Parental and professional assessment of early child development: the ASQ-3 and the Bayley-III-NL

Background: The Ages and Stages Questionnaire (ASQ-3) is frequently used for screening developmental delay in problem solving, communication, fine- and gross motor skills and personal-social behavior of infants, toddlers and preschool aged children. The adequacy of the ASQ-3 is evaluated for Dutch children by comparing results of the ASQ-3, completed by parents, to results of a standardized, professionally administered developmental assessment of cognition, fine- and gross motor skills and receptive and expressive communication for infants and toddlers: the Bayley-III-NL.

Methods: The ASQ-3 and Bayley-III-NL were administered to 1244 children aged 1 to 43months old. Two age cohorts were used: 1) the 2-16month age-versions; and 2) the 18-42month age-versions. Cutoff points for all ASQ-3 age-versions were calculated in three ways. Sensitivity and specificity of the ASQ-3 were evaluated with four methods, using different cutoff point combinations of 1 SD or 2 SD below the mean.

Results: Overall, sensitivity was between 7% and 77% and specificity between 53% and 99%. Sensitivity and specificity values were higher for the older age-cohort than for the younger age-cohort. For the older age-cohort, the best sensitivity (69%) and specificity (92%) was found, using 1 SD for the total ASQ-3 score and 2 SD for the Bayley-III-NL subtests as cutoff points.

Conclusions: For the oldest age-cohort, the ASQ-3 for now has the best potential as a screener for Dutch children. The ASQ-3 identifies most children without a developmental delay according to the Bayley-III-NL, but sensitivity needs improvement.