Description:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>Early detection of cognitive disability is challenging. We assessed the domain-specific, concurrent validity of the ages and stages questionnaire (ASQ-3) and the Bayley Scales of Infant and Toddler Development (BSID-III), and their ability to predict cognitive delay at school age.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>Within a longitudinal birth cohort study, a nested cohort of children was assessed using ASQ-3 and BSID-III at 24 months, and at 5 years using the Kaufmann brief IQ test (KBIT).</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>278 children were assessed using BSID-III and ASQ-3 at 24-months; mean(SD) BW = 3445(506) grams, M:F ratio=52:48. ASQ-3 had reasonable predictive ability (AUROC, <jats:italic>p</jats:italic> value, sensitivity:specificity) of same domain delay for motor (0.630, <jats:italic>p</jats:italic> = 0.008, 50%:76.1%) and language (0.623, <jats:italic>p</jats:italic> = 0.010, 25%:99.5%) at 2 years, but poor ability to detect cognitive delay compared to BSID-III (0.587, <jats:italic>p</jats:italic> = 0.124, 20.7%/96.8%;). 204/278 children were assessed at 5 years. BSID-III language and cognition domains showed better correlation with verbal and nonverbal IQ (R = 0.435, <jats:italic>p</jats:italic> < 0.001 and 0.388, <jats:italic>p</jats:italic> < 0.001 respectively). Both assessments showed high specificity and low sensitivity for predicting delay at 5 years.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>The ASQ-3 cognitive domain showed poor concurrent validity with BSID-III cognitive score. Both ASQ-3 and BSID-III at 2 years poorly predict cognitive delay at 5 years.</jats:p>
</jats:sec><jats:sec>
<jats:title>Impact</jats:title>
<jats:p><jats:list list-type="bullet">
<jats:list-item>
<jats:p>The ASQ-3 does not adequately detect cognitive delay or predict cognitive delay at 5 years, particularly for children with mild to moderate delay.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>The ASQ-3 shows reasonable concurrent validity with the motor and language subscales of the BSID-III. Neither early screening nor formal developmental testing demonstrated significant predictive validity to screen for cognitive delay at school age.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>This article highlights the need to analyse our existing model of using the ASQ-3 to screen for cognitive delay in children aged 2 years.</jats:p>
</jats:list-item>
</jats:list></jats:p>
</jats:sec>