Prospective evaluation of the Ages and Stages Questionnaire 3rd Edition in very‐low‐birthweight infants

Abstract

Aim To evaluate the predictive and concurrent diagnostic agreement of the Ages and Stages Questionnaire 3rd Edition (ASQ‐3) with the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley‐III) in infants born preterm and very‐low‐birthweight (PT/VLBW; ≤1250g). Method We evaluated 141 PT/VLBW infants (68 males, 73 females) born at the KK Women's and Children's Hospital between January 2010 and December 2011, to determine predictive and concurrent diagnostic agreement between the ASQ‐3 at 9, 12, 18, and 24 months corrected age and Bayley‐III at 24 months. Cut‐offs on the ASQ‐3 at 24 months were estimated by receiver operating characteristic curves. Results Sixty (43%) and 25 (18%) failed in any domain of the ASQ‐3 and Bayley‐III (<70) respectively. A negative predictive value (NPV) >98% was achieved for the motor domain from 9 months, and >90% for the communication domain and the overall results at 24 months. Optimal referral ASQ‐3 score at 24 months to achieve 100% NPV was 243. Interpretation In PT/VLBW infants, ASQ‐3 screening at 24 months can reduce the need for costly psychometric assessments in children with normal results. Clinicians can be assured of normal motor development at 9 months using the ASQ‐3, but should continue to screen children on other domains.