatient care during an infectious disease outbreak

BackgroundDuring severe acute respiratory syndrome (SARS) outbreak in Toronto, outpatient clinics at SickKids Hospital were closed to prevent further disease transmission. In response, a decision was made by the neonatal neuro-developmental follow up (NNFU) clinic staff to select patients with scheduled appointments to have a mail/telephone assessment using Ages and Stages Questionnaire (ASQ) or to postpone/skip their visit. The objective of this study was to compare the developmental assessment and its outcome in two groups of NNFU clinic patients, SARS versus non-SARS, over three standard clinic appointments.MethodsWe compared the diagnostic accuracy (identification of developmental delay), and patient management (referral for therapy or communication of a new diagnosis) of the strategies used during SARS, April/May 2003, to the standard assessment methods used for patients seen in April/May 2005 (non-SARS). In all cases data were obtained for 3 patient visits: before, during and after these 2 months and were compared using descriptive statistics.ResultsThere were 95 patients in the SARS group and 99 non-SARS patients. The gestational age, sex, entry diagnosis and age at the clinic visit was not different between the groups. The NNFU clinic staff mailed ASQ to 27 families during SARS, 17 (63%) were returned, and 8 of the 17 were then contacted by telephone. Criteria used to identify infants at risk selected for either mailed ASQ or phone interviews were not clearly defined in the patients' charts. There was a significant under identification of developmental delay during SARS (18% versus 45%). Of those who responded to the mailed questionnaire, referrals for therapy rates were similar to non-SARS group. The lost to follow up rate was 24% for the SARS group compared with 7% for non-SARS. There was no difference in the overall rate of developmental delay in the two groups as identified at the 'after' visit.ConclusionsPoor advanced planning led to a haphazard assessment of patients during this infectious disease outbreak. Future pandemic plans should consider planning for outpatient care as well as in hospital management of patients.

Concurrent validity of the parent‐completed Ages and Stages Questionnaires, 2nd Ed. with the Bayley Scales of Infant Development II in a low‐risk sample

Abstract Background This study assessed the concurrent validity of the Ages and Stages Questionnaire (ASQ) compared with Bayley Scales of Infant Development II (BSID II) amongst children aged 24 months. Methods Data were collected from 53 infants and mothers who participated in the New York State Angler Cohort Child Development Study. Parents completed the 24-month ASQ to assess communication, personal-social, problem-solving ability, and fine and gross motor control. The BSID II was administered by a clinical psychologist at the 24-month home visit for cognitive and psychomotor assessment. The ASQ was scored using age-specific norms of <2 SDs below any domain mean to define failure. A BSID II score of <85 indicated mild or severe delay, while a score of <70 suggested a severe delay. Results Scores on the ASQ communication and personal-social domains were moderately correlated with the BSID II Mental Scale (R= 0.52, P < 0.001; R= 0.45, P < 0.01) and ASQ gross motor with the BSID II Motor Scale (R= 0.46, P < 0.01), whereas ASQ problem-solving and fine motor domains were not significantly correlated with BSID II scores. The ASQ had a sensitivity of 100% and specificity of 87% at 24 months (n= 40) for severely delayed status. Conclusions Results suggest the ASQs provide a simple, valid, and cost-effective method for clinicians and field-based researchers to reduce the number of standardized assessments required to identify developmentally delayed infants at age 24 months. Future studies should further assess the validity of the ASQs in larger, more diverse populations of infants.

Successfully Translating Language and Culture when Adapting Assessment Measures

A need exists for culturally valid and reliable developmental assessment tools for children with disabilities that are able to accommodate multiple languages. One way in which this goal can be achieved is through test translations. The purpose of this preliminary study was to examine the use of translations of select developmental assessment instruments from English to Afrikaans and from one cultural context to another (Western to South African). Specifically, we examined children's performance on two measures of development: the Mullen Scales of Early Learning and the Ages and Stages Questionnaires (ASQ). Both measures were completed for 47 typically developing South African preschool children between 3 and 6 years of age. The Mullen was completed by a speech and language therapist and the ASQ by a parent. Both of the measures used yielded similar results, and compared favorably with the existing norms. The procedures provide a framework for expanding such adaptations in other applications.

How Applicable Are Ages and Stages Questionnaires for Use With Turkish Children?

The majority of eligible children cannot access early intervention services in Turkey, often because they are not assessed. The authors adapted the Ages and Stages Questionnaires (ASQ) for Turkish children ages 3 to 72 months. Study participants consisted of 375 children who were classified as at risk for developmental delays, 564 children considered not at risk for developmental delays (both groups according to standardized assessments), and 39 children with known disabilities. The ROC analyses indicated that a two-domain criterion for classification would be used to classify children as at risk, unlike the original ASQ, which had a one-domain classification. The sensitivity, specificity, positive predictive value, and negative predictive value of ASQ were .94, .85, .97, and .75, respectively. Test—retest and interrater reliabilities calculated as overall percentage agreements were found to be 82% and 87%, respectively. The results demonstrated that the ASQ could be used to screen Turkish children who are at risk for developmental delays.