Developmental delays can be identified in quick screening, study says

A few minutes spent interpreting results of a brief questionnaire can help pediatricians identify up to 82% of children with developmental delays, according to a recent study from British Columbia.

When completed by parents at home or in a clinic and then quickly scored by a pediatrician, both the Ages and Stages Questionnaire (ASQ) and the Parents’ Evaluation of Developmental Status (PEDS) had sensitivity and specificity for children younger than 30 months within or exceeding the 70% to 80% recommended by the American Academy of Pediatrics (AAP) for developmental screening tests. Clinicians considered the presence of 1 or more predictive concerns or abnormal domains to be a positive screen. The tests identified developmental delay in 10% of the children. Results of the screens were compared to findings from a full battery of psychological testing.

Currently, according to the AAP, “Few pediatricians use effective means to screen their patients for developmental problems,” perhaps because of concerns about the time required to administer tests.

The ASQ had greater overall sensitivity (82%) and specificity (78%) than PEDS, which had 74% and 64%, respectively. PEDS performed best in the younger-than-30-months age group, in which it had 78% sensitivity and 75% specificity. The AAP recommends screening at the 9-, 18-, and 30-month visits.

"Our research shows that overall, the ASQ and, to a lesser extent, the PEDS are accurate and can be administered effectively and at low cost," said Marjolaine Limbos, PhD, RPsych, principal investigator and a psychologist at British Columbia Children's Hospital. "The study results will hopefully provide physicians with the confidence that the tests can be incorporated into a busy physician practice with relatively little demand on staff time, with the results being easy to interpret and validate."

Approximately 10% of children have some developmental delay, but 70% are not identified until they reach school age, according to researchers. “It's critical to catch and treat disabilities early because the longer you leave them, the more intractable they become. The brain becomes more hard-wired, and opportunities for change become narrower," noted coauthor David Joyce, MD, a clinical assistant professor in the University of British Columbia’s Department of Family Practice and a Vancouver family physician.

Researchers recruited 334 children aged 12 to 60 months from 80 physicians’ practices in Ontario (mean age, 32.3 months).

The ASQ has about 30 questions and takes parents 10 to 15 minutes to complete. Completing the very brief PEDS questionnaire takes parents approximately 5 minutes.

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