Screening and Assessment Tools for Child Welfare

Ages and Stages Questionnaire (ASQ) has received the Assessment Rating of "A - Reliability and Validity Demonstrated" based on the published, peer-reviewed research available. The assessment must have 2 or more published, peer-reviewed studies that demonstrated that the measure is reliable and valid. For more information on all of the Assessment Ratings, please click here.

Squires, J., Bricker, D., & Potter, L. (1997). Revision of a parent-completed developmental screening tool: Ages and Stages Questionnaire. Journal of Pediatric Psychology, 22(3), 313-328.

Sample:
Participants: 2008 children, including a sample with medical or environmental risk factors and a normative sample
Race/Ethnicity: Not given

Summary:
Parents completed the ASQ beginning at a child's age of 4 months. The majority completed only one questionnaire, but some completed between 6 and 8 questionnaires, at 4-month intervals. Medical risk factors included respiratory distress, pre-maturity, and low birth weight. Environmental risk factors included poverty, low maternal age and education level, and involvement with child protective services (CPS). Reliability was measured by internal consistency. Test-retest and inter-rater reliabilities were computed for subsets of parents. Reliabilities for the ASQ were consistently high. Concurrent validity was assessed by comparing the child's ASQ with his or her classification on the Revised Gesell and Armatruda Developmental and Neurologic Examination, the Bayley Scales of Infant Development and, for children over 3 years, the Stanford-Binet Intelligence Test. The ASQ showed an overall 88% percent agreement with standardized assessments. A subset of children with disabilities showed 96% agreement with standardized assessments. The validity assessment was limited by a small sample of children with disabilities.

Squires, J. K., Potter, L., Bricker, D. D., & Lamorey, S. (1998). Parent-completed developmental questionnaires: Effectiveness with low and middle income parents. Early Childhood Research Quarterly, 13(2), 345-354.

Sample:
Participants: 96 parent-infant pairs recruited through birth announcements, public clinics, public housing projects, teen parent programs, and migrant worker sites in Oregon.
Race/Ethnicity: Caucasian, 63%, African American, 10%, Hispanic 11%, Native American, 5%, and 3% other.

Summary:
Parents completed the ASQ at home at up to eight 4-month intervals, beginning when the child was 4 months old. To assess concurrent validity, at 12, 24, and 30 months children were also given a standardized assessment using the Bayley Scales of Infant Development. Parents were divided into low and middle income groups. For low income parents the agreement between the completed ASQ and the standardized assessment ranged from 80-91%, and the agreement for middle income parents was 85-93%. This study was limited by a high attrition rate, leading to small numbers of parents completing multiple questionnaires.

Skellern, C. Y., Rogers, Y., & O'Callaghan, M. J. (2001). A parent-completed developmental questionnaire: Follow-up of ex-premature infants. Journal of Paediatrics and Child Health, 37, 125-129.

Sample:
Participants: 167 children who had been pre-mature infants recruited from a hospital in Brisbane, Australia.
Race/Ethnicity: Not given

Summary:
Study children were followed up using the ASQ at 12, 18, 24, or 48 months. Children were also assessed during a clinic visit using a set of standardized tests including subscales of the Griffith Mental Development Scales, the Bayley Scales of Infant Development and the Neuro-Sensorimotor Development Assessment. Results indicate a negative predictive value of 98% and a positive predictive value of 40%, indicating a high likelihood that children who pass the ASQ are developing normally, although with some likelihood that normal children would be referred for further evaluation. Results were conflicting for some children with subtle neurological impairments. The authors suggest that the ASQ can be used as one component of programs to assess later development delay in children who were premature.

Elbers, J., McNab, A., McLeod, E., & Gagnon, F. (2008). The Ages and Stages Questionnaires: feasibility of use as a screening tool for children in Canada. Canadian Journal of Rural Medicine, 13(1), 9-14.

Sample:
Participants: 43 children assessed following open-heart surgery and 68 children from a community health center.
Race/Ethnicity: Not given.

Summary:
Questionnaires were sent to families before the children's 4-, 8-, 12-, 16-, 20-, 24-, 30-, and 36-month birthdays. At the end of the third year, 25 children remained in the cardiac group and 59 in the community group. The ability to detect developmental delay in the cardiac group was 75%. That is, of 4 children identified as delayed by the ASQ, 3 were also identified by a specialist. No children with specialist-identified delays were reported to have been missed by the ASQ in the community sample. In this sample 7 children were identified with possible delays and 1 of those was also identified by a specialist. The authors note that this sample was from a relatively affluent community, and so those most likely to benefit from early intervention were not included.