Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland.
Department of Clinical Medicine, Trinity College, Dublin, Ireland.
Pediatr Res. 2023 Oct;94(4):1465-1471. doi: 10.1038/s41390-023-02528-y. Epub 2023 Feb 25.
Early detection of cognitive disability is challenging. We assessed the domain-specific, concurrent validity of the ages and stages questionnaire (ASQ-3) and the Bayley Scales of Infant and Toddler Development (BSID-III), and their ability to predict cognitive delay at school age.
Within a longitudinal birth cohort study, a nested cohort of children was assessed using ASQ-3 and BSID-III at 24 months, and at 5 years using the Kaufmann brief IQ test (KBIT).
278 children were assessed using BSID-III and ASQ-3 at 24-months; mean(SD) BW = 3445(506) grams, M:F ratio=52:48. ASQ-3 had reasonable predictive ability (AUROC, p value, sensitivity:specificity) of same domain delay for motor (0.630, p = 0.008, 50%:76.1%) and language (0.623, p = 0.010, 25%:99.5%) at 2 years, but poor ability to detect cognitive delay compared to BSID-III (0.587, p = 0.124, 20.7%/96.8%;). 204/278 children were assessed at 5 years. BSID-III language and cognition domains showed better correlation with verbal and nonverbal IQ (R = 0.435, p < 0.001 and 0.388, p < 0.001 respectively). Both assessments showed high specificity and low sensitivity for predicting delay at 5 years.
The ASQ-3 cognitive domain showed poor concurrent validity with BSID-III cognitive score. Both ASQ-3 and BSID-III at 2 years poorly predict cognitive delay at 5 years.
The ASQ-3 does not adequately detect cognitive delay or predict cognitive delay at 5 years, particularly for children with mild to moderate delay. The ASQ-3 shows reasonable concurrent validity with the motor and language subscales of the BSID-III. Neither early screening nor formal developmental testing demonstrated significant predictive validity to screen for cognitive delay at school age. This article highlights the need to analyse our existing model of using the ASQ-3 to screen for cognitive delay in children aged 2 years.
认知障碍的早期检测具有挑战性。我们评估了年龄和阶段问卷（ASQ-3）和贝利婴幼儿发育量表（BSID-III）的特定领域的同时效度，以及它们预测学龄期认知障碍的能力。
在一项纵向出生队列研究中，嵌套队列的儿童在 24 个月时使用 ASQ-3 和 BSID-III 进行评估，并在 5 岁时使用 Kaufmann 简明智商测试（KBIT）进行评估。
278 名儿童在 24 个月时接受了 BSID-III 和 ASQ-3 的评估；平均（SD）BW=3445（506）克，M:F 比=52:48。ASQ-3 对运动（AUROC，p 值，敏感性：特异性）和语言（0.623，p=0.010，25%：99.5%）领域的同域延迟具有合理的预测能力，但其检测认知延迟的能力比 BSID-III 差（0.587，p=0.124，20.7%/96.8%）。278 名儿童中有 204 名在 5 岁时接受了评估。BSID-III 语言和认知领域与言语和非言语智商的相关性更好（R=0.435，p<0.001 和 0.388，p<0.001）。这两种评估方法都具有较高的特异性和较低的敏感性，用于预测 5 岁时的延迟。
ASQ-3 认知域与 BSID-III 认知评分的同时效度较差。ASQ-3 和 BSID-III 在 2 岁时均不能很好地预测 5 岁时的认知障碍。
ASQ-3 不能充分检测认知障碍或预测 5 岁时的认知障碍，尤其是对于轻度至中度延迟的儿童。ASQ-3 与 BSID-III 的运动和语言分量表具有合理的同时效度。早期筛查和正式发育测试均未显示出显著的预测效度，无法筛查学龄期的认知障碍。本文强调需要分析我们目前使用 ASQ-3 筛查 2 岁儿童认知障碍的模型。
