The assessment of developmental status using the Ages and Stages questionnaire-3 in nutritional research in north Indian young children

Abstract

Objective and backgroundFor large epidemiological studies in low and middle-income countries, inexpensive and easily administered developmental assessment tools are called for. This report evaluates the feasibility of the assessment tool Ages and Stages Questionnaire 3.edition (ASQ-3) “home procedure” in a field trial in 422 North Indian young children.MethodsASQ-3 was translated and adjusted for a North Indian Hindi setting. Three examiners were trained by a clinical psychologist to perform the assessments. During the main study, ten % of the assessments were done by two examiners to estimate inter-observer agreement. During all sessions, the examiners recorded whether the scoring was based on observation of the skill during the session, or on caregiver’s report of the child’s skill. Intra class correlation coefficient was calculated to estimate the agreement between the raters and between the raters and a gold standard. Pearson product moment correlation coefficient and standardized alphas were calculated to measure internal consistency.Principal findingsInter-observer agreement was strong both during training exercises and during the main study. In the Motor subscales and the Problem Solving subscale most items could be observed during the session. The standardized alphas for the total ASQ-3 scale across all ages were strong, while the alpha values for the different subscales and age levels varied. The correlations between the total score and the subscale scores were consistently strong, while the correlations between subscale scores were moderate.Conclusions/significanceWe found that the translated and adjusted ASQ-3 “home procedure” was a feasible procedure for the collection of reliable data on the developmental status in infants and young children. Examiners were effectively trained over a short period of time, and the total ASQ scores showed adequate variability. However, further adjustments are needed to obtain satisfying alpha values in all subscales, and to ensure variability in all items when transferred to a North Indian cultural context.

Psychometric properties and validation of Portuguese version of Ages & Stages Questionnaires (3rd edition): 9, 18 and 30 Questionnaires

“…To analyze inter-observer agreement and test-retest reliability for 9, 18 and 30 months questionnaires, Pearson's r test was tested. The results are similar to previous studies, including the original ASQ-3 [21] and the Indian version [31] where satisfactory agreement was noted in both tests.…”

“…Strong correlation values between the overall scores indicated concurrency, consistent with ASQ-3 original [21] study and Indian study [31]. Moderate to weak correlation Table 3 Correlations between developmental area and overall on the 9, 18 and 30 month ASQ-PT questionnaires (6 …”

“…According to Pomés [25], the communication dimension, was the one that reflected the largest differences of functioning between the original version of ASQ-3 and the Spanish version studied in the US. In other international studies, personal-social dimension presented the lowest alphas, as studied in Norway [23], India [31] and Brazil [24]. Different possibilities were discussed when trying to understand these facts, like cultural differences, and Kvestad [31] and Filgueiras et al [24] argued that personal-social domain has several constructs, such as child independence and social behavior that are culturally laden.…”

“…Some countries in which ASQ-3 studies were completed include: Norway [23], Brazil [24], United States of America [25], Chile [26], Peru [27], Netherlands [28], Australia [29], China [30] and India [31].…”

Translations of Developmental Screening Instruments

“…Some articles gave specific examples of changes that were made. Sometimes, 24 Persian, 25 French, [26][27][28][29] Chinese, 30 Portuguese, 31 Hindi, 32,33 Dutch, 34 Thai, 35 Norwegian, 36,37 Korean, 38 Turkish, 39 56 Native African, 57 Japanese, [58][59][60][61] Cambodian, 62 Portuguese, 63 Spanish, [64][65][66] Cree, 67 Romanian, 68 Turkish, [69][70][71] Hmong, 62 Sinhalese, 72 Hebrew, 73,74 Indian, 51 Tamil, 72 Filipino, 75,76 Laotian, 62 Thai, 77 items were adapted to account for local conditions that were not specifically related to language. For example, in the translation of the Korean ASQ, the word for "black bean" was substituted for "Cheerio" in a question that asked if a child could pick up a small item with his/her thumb and finger as Cheerios are unfamiliar in Korean culture.…”