The Ages and Stages Questionnaire is moderately accurate at ruling in/out developmental delays in children 12 to 60 months of age

Reference

Muthusamy S, Wagh D, Tan J, Bulsara M, Rao S. Utility of the Ages and Stages Questionnaire to identify developmental delay in children aged 12 to 60 months: a systematic review and meta-analysis. JAMA Pediatr 2022;176(10):980-989. 

Synopsis

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.