title: Developmental screening in children with CHD: Ages and Stages Questionnaires.
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.
authors.affiliation: 1Nemours Neurosciences Center,Division of Behavioral Health,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Maia M
authors.initials: MM
authors.lastname: Noeder
authors.affiliation: 1Nemours Neurosciences Center,Division of Behavioral Health,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Logan
authors.affiliation: 1Nemours Neurosciences Center,Division of Behavioral Health,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Kari L
authors.initials: KL
authors.lastname: Struemph
authors.affiliation: 2Department of Outpatient Therapy Services,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Nancy
authors.initials: N
authors.lastname: Condon
authors.affiliation: 2Department of Outpatient Therapy Services,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Isabel
authors.initials: I
authors.lastname: Mueller
authors.affiliation: 3Nemours Cardiac Center,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sands
authors.affiliation: 3Nemours Cardiac Center,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware.
authors.forename: Ryan R
authors.initials: RR
authors.lastname: Davies
authors.affiliation: 1Nemours Neurosciences Center,Division of Behavioral Health,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Erica
authors.initials: E
authors.lastname: Sood
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D006348:Cardiac Surgical Procedures; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Assessment; cardiology; neurodevelopment