Use of Ages and Stages Questionnaires™ (ASQ) in a Navajo population: Comparison with the U.S. normative dataset.

BACKGROUND: The Ages and Stages Questionnaires-Third Edition (ASQ-3) is a parent-completed screening to identify young children at-risk for developmental delays in the United States and internationally. Federal programs operating on Navajo Nation use the ASQ-3 to determine the need for early intervention services, even though the ASQ-3 national sample used to establish cutoff scores for referral included only 1% Native American children. OBJECTIVES: The current study aimed to compare the ASQ-3 results from a sample of Navajo infants to those from a representative national U.S. sample and to examine the specificity and sensitivity of the ASQ-3 in Navajo population. METHODS: The sample included 530 Navajo infants (47.3% males) aged between 1 and 13 months who lived in remote and rural areas across the Navajo Nation. Children's development was assessed during home visits at 2-, 6-, 9-, and 12-month assessment windows. RESULTS: Results showed that after 6 months, Navajo children had lower mean scores and higher percentages of children at-risk for developmental delays than those from the national sample. The sensitivities and specificities, estimated using a Bayesian diagnostic approach under both conservative and nonconservative prior range choices, suggested a comparable validity performance to that from other ASQ-3 studies. DISCUSSION: The results of this study along with our ongoing comprehensive assessments at 4 years of age inform current programs working with Navajo children to improve early identification of developmental delays.

Confirmatory analysis and normative tables for the Brazilian Ages and Stages Questionnaires: Social-Emotional.

BACKGROUND: In Brazil, large-scale governmental programmes have been implemented to evaluate the development of all children who are enrolled in public daycare centres and preschools using the Brazilian Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) as a screening tool. However, in the Brazilian context, there is a lack of studies that have investigated the clinical utility of the ASQ:SE, and only a few studies have partially investigated the psychometric properties of the Brazilian version of this scale. OBJECTIVES: The present study had two aims: (a) to develop reference norms for the ASQ:SE to help professionals screen child development and because the psychometric properties of the ASQ:SE have only been partially examined, (b) to confirm its factorial structure within a multidimensional item response theory framework. METHODS: The sample size was 54,570 children (53% males, 1-5 years old) who were enrolled in Brazilian public daycare centres and preschools and assessed in 2011. The results allowed the development of reference norms for all age intervals by considering raw scores at the 95th percentile as "monitoring zone" and scores at the 99th percentile as "refer child for further evaluation." Samejima's graded response model was employed, and its fit was checked by the root mean squared error of approximation. RESULTS: The results were ≤0.08, indicating sufficient fit for the two-factor structure. The raw results were 70 and 99.75 (12 months), 75 and 100 (18 months), 70 and 100 (24 months), 85 and 120 (30 months), 90 and 130 (36 months), 95 and 135 (48 months), and 110 and 150 (60 months) for monitoring zone and to refer the child for further evaluation. DISCUSSION: Early identification is the initial stage in this early identification process, thus allowing for referral or intervention. This study may help identify children with developmental delays.

Adapting and validating a developmental assessment for chinese infants and toddlers: The ages & stages questionnaires: Inventory.

The Chinese government has announced the 2013 Guidelines for developing a national system for early detection of disability among children under 6 years of age. However, given limited resources, challenges exist with developmental measures required in the 2013 Guidelines. In order to meet the needs for a more accurate and cost-efficient measure for developmental assessment, the Ages & Stages Questionnaires: Inventory (ASQ:I) was translated into Simplified Chinese, and validated on a regional sample of 812 Chinese children ages from 1 to 25 months. Results indicated that the Chinese ASQ:I domain scores increased across children's age. When dividing the sample into seven age intervals, Cronbach's alpha in each interval ranged from 0.59 to 0.96 across five domains. When using the whole sample for analyses, item expected a posteriori/plausible value (EAP/PV) reliability was above 0.99 in all domains, test-retest reliability using intra-class correlation analyses ranged from 0.95 to 0.99, and the agreement with the concurrent measure ranged from 0.29 to 0.89. Domain scores on the ASQ:I correctly predicted 92-99% of participating children's disability status. Findings suggested that the Chinese ASQ:I has adequate psychometric properties and thus provides a promising alternative measure for screening and progress monitoring in young children in China. Implications for future research and implementation are discussed.

Developmental screening in a Canadian First Nation (Mohawk): psychometric properties and adaptations of ages & stages questionnaires (2nd edition).

BACKGROUND: The need for early intervention tools adapted to the First Nation culture is well documented. However, standards derived from First Nation communities are absent from the literature. This study examines the psychometric properties of an adaptation of a caregiver-completed screening tool, the Ages & Stages Questionnaires (ASQ), for the Mohawk population. METHODS: Participants who completed the questionnaires include 17 teachers, along with the parents of 282 children (130 girls and 152 boys) between the ages of 9 and 66 months who attend the Child and Family Center Mohawk Territory, Quebec. RESULTS: For the internal consistency of the four questionnaires (36-, 42-, 48- and 54-month intervals), Cronbach's alphas varied between .61 and .84. Five results were below 0.60: "gross motor" (Q36 and Q42), "problem solving" (Q36) and "personal-social" (Q36 and Q42). A comparison of the results shows that parents and teachers agreed in 85% of the cases concerning the referral of the child for further evaluation. Moreover, the group discussion with the parents revealed that the use of the questionnaire was appreciated and was deemed appropriate for use within the community. CONCLUSION: The results show that the ASQ is a screening test that may be appropriate for use with children from communities that are seemingly very different in terms of geographic, climatic and cultural backgrounds. This preliminary study with the Child and Family Center appears to support further study and the use of the ASQ with the Mohawk population.