Diagnostic accuracy of Ages and Stages Questionnaire, Third Edition to identify abnormal or delayed gross motor development in high-risk infants

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health Pub Date : 2024-09-12 DOI:10.1111/jpc.16665

Marcella T Danks, Peter H Gray, Elizabeth M Hurrion

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Abstract

Aim

To investigate the diagnostic accuracy of parent-completed Ages and Stages Questionnaire, Third Edition (ASQ-3) to identify abnormal or delayed gross motor development in infants born less than 1000 g or less than 28 weeks gestation.

Methods

Prospective cohort study of high-risk infants comparing ASQ-3 as the index test with concurrent score on Alberta Infant Motor Scale (AIMS) as the reference standard, at 4-, 8- and 12-month corrected (post-term) age. Reference standard positivity cut-offs were ‘Abnormal motor development’ (AIMS Clinical Range) and ‘Motor delay’ (AIMS score >1 SD below mean, not captured in Clinical Range).

Results

Participating infants (n = 191) had mean gestational age (95% confidence interval (CI)) 26.8 weeks (26.6–27.1) and mean birthweight (95% CI) 870 g (844–896). AIMS rated 51%, 31% and 23% of infants as having ‘Abnormal motor development’ and 12%, 28% and 13% with ‘Motor delay’, at 4, 8 and 12 months, respectively. Diagnostic accuracy of ASQ-3 to identify abnormal motor development was acceptable for older infants only if ‘Monitor’ cut-off was used: sensitivity (95% CI) 33% (23–44), 86% (73–95) and 80% (63–92) and specificity (95% CI) 84% (74–92), 76% (66–84), and 76% (67–83) at 4, 8 and 12 months, respectively. ASQ-3 sensitivity to identify motor delay was low.

Conclusions

ASQ-3 has poor sensitivity to identify abnormal or delayed motor development at 4 months. Using the ‘Monitor’ cut-off improves the diagnostic accuracy of ASQ-3 for identification of older infants with abnormal motor development who are at high risk of motor disability. However, ASQ-3 has poor sensitivity to identify motor delay. Clinical motor assessment of high-risk infants is recommended, particularly in early infancy.

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年龄与阶段问卷（第三版）在识别高风险婴儿粗大运动发育异常或延迟方面的诊断准确性

目的研究由家长填写的年龄与阶段问卷第三版（ASQ-3）的诊断准确性，以识别出生时体重不足 1000 克或妊娠不足 28 周的婴儿的粗大运动发育异常或延迟。方法对高风险婴儿进行前瞻性队列研究，在 4 个月、8 个月和 12 个月（足月儿）校正年龄时，将 ASQ-3 作为指标测试，阿尔伯塔婴儿运动量表（AIMS）的同期得分作为参考标准。参考标准的阳性临界值为 "运动发育异常"（AIMS 临床范围）和 "运动发育迟缓"（AIMS 分数低于平均值 1 SD，未纳入临床范围）。结果参与测试的婴儿（n = 191）的平均胎龄（95% 置信区间 (CI)）为 26.8 周（26.6-27.1），平均出生体重（95% CI）为 870 克（844-896）。在 4 个月、8 个月和 12 个月时，AIMS 分别将 51%、31% 和 23% 的婴儿评为 "运动发育异常"，将 12%、28% 和 13% 的婴儿评为 "运动迟缓"。只有在使用 "监测 "临界值的情况下，ASQ-3 对较大婴儿运动发育异常的诊断准确性才可接受：4、8 和 12 个月时的灵敏度（95% CI）分别为 33% (23-44)、86% (73-95) 和 80% (63-92)，特异度（95% CI）分别为 84% (74-92)、76% (66-84) 和 76% (67-83)。结论ASQ-3对识别4个月时运动发育异常或延迟的灵敏度较低。使用 "监测 "分界点可提高 ASQ-3 的诊断准确性，以识别运动发育异常且运动障碍风险较高的大龄婴儿。然而，ASQ-3 在识别运动迟缓方面的灵敏度较低。建议对高风险婴儿进行临床运动评估，尤其是在婴儿早期。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of paediatrics and child health 医学-小儿科

CiteScore

2.90

自引率

5.90%

发文量

487

审稿时长

3-6 weeks

期刊介绍： The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.