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Developmental screening in children with CHD: Ages and Stages Questionnaires

Published online by Cambridge University Press:  05 April 2017

Maia M. Noeder ,
Beth A. Logan ,
Kari L. Struemph ,
Nancy Condon ,
Isabel Mueller ,
Barbara Sands ,
Ryan R. Davies  and
Erica Sood
Maia M. Noeder*
Affiliation:
Nemours Neurosciences Center, Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
Beth A. Logan
Affiliation:
Nemours Neurosciences Center, Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
Kari L. Struemph
Affiliation:
Nemours Neurosciences Center, Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
Nancy Condon
Affiliation:
Department of Outpatient Therapy Services, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
Isabel Mueller
Affiliation:
Department of Outpatient Therapy Services, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
Barbara Sands
Affiliation:
Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
Ryan R. Davies
Affiliation:
Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
Erica Sood
Affiliation:
Nemours Neurosciences Center, Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: M. M. Noeder, PhD, Nemours Neurosciences Center, Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, United States of America. Tel: +1 302 651 4001; Fax: +1 302 651 5385; E-mail: maia.noeder@nemours.org
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Abstract

Objective

Standardised developmental screening tools are important for the evaluation and management of developmental disorders in children with CHD; however, psychometric properties and clinical utility of screening tools, such as the Ages & Stages Questionnaires, Third Edition (ASQ-3), have not been examined in the CHD population. We hypothesised that the ASQ-3 would be clinically useful for this population.

Study design

ASQ-3 developmental classifications for 163 children with CHD at 6, 12, 24, and/or 36 months of age were compared with those obtained from concurrent developmental testing with the Bayley Scales of Infant and Toddler Development, Third Edition.

Results

When ASQ-3 screening failure was defined as ⩾1 SD below the normative mean, specificity (⩾81.9%) and negative predictive value (⩾81.0%) were high across ASQ-3 areas. Sensitivity was high for gross motor skills (79.6%), increased with age for communication (35.7–100%), and generally decreased with age for problem solving (73.1–50.0%). When ASQ-3 screening failure was defined as ⩾2 SD below the normative mean, specificity (⩾93.6%) and positive predictive value (⩾74.5%) were generally high across ASQ-3 areas, but sensitivity was low (31.1%) to fair (62.8%). The ASQ-3 showed improved accuracy in predicting delays over clinical risk factors alone.

Conclusions

The ASQ-3 appears to be a clinically useful tool for screening development in children with CHD, although its utility varied on the basis of developmental area and time point. Clinicians are encouraged to refer children scoring ⩾1 SD below the normative mean on any ASQ-3 area for formal developmental evaluation.

Keywords

Assessmentneurodevelopmentcardiology
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1447 - 1454
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Copyright
© Cambridge University Press 2017 

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Supplementary material: File

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Supplementary material: File

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Table S2

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