Support for the global feasibility of the Ages and Stages Questionnaire as developmental screener

Objective: To investigate the psychometric properties of the Dutch version of the 48 months Ages and Stages Questionnaire (D_ASQ_48). Design: Prospective cohort study of a community-based sample of children born in 2002 and 2003 whose parents filled out the D_ASQ_48 and a questionnaire on school status at 60 months. The ASQ was translated into Dutch and back-translated into English by three independent translators. Setting: Well Child Centers covering 25% of the Netherlands. Participants: Parents of 1510 preterm and 562 term children born in 2002-2003 attending routine Well Child visits at age 45-50 months. Main outcome measures: Reliability, validity and mean population scores for D_ASQ_48 compared to other countries. Results: Mean population scores for the D_ASQ_48 were mostly similar to those in the USA, Norway and Korea. Exceptions (effect sizes of difference >0.5) were problem solving (USA) and fine motor (Korea). Reliability was good for the total score (Cronbach alpha 0.79) and acceptable for all domains (0.61-0.74). As expected, infants born at gestational age <32 weeks, children from low income families, of low educated mothers, and boys were more likely to fail on several domains (odds ratios, OR ranging from 1.5 to 4.9). The only unexpected association concerned children from one-parent families. Sensitivity to predict special education at five years of age was 89% and specificity 80%. Conclusions: The good psychometric properties of the Dutch ASQ_48 and the small differences when compared to other countries support its usefulness in the early detection of developmental problems amongst children worldwide. (C) 2009 Elsevier Ireland Ltd. All rights reserved.