Utility of the Ages and Stages Questionnaire to Identify Developmental Delay in Children Aged 12 to 60 Months: A Systematic Review and Meta-analysis
JAMA Pediatrics
Muthusamy, S., Wagh, D., et al. (2022).
JAMA Pediatrics, 176(10), 980-989.
This systematic review and meta-analysis investigates the clinical utility of the Ages and Stages Questionnaire to identify developmental delay in children aged 1 to 5 years.
Not stated
From database inception to December 2021
Prospective and retrospective designs
43, with 36 included in meta-analysis
Findings demonstrated the following sensitivity and specificity data for the Ages and Stages Questionnaire (ASQ) in diagnosing developmental delay for thresholds of either two standard deviations (ASQ-2D) or one standard deviation (ASQ-1D) below the mean: <br />
<ul>
<li>ASQ-2D to diagnose any developmental delay (sensitivity: 0.77, specificity: 0.81) or severe developmental delay (sensitivity: 0.84, specificity: 0.77);</li>
<li>ASQ-2D motor domain to predict motor delay (sensitivity: 0.41, specificity: 0.94) or severe motor delay (sensitivity: 0.43, specificity: 0.87);</li>
<li>ASQ-2D cognitive domain to predict cognitive delay (sensitivity: 0.44, specificity: 0.93) or severe cognitive delay (sensitivity: 0.32, specificity: 0.93);</li>
<li>ASQ-1D to diagnose any developmental delay ( sensitivity: 0.79, specificity: 0.67) or severe developmental delay (sensitivity: 0.88, specificity: 0.53);</li>
<li>ASQ-1D motor domain to predict motor delay (sensitivity: 0.64, specificity: 0.79); and</li>
<li>ASQ-1D cognitive domain to predict cognitive delay (sensitivity: 0.58, specificity: 0.79).</li>
</ul>
Findings suggest that if a child ages 1 to 5 years passes all ASQ domains, then there is a moderate probability that they do not have a severe developmental delay. If the child fails the motor or cognitive components, then there is a moderate probability that they have a delay in the corresponding domain (low to very low certainty of evidence). Limitations to this review include small sample sizes within domains and potential risk of bias. Further research is warranted.
