The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children
Jorien M Kerstjens, Ard Nijhuis, Christian V Hulzebos, Deirdre E van Imhoff, Aleid G van Wassenaer-Leemhuis, Ingrid C van Haastert, Enrico Lopriore, Titia Katgert, Renate M Swarte, Richard A van Lingen, Twan L Mulder, Céleste R Laarman, Katerina Steiner, Peter H Dijk, Jorien M Kerstjens, Ard Nijhuis, Christian V Hulzebos, Deirdre E van Imhoff, Aleid G van Wassenaer-Leemhuis, Ingrid C van Haastert, Enrico Lopriore, Titia Katgert, Renate M Swarte, Richard A van Lingen, Twan L Mulder, Céleste R Laarman, Katerina Steiner, Peter H Dijk
Abstract
Objective: To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two.
Methods: We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on ASQ3 and Bayley Scales of Infant and Toddler Development, Third Edition (BSIDIII) and neurological examination at 22-26 months' corrected age. We defined NDI as a score of <70 on the cognitive--or motor composite scale of BSIDIII, or impairment on neurological examination or audiovisual screening. We compared NDI with abnormal ASQ3 scores, i.e., < -2SDs on any domain, and with ASQ3 total scores. To correct for possible overestimation of BSIDIII, we also analyzed the adjusted BSIDIII thresholds for NDI, i.e., scores <80 and <85.
Results: We found 61 (27%) children with abnormal ASQ3 scores, and 10 (4.5%) children who had NDI with original BSIDIII thresholds (<70). Twelve children had NDI at BSIDIII thresholds at <80, and 15 had <85. None of the 163 (73%) children who passed ASQ3 had NDI. The sensitivity of ASQ3 to detect NDI was excellent (100%), its specificity was acceptable (76%), and its negative predictive value (NPV) was 100%. Sensitivity and NPV remained high with the adjusted BSIDIII thresholds.
Conclusion: The Ages and Stages Questionnaire is a simple, valid and cost-effective screening tool to help identify and exclude NDI in very preterm-born children at the corrected age of two years.
Conflict of interest statement
Competing Interests: The authors have declared that no competing interests exists.
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Source: PubMed