Chong K C, Zhou V L, Tarazona D, Tuesta H, Velásquez-Hurtado J E, Sadeghi R, Llanos F
School of Medicine, University of Rochester, Rochester, NY, USA.
Ministry of Development and Social Inclusion, Lima, Peru.
Child Care Health Dev. 2017 Jul;43(4):556-565. doi: 10.1111/cch.12469. Epub 2017 May 7.
The Ages and Stages Questionnaires Edition 3 (ASQ-3) are a well-validated international screen for developmental delays in young children. However, previous studies demonstrate variable scores between children eligible to take the same ASQ-3 interval. This study aimed to determine a relationship between age and ASQ-3 score for each screening interval.
This was a baseline exploratory cross-sectional study of infants under 2 years old evaluated for the Peruvian social programme Cuna Más. Participants were included in Cuna Más if they lived in districts with fewer than 2000 inhabitants or 400 homes, indicating a predominantly rural population. The appropriate ASQ-3 screening interval was administered to each subject. Subjects were divided into four 2-week chronological subgroups based on age within each 2-month screening window and aggregated across all 12 screening intervals. Fisher's exact test, analysis of variance and Bonferonni post hoc test were used to compare differences between age subgroups. Linear regression was performed to assess the relationship between ASQ-3 score and both aggregated and disaggregated age subgroup.
A total of 5850 Peruvian infants were evaluated in 2013. Mean age was 13 ± 6.6 months, 50.7% were male and mean maternal education was 6.6 ± 4.0 years; 34.8% infants were stunted, 7.8% were underweight, 0.9% were wasted and 2% had age adjusted greater than 35 days for prematurity for ASQ-3 interval assignment. Mean total ASQ-3 was 42.2 ± 8.2. The ASQ-3 allocated 49.6% with suspected delay in one or more developmental areas. Before and after adjusting for wealth quintile, maternal education level, infant nutritional status and prematurity adjustment, age subgroup remained significantly associated with total ASQ-3 score (β = 1.8, CI: 1.7-2.0, P < 0.001), sectional ASQ-3 score (all P < 0.001) and inversely associated with one or more scores indicating suspected developmental delay (P < 0.001).
The ASQ-3 may underestimate the sensitivity of child development to small differences in age in this population.
《年龄与发育阶段问卷》第3版（ASQ - 3）是一项经过充分验证的用于筛查幼儿发育迟缓的国际筛查工具。然而，先前的研究表明，符合参加相同ASQ - 3筛查间隔的儿童之间得分存在差异。本研究旨在确定每个筛查间隔中年龄与ASQ - 3得分之间的关系。
这是一项针对参与秘鲁社会项目“库纳·马斯”（Cuna Más）评估的2岁以下婴儿的基线探索性横断面研究。如果参与者居住在居民少于2000人或家庭少于400户的地区（表明主要为农村人口），则纳入“库纳·马斯”项目。对每个受试者进行适当的ASQ - 3筛查间隔评估。在每个2个月的筛查窗口内，根据年龄将受试者分为四个按时间顺序排列的2周亚组，并汇总所有12个筛查间隔的数据。使用Fisher精确检验、方差分析和Bonferonni事后检验来比较年龄亚组之间的差异。进行线性回归以评估ASQ - 3得分与汇总和细分的年龄亚组之间的关系。
2013年共评估了5850名秘鲁婴儿。平均年龄为13 ± 6.6个月，50.7%为男性，母亲平均受教育年限为6.6 ± 4.0年；34.8%的婴儿发育迟缓，7.8%体重不足，0.9%消瘦，2%因早产在ASQ - 3间隔分配时年龄调整大于35天。ASQ - 3总平均分是42.2 ± 8.2。ASQ - 3显示49.6%的儿童在一个或多个发育领域存在疑似发育迟缓。在调整财富五分位数、母亲教育水平、婴儿营养状况和早产调整因素前后，年龄亚组与ASQ - 3总分（β = 1.8，CI：1.7 - 2.0，P < 0.001）、ASQ - 3各部分得分（所有P < 0.001）仍显著相关，且与一个或多个表明疑似发育迟缓的得分呈负相关（P < 0.001）。
在该人群中，ASQ - 3可能低估了儿童发育对年龄微小差异的敏感性。
