Level of Agreement of 36-Month ASQ-3 between Parents, Child Care Providers, and Health Care Professionals

Introduction Developmental delay is present in approximately 15 percent of children in the United States. 1 Less than one fifth of those children receive early intervention before age 3. Screening processes in pediatric settings are insufficient to identify all children with developmental delay. Objective Investigate the level of agreement in typical methods of administration of the 36 month Ages and Stages Questionnaire 3rd ed. (ASQ 3) between parents, CCPs, and student physical therapists (SPTs). Participants 11 children and parents from 2 childcare centers 5 childcare providers (CCPs) 7 student physical therapists (SPTs) Methods Outcome Measure: 36-Month ASQ-3 Standardized developmental screening tool designed to test a wide age range and be administered by various parties Rapid, simple, and cost effective way to monitor a child’s development Developmental screening was conducted across two testing sessions for each child based on common practices of ASQ-3 administration (Fig. 1). Session 1: Parent scored child’s performance from memory, unless confronted with novel items in which scoring was inferred or administered. SPT was present for questions. Session 2: CCP administered every item and scored the child based on their elicited performance while another SPT scored as an observer. Results Inter-rater Agreement: CCPs and SPTs significantly agreed in 4/5 domains No significant agreement between parents/CCPs or parents/SPTs for any domain (Table 1). Trends in specific domains (Fig. 2): Highly variable across the 5 domains Gross Motor: 73% of parents scored their child’s ability higher than at least one rater from the standardized session by as much as 25 points. Problem Solving: 64% of the parents scored their child as much as 30 points lower than at least one other rater. Conclusion Inter rater agreement between parents and CCPs or healthcare professionals was limited. Clinical Relevance Testing condition for parents was not parallel to the condition for other groups Recommend future exploration into interpretation of this screening tool and best use of the ASQ 3 by parents and CCPs to promote their participation