Predictive Validity of Developmental Screening Questionnaires for Identifying Children With Later Cognitive or Educational Difficulties: A Systematic Review

Abstract

Context: Parent/caregiver completing developmental screening questionnaires (DSQs) for children before 5 years of age is currently recommended. The DSQs recommended by the American Academy of Pediatrics (AAP) are the Ages and Stages Questionnaires (ASQ), Parents' Evaluation of Developmental Status (PEDS), and the Survey of Well-being of Young Children (SWYC). Nevertheless, their predictive validity has not been well-established.Objective: To assess in the current literature, the value of AAP-recommended DSQs (ASQ, PEDS, SWYC) administered between 0 and 5 years of age, for predicting long-term cognitive achievement and/or school performance (CA/SP), after 1 year or more of evaluation and at/or after age 5 years, in the general population.Data Sources: Cochrane, MEDLINE PubMed, CINAHL, EMBASE, Web of Science, Scielo, and Scopus databases (until March 2021).Study Selection: Two authors selected the studies. Forward and backward citation follow-up was done; authors of DSQ were contacted to identify additional studies.Data Extraction: Cohorts were identified, and authors of selected studies were contacted to corroborate and complete extracted data.Results: Thirty-two publications, corresponding to 10 cohorts, were included. All cohorts used ASQ. Only cohort using PEDS was identified but did not meet the inclusion criteria. No cohorts conducted with SWYC were identified. Associations between ASQ and CA/SP were extracted for eight cohorts. The odds ratios were >3, and the area under the curve was 0.66–0.87. A trade-off between sensitivity and specificity was observed.Limitations: Heterogeneity in population characteristics and in DSQ adaptations.Conclusions: A positive association between ASQ and later CA/SP was found in different social, cultural, and economic settings. Additional studies are necessary to determine the impact factors in the predictive capacity of DSQs.Systematic Review Registration: PROSPERO, identifier: CRD42020183883.

Utility of the Ages and Stages Questionnaire to Identify Developmental Delay in Children Aged 12 to 60 Months

“…Schonhaut et al 13 evaluated the ASQ and other tools for predicting future cognitive achievement or school performance. In contrast, our focus was to compare ASQ vs concurrently performed (plus or minus 2 months) developmental assessments.…”

Predictive validity of the Infant Toddler Checklist in primary care at the 18-month visit and developmental diagnosis at 3–5 years: a prospective cohort study

“…27 Three recent systematic reviews addressed the predictive criterion validity of developmental screening tools; however, of included studies, few examined screening at 18 months or younger, and none included the ITC. [28][29][30] While the ITC may be a promising developmental screening tool for the 18-month visit in primary care, we have identified gaps in evidence regarding its predictive validity. Our objective was to examine the predictive validity of the ITC at the 18-month visit to predict a developmental diagnosis at 3-5 years of age.…”

“…There have been three recent systematic reviews of predictive validity of developmental screening in early childhood, highlighting the interest in understanding which tools best identify children who may benefit from early identification and intervention. [28][29][30] Of included studies, few examined screening at ≤18 months, and none examined the ITC.…”

“…Schonhaut et al examined the predictive validity of the Ages & Stages Questionnaire (ASQ), which is of great importance given its common use in many countries. 29 Of five included studies, three screened children at 36 or 48 months; and while the remaining two studies screened some children at 18 months, they included children born preterm. Lamsal et al (not included in any systematic review) examined the predictive validity of the ASQ for parent report of a developmental diagnosis at 4-5 years.…”

“…However, there is great interest in the predictive validity of developmental tools which ‘offers a critical illustration of whether a screening test measures dimensions of development that are enduring and have a meaningful impact on children’s long-term outcomes’ 27. Three recent systematic reviews addressed the predictive criterion validity of developmental screening tools; however, of included studies, few examined screening at 18 months or younger, and none included the ITC 28–30…”