Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Xi'an, Shaanxi, China.
School of Software and Microelectronics, Peking University, Beijing, China.
PLoS One. 2019 Sep 5;14(9):e0221675. doi: 10.1371/journal.pone.0221675. eCollection 2019.
Choosing a valid and feasible method to measure child developmental outcomes is key to addressing developmental delays, which have been shown to be associated with high levels of unemployment, participation in crime, and teen pregnancies. However, measuring early childhood development (ECD) with multi-dimensional diagnostic tests such as the Bayley Scales of Infant and Toddler Development III (Bayley-III) can be time-consuming and expensive; therefore, parental screening tools such as the Ages and Stages Questionnaire (ASQ-3) are frequently an alternative measure of early childhood development in large-scale research. The ASQ is also becoming more frequently used as the first step to identify children at risk for developmental delays before conducting a diagnostic test to confirm. However, the effectiveness of the ASQ-3 is uncertain. In this study, we evaluate the accuracy of the ASQ-3 as a screening measure for children at risk of developmental delay in rural China by age group. To do so, we administered the Bayley-III, widely considered to be the "gold standard" of ECD diagnostic tests, to a sample of 1,831 five to twenty-four month-old children and also administered the ASQ-3 to their caregivers. We then compared the outcomes of the ASQ-3 test to those of the Bayley-III. We find that the ASQ-3 was significantly though weakly correlated with the Bayley-III and that the strength of this correlation increased with child age and was stronger when the mother was the primary caregiver (as compared to the grandmother). We also find that the sensitivity and specificity of ASQ-3 ranged widely. The overall findings suggest that the ASQ-3 may not be a very accurate screening tool for identifying developmentally delayed children, especially for children under 13 months of age or children whose primary caregiver is not the mother.
选择一种有效且可行的方法来衡量儿童发育结果是解决发育迟缓问题的关键，发育迟缓与高失业率、犯罪参与率和青少年怀孕率都有密切关联。然而，使用贝雷（Bayley）婴儿和幼儿发展量表第三版（Bayley-III）等多维诊断测试来衡量幼儿发育（ECD）可能既耗时又昂贵；因此，像年龄与阶段问卷（ASQ-3）这样的父母筛查工具通常是大规模研究中幼儿发育的替代衡量标准。ASQ 也越来越多地被用作在进行诊断测试以确认之前，识别有发育迟缓风险的儿童的第一步。然而，ASQ-3 的有效性尚不确定。在这项研究中，我们根据年龄组评估 ASQ-3 作为中国农村有发育迟缓风险儿童筛查措施的准确性。为此，我们对 1831 名 5 至 24 个月大的儿童进行了贝雷（Bayley）III 测试，这被广泛认为是 ECD 诊断测试的“金标准”，并对他们的照顾者进行了 ASQ-3 测试。然后，我们将 ASQ-3 测试的结果与贝雷（Bayley）III 测试的结果进行了比较。我们发现 ASQ-3 与 Bayley-III 呈显著相关，但相关性较弱，且这种相关性随着儿童年龄的增长而增强，并且当母亲是主要照顾者（而不是祖母）时，相关性更强。我们还发现，ASQ-3 的敏感性和特异性差异很大。总体结果表明，ASQ-3 可能不是一种非常准确的筛查工具，无法识别发育迟缓的儿童，尤其是对于年龄在 13 个月以下或主要照顾者不是母亲的儿童。
