Predictive Value of the Parent-Completed ASQ for School Difficulties in Preterm-Born Children <35 Weeks' GA at Five Years of Age

Abstract

Background: Preterm infants are at greater risk of developmental impairment and require close follow-up for early and optimal care. Objectives: The objective of the present study was to determine from which age the parental Ages and Stages Questionnaire (ASQ) allows detection of school difficulties in preterm children <35 weeks' gestational age. Methods: Preterm children from the regional Loire Infant Follow-up Team network were evaluated with the Global School Adaptation (GSA) assessment tool at 5 years of age and at least one parental-completed ASQ at 18, 24, or 36 months. Children belonging to the first decile of the GSA score (<38) were considered to have severe school difficulties. Using overall ASQ scores as continuous variables, receiver operating characteristic (ROC) curves were generated at every age in order to identify preterm children with severe school difficulties. Results: GSA scores were obtained in 1,775 infants at 5 years of age, and at least one ASQ score at 18, 24, or 36 months was completed. Upon ROC analysis, we observed that the 18-, 24-, and 36-month ASQ scores produced respective area under the ROC curve values of 0.66 (0.64-0.69), 0.72 (0.70-0.75), and 0.77 (0.75-0.80) for predicting a GSA score in the first decile. An ASQ cutoff value of 255 at 36 months showed optimal discriminatory power for identifying significant school difficulties at 5 years of age. Conclusions: The 36-month ASQ is a simple and cost-effective tool that can be employed to help predict future severe school difficulties at 5 years of age in preterm-born children.

Validez del Ages & Stages questionnaires para predecir el desempeño cognitivo en los primeros años de educación escolar

“…Furthermore, under-referral rates were below 10%, which was acceptable 8 . Unlike what was reported by Halbwachs using ASQ, and by Doyle using the Bayley scale 29,30 , a tendency to improve the ASQ psychometric properties as children age increased was not observed. At 8 months, a ROC curve with an excellent discriminative capacity (AUC 98%) was obtained compared to 18 and 30 months where AUC was overall good (78.1% and 79.3%, respectively).…”

Prenatal triptan exposure and parent‐reported early childhood neurodevelopmental outcomes: an application of propensity score calibration to adjust for unmeasured confounding by migraine severity

“…The Ages and Stages Questionnaire (ASQ) is a parent‐completed questionnaire appropriate for children aged 4 months to 5 years. Deficits detected by the ASQ predict school difficulties in older children, and fine motor skills predict later academic achievement . The abbreviated ASQ used in MoBa includes questions about developmental milestone attainment in three major categories: gross motor (two items), fine motor (two items), and communication (six items); this shortened version, adapted from the ASQ:SE‐2, has been validated in a Norwegian population .…”

“…Between 1999 and 2008, the Norwegian Institute of Public Health invited women to participate in the Norwegian Mother and Child Cohort Study (MoBa). Women were invited prior to their first routine ultrasound appointment (gestational week [13][14][15][16][17]. A total of 108 841 women consented to participate (participation rate 40.6%), with 84.8% of the participants completing the 6-month postpartum questionnaire and 60.2% completing the 36-month postpartum questionnaire.…”

Prospective evaluation of the Ages and Stages Questionnaire 3rd Edition in very‐low‐birthweight infants

“…Because of missing data, we were unable to conclude whether our participants were representative of our cohort in socio-economic status. 17,18 Halwachs et al 19 found that an ASQ-2 cut-off value of 255 at 36 months showed optimal discriminatory power (area under the curve 0.82) for identifying school difficulties at age 5, while earlier assessments were less reliable. 16 Other authors have found significant differences between the USA and other population-specific norms on the Bayley III.…”

“…Concerns exist regarding the limited predictive validity of early Bayley scores for school-age cognition. 17,18 Halwachs et al 19 found that an ASQ-2 cut-off value of 255 at 36 months showed optimal discriminatory power (area under the curve 0.82) for identifying school difficulties at age 5, while earlier assessments were less reliable. We plan to assess the cognitive function and school readiness of our cohort at 5.5 years of age, to further validate the predictive value of the ASQ-3.…”