Use of Ages and Stages Questionnaires™ (ASQ) in a Navajo population: Comparison with the U.S. normative dataset

Abstract

Background: The Ages and Stages Questionnaires-Third Edition (ASQ-3) is a parentcompleted screening to identify young children at-risk for developmental delays in the United States and internationally. Federal programs operating on Navajo Nation use the ASQ-3 to determine the need for early intervention services, even though the ASQ-3 national sample used to establish cutoff scores for referral included only 1% Native American children.Objectives: The current study aimed to compare the ASQ-3 results from a sample of Navajo infants to those from a representative national U.S. sample and to examine the specificity and sensitivity of the ASQ-3 in Navajo population. Methods:The sample included 530 Navajo infants (47.3% males) aged between 1 and 13 months who lived in remote and rural areas across the Navajo Nation.Children's development was assessed during home visits at 2-, 6-, 9-, and 12-month assessment windows.Results: Results showed that after 6 months, Navajo children had lower mean scores and higher percentages of children at-risk for developmental delays than those from the national sample. The sensitivities and specificities, estimated using a Bayesian diagnostic approach under both conservative and nonconservative prior range choices, suggested a comparable validity performance to that from other ASQ-3 studies.Discussion: The results of this study along with our ongoing comprehensive assessments at 4 years of age inform current programs working with Navajo children to improve early identification of developmental delays.

Cat and Dog Ownership in Early Life and Infant Development: A Prospective Birth Cohort Study of Japan Environment and Children’s Study

“…The mean scores of the ASQ-3 in this study were relatively lower compared to the recent cohort study (n = 318) as well as US national data [20]. The mean scores were also lower compared to the original scores from the ASQ manual.…”

Serum-borne factors alter cerebrovascular endothelial microRNA expression following particulate matter exposure near an abandoned uranium mine on the Navajo Nation

“…Metals-based exposure has been implicated in several adverse health effects, including pulmonary and cardiovascular diseases, neurological disorders and cancer [53][54][55][56]. Recent epidemiological evidence from the area has suggested cognitive deficits in Navajo children compared to the national average [57]. We surmise that inhaled exposures from AUMs may play a role in this etiology of neurological outcomes.…”

Prenatal Metal Exposures and Infants’ Developmental Outcomes in a Navajo Population

“…This procedure was based on our team’s unpublished finding that there were increased levels of item completion and accuracy when staff administered the survey rather than relying solely on parental self-completion. We previously published data on validation of this instrument in a Navajo population relative to the ASQ normative data set [ 9 ]. The child was present during survey administration.…”

“…In the current study, we examined samples from the NBCS for associations between in utero maternal exposure (measured through biomonitoring of a panel of 35 metals and metalloids) and infants’ neurodevelopmental outcomes (assessed using developmental screening of infants between 10 and 13 months) in mother–infant pairs from mined and unmined regions that encompass a broad range of exposures. The developmental period of 10–13 months was chosen because elevated developmental delays around 10 months of age were observed in previous analysis of data from NBCS [ 9 ]. The subset of co-occurring metals assessed in the current study includes uranium, lead, arsenic, cadmium, manganese, copper, barium, cobalt, cesium, molybdenum, antimony, strontium, tin, thallium, and tungsten.…”