Lamsal Ramesh, Dutton Daniel J, Zwicker Jennifer D
School of Public Policy, University of Calgary, 906 8th Ave SW, Calgary, Canada.
Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
BMC Pediatr. 2018 Apr 3;18(1):122. doi: 10.1186/s12887-018-1105-z.
Early detection of neurodevelopmental disorders (NDDs) enables access to early interventions for children. We assess the Ages and Stages Questionnaire (ASQ)'s ability to identify children with a NDD in population data.
Children 4 to 5 years old in the National Longitudinal Survey of Children and Youth (NLSCY) from cycles 5 to 8 were included. The sensitivity, specificity, positive and negative predictive values were calculated for the ASQ at 24, 27, 30, 33, 36 and 42 months. Fixed effects regression analyses assessed longitudinal associations between domain scores and child age.
Specificity for the ASQ was high with 1SD or 2SD cutoffs, indicating good accuracy in detecting children who will not develop a NDD, however the sensitivity varied over time points and cut-offs. Sensitivity for the 1 SD cutoff at 24 months was above the recommended value of 70% for screening. Differences in ASQ domains scores between children with and without NDD increases with age.
The high specificity and negative predictive values of the ASQ support its use in identifying children who are not at the risk of developing a NDD. The capacity of the ASQ to identify children with a NDD in the general population is limited except for the ASQ-24 months with 1SD and can be used to identify children at risk of NDD.
早期发现神经发育障碍(NDDs)有助于为儿童提供早期干预。我们评估年龄与发育阶段问卷(ASQ)在人群数据中识别患有NDD儿童的能力。
纳入儿童和青少年全国纵向调查(NLSCY)第5至8轮中4至5岁的儿童。计算了ASQ在24、27、30、33、36和42个月时的敏感性、特异性、阳性预测值和阴性预测值。固定效应回归分析评估了各领域得分与儿童年龄之间的纵向关联。
ASQ在1个标准差或2个标准差临界值时特异性较高,表明在检测不会患NDD的儿童方面具有良好的准确性,然而敏感性随时间点和临界值而变化。24个月时1个标准差临界值的敏感性高于筛查推荐值70%。患有和未患有NDD的儿童在ASQ各领域得分上的差异随年龄增加。
ASQ的高特异性和阴性预测值支持其用于识别无NDD患病风险的儿童。除24个月时1个标准差的ASQ外,ASQ在普通人群中识别患有NDD儿童的能力有限,可用于识别有NDD风险的儿童。