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, Celeste R. Laarman, Katerina Steiner, Peter H. Dijk*

*Corresponding author for this work

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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

Original languageEnglish
Article numbere0133087
Number of pages14
JournalPLoS ONE
Volume10
Issue number7
DOIs
Publication statusPublished - 20-Jul-2015

Keywords

  • BIRTH-WEIGHT INFANTS
  • RANDOMIZED CONTROLLED-TRIAL
  • BAYLEY-III SCALE
  • DEVELOPMENTAL DELAY
  • FOLLOW-UP
  • SURVEILLANCE
  • PREMATURE
  • VALIDITY
  • OUTCOMES
  • 2ND

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