15-minute Test Can Accurately Identify Childhood Developmental Delays

A recent study supports the accuracy of developmental screening tests that can be administered by family physicians.

According to a recent study performed by British Columbia’s Children's Hospital and University of British Columbia (UBC) researchers, two pre-existing, quick, and low-cost screening tests can accurately diagnose development delays in children.

The two tests— the Ages and Stages Questionnaire (ASQ) and the Parents' Evaluation of Developmental Status (PEDS)—were found to be very convenient for busy families, and very simple to understand; parents can complete either test at home or in the family physician's office. The primary care physician can then score the test and provide an outcome in minutes.

Should the screening tests identify a child with a developmental disability, he or she would then be referred to a specialist for further testing and treatment.

"Only 30% of children with developmental delays are identified prior to school age—whether that's social, physical or learning—and most experts would agree that we should be identifying those delays earlier through regular screening," reported principal investigator Dr. Marjolaine Limbos, a psychologist at BC Children's Hospital.

Despite their convenience, however, the researchers believe that the tests are not being routinely administered by family physicians due to their invalidity in a primary care setting. Also, lack of administration may be because some physicians fear that giving such tests would not be time efficient for a busy practice.

"Right now, the majority of family physicians do the eyeball test," stated co-author Dr. David Joyce, a clinical assistant professor in UBC's Department of Family Practice and a Vancouver family physician. "But research shows that is not very accurate, and kids are falling through the cracks. 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."

For this study, the researchers focused on 334 children between the ages of one and five years old, recruited from more than eighty physician offices in Ontario. The parents filled out both the PEDS and the ASQ tests, and the children were administered full psychological testing in order to serve as a gold standard.

The researchers found that, while both tests were reasonably accurate at detecting abnormalities in the children, the PEDS was slightly less accurate than the ASQ.

The PEDS is the shorter test of the two and takes roughly five minutes to complete. It revolves around the parent's memory of their child's abilities, with yes or no answers.

The ASQ takes about fifteen minutes. It questions parents regarding their child's ability to perform certain activities, such as throwing a ball to test motor skills; the researchers found that the sensitivity and precision of the ASQ in identifying developmental delays was higher.

"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 Limbos.

"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," Limbos concluded.

The findings were published recently in the online version of the Journal of Developmental & Behavioral Pediatrics.