À compter du 1er décembre 2023, l’accès à POEMs et à Essential Evidence Plus ne fera plus partie des avantages offerts aux membres de l’AMC.
Question clinique
How accurate is the Ages and Stages Questionnaire in identifying developmental delays in children 12 to 60 months of age?
L’Essentiel
The ASQ, whether using 1 or 2 standard deviations below the mean, is moderately accurate in identifying children with developmental, motor, cognitive, and language delays. In other words, if a child passes all domains, there is a moderate probability the child does not have a severe delay. Because the ASQ isn’t all that reliable, more comprehensive assessment is warranted in children for whom there is a concern, whether by parents or others. 1a
Référence
Plan de l'etude: Meta-analysis (other)
Financement: Unknown/not stated
Cadre: Various (meta-analysis)
Sommaire
These authors systematically reviewed several databases to identify studies that administered the Ages and Stages Questionnaire (ASQ) to children 12 to 60 months of age and conducted a formal behavioral assessment within 2 months of the ASQ. They excluded studies that only assessed longer-term outcomes. In this analysis, the authors used as failure thresholds both 1 standard deviation and 2 standard deviations below the age-specific mean in one or more domains. They identified 43 eligible studies, but only 36 reported data in a manner suitable for meta-analysis. The studies included between 13 and 1511 children. Overall, the methodologic quality of the included studies was middling, and the studies included more than a dozen different reference standards. The ASQ assesses many specific fine and gross motor tasks that the researchers mashed into a single motor domain; similarly, the researchers combined problem-solving, communication, cognitive, and language skills into a single cognitive domain. Regardless of whether using 1 or 2 standard deviations as a threshold, detection accuracy for significant delays was modest (area under the curve 0.75 - 0.87) and the specific test properties ranged from poor to modest: sensitivity (range: 0.32 - 0.88), specificity (range: 0.53 - 0.93), positive likelihood ratio (range: 1.9 - 6.5), and negative likelihood ratio (range 0.22 - 0.73). For all these data, the authors identified significant heterogeneity.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Commentaires
ASQ
Reasonable scoring system for developmental delay
ASQ in 12-60 month children
good screening tool for developmental delay but may need more testing if there is concern for delay