Psychometric Properties and Validation of the Italian Version of Ages & Stages Questionnaires Third Edition

Abstract

Objectives: The Ages & Stages Questionnaires Third Version (ASQ-3) identifies the risk of developmental delay in children aged 1 to 66 months. The aim of this study was to determine a reliable and valid instrument for the Italian population to enable the screening of children’s development. Methods: Data from 2278 Italian children (age range: 1–66 months) were used to evaluate item discrimination power using the corrected item-total correlation. Internal consistency was analyzed by Cronbach’s alpha scores and a Confirmative Factor Analysis was conducted to test the factor structure of the test. Data were also collected to examine the ASQ-3 test-retest reliability and concurrent validity, which was investigated using the Griffiths Scales of Child Development, Third Edition, the Peabody Developmental Motor Scale, Second Edition, and the Developmental Profile, Third Edition tools. In order to evaluate discriminant validity, differences between typical development children and several clinical groups have been performed. Finally, two different cut-off scores have been proposed. Results: The results showed that the questionnaires are composed of high-quality items; the original factor structure has been confirmed and strong Pearson product-moment correlation coefficients between the overall and the total for each domain (ranging from 0.73 to 0.88). The Italian version of the ASQ-3 had adequate internal consistency and a strong agreement between observations with two weeks’ intervals. Moreover, the test showed a high discriminant validity due to the possibility of fully discriminating between typical development children and several clinical groups. Finally, two different cut-off scores have been identified using ROC curves in order to have a screening and a diagnostic cut-off value. Conclusion: This study evaluated the psychometric properties of the Italian adaptation of ASQ-3 questionnaires. We demonstrated the validity of the ASQ-3 and determined new cut-off scores for Italian children. Early identification and accurate assessment are important starting points to better understand and anticipate the needs of children and their link to services.

Reliability and acceptability of web‐based administration of Spanish ages and stages questionnaires third edition®

“…Although the reliability between items was lower than that reported in the US and in a previous study conducted in Chile with national representation and using a paper‐pencil modality (Armijo et al, 2015; Squires & Bricker, 2009), Cronbach's alpha between items and total score was significant. Studies performed in different countries reported variable results, depending on the heterogeneity of the sample (Helms et al, 2006), which might explain the differences between results in the current sample with WB‐ASQ‐3 versus the previous study carried out in a national sample, in the original validation in the USA, at Daycare centers in Brazil or Italy (Armijo et al, 2015; Filgueiras et al, 2013; Manti et al, 2023; Squires & Bricker, 2009), which is different from more homogenous samples (Charafeddine et al, 2013; Lopes et al, 2015; Schonhaut et al, 2019). In a systematic review, Velikonja y cols reported that the reliability of the ASQ was generally ‘positive’ for the original versions of the ASQ‐3, compared to the translated/adapted questionnaires, for more culturally specific domains in particular (Velikonja et al, 2016).…”

“…Given that the participation in screening programs was voluntary, a certain amount of non‐adherence was to be expected; in this study, it stood out that 86% of enrolled children answered at least one development assessment, which is above the participation reported in other survey studies (Janson, 2003) and it was certainly encouraged by the web‐based modality. In addition, the low proportion of incorrectly fulfilled questionnaires indirectly confirmed that the ASQ‐3 was relatively easy to complete (Manti et al, 2023). Although we do not take a gold standard test as a reference, the dimensions analysed allow us to conclude that the instrument is reliable and feasible to apply.…”

Maternal Mental Health in Pregnancy and Its Impact on Children’s Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study)

“…We assessed children's cognitive development at 18 months using the validated tool ASQ-3 [25,26]. The ASQ-3 is a screening tool reported by parents, which assesses the children's cognitive development across five domains: communication, gross motor, fine motor, problem solving, and personal-social.…”

“…Based on the ASQ-3 cutoffs, we categorized each domain into three groups: development on schedule (DS) (scores above the cut-off), requiring learning activities and monitoring (RLAM) (scores close to the cut-off), further assessment required with a professional (FARP) (scores below the cut-off) [28,29]. Communication scores were categorized as: DS (30-60); RLAM (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29); FARP (0-14) [28,29]. Gross motor scores were categorized as: DS (46-60); RLAM (36)(37)(38)(39)(40)(41)(42)(43)(44)(45); FARP (0-35).…”

“…Fine motor scores were categorized as: DS (45-60); RLAM (35)(36)(37)(38)(39)(40)(41)(42)(43)(44); FARP (0-34) [28,29]. Problem-solving scores were categorized as: DS (36-60); RLAM (26)(27)(28)(29)(30)(31)(32)(33)(34)(35); FARP (0-25) [28,29]. Personal-social scores were categorized as: DS (38-60); RLAM (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37); FARP (0-26) [28,29].…”