Affiliations: [a] Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore
| [b]
Duke-NUS Medical School, Singapore
| [c]
Lee Kong Chian School of Medicine, Singapore
| [d]
Singapore Clinical Research Institute, Singapore
| [e] Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Correspondence:
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Address for correspondence: Yeo Cheo Lian, MBBS, M.Med (Paeds), MMEd (Dundee), FAMS, Department of Neonatal and Developmental Medicine, Singapore General Hospital, 20 College Road, Academia, Singapore 169856. Tel.: +65 6321 4597; E-mail: yeo.cheo.lian@singhealth.com.sg.
Abstract: BACKGROUND:Parent-completed tools like the Ages and Stages Questionnaire Third Edition (ASQ-3) are important in developmental screening. As a screening tool, a high negative predictive value (NPV) is critical to avoid missing the diagnosis of developmental delay. This study evaluated the NPV and accuracy of the ASQ-3 in assessing the development of preterm infants. METHODS:Infants born at <32 weeks and/or <1250 grams, presenting to the Neonatal Neurodevelopmental Clinic at the Singapore General Hospital for follow-up from January 2014 to June 2017, at 6, 12, and 18 months corrected age, were included. The ASQ-3 and standardized tests – Peabody Developmental Motor Scale-Second Edition (PDMS-2) and Preschool Language Scale, Fourth Edition UK (PLS-4 UK) – were administered. ASQ-3 gross motor and fine motor scores were compared to PDMS-2 at 6 and 12 months, and ASQ-3 communication scores to PLS-4 UK at 18 months. RESULTS:At 6 months (n = 145), NPV for gross motor and fine motor were 96.4% (accuracy 80.0%) and 95.4% (accuracy 77.2%) respectively. At 12 months (n = 127), NPV for gross motor and fine motor were 88.9% (accuracy 79.8%) and 82.8% (accuracy 74.0%) respectively. At 18 months (n = 113), NPV for language was 56.9% (accuracy 63.7%). CONCLUSIONS:The ASQ-3 showed high NPV and accuracy in screening gross motor and fine motor skills at 6 and 12 months, but not in screening language skills at 18 months. Judicious use of the ASQ-3 may allow for more effective utilization of resources.
