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Universal language development screening: comparative performance of two questionnaires
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  • Published on:
    Lack of sensitivity of ASQ communication domain remains a problem.
    • Philip Wilson, Professor of primary care and rural health University of Aberdeen
    • Other Contributors:
      • Vicky Gilroy, Head of Projects and Evaluation
      • Jenna Charlton, Research Fellow
      • Robert Rush, Independent statistical consultant
      • Cristina McKean, Professor of Child Language Development and Disorders

    We thank Professor Squires for her interest in our work and we agree that concern about any neurodevelopmental problem merits early comprehensive assessment of all developmental domains. We would like to reassure her that all the participants in our study received the full ASQ, interpreted by the family’s health visitor who took action according to the overall assessment. We were, however interested specifically in the performance of the ASQ’s communication domain in terms of identifying developmental language disorders. Even when we included children in the ‘Monitoring Zone’ of that domain we found that at least a third of children with significant problems were missed.
    To our surprise, parental concern about their child’s language did not improve the performance of the Sure Start Language Measure (SSLM): parental concern was associated with an increased likelihood of false positivity among the screen-positive children.
    We therefore suggest that if the ASQ is to be used without an additional language measure such as the SSLM on a universal level with 24-30 month old children, consideration should be given at least to lowering the thresholds for monitoring or referral within the communication domain.

    Conflict of Interest:
    None declared.
  • Published on:
    User Beware: For accurate screening, use complete tests

    As a developer and researcher of the Ages & Stages Questionnaires, I read with interest Universal Language Development Screening: Comparative Performance of Two Questionnaires by Wilson et al., published January 6, 2022. I was not able to review this manuscript prior to publication; there are several methodological errors that severely limit the design and consequent outcomes of this study.

    First, the ASQ was developed to be used in total—all 30 items, 5 domains, at each administration point. Domains or areas were not designed to be used individually or independently. The psychometric properties of the ASQ will be robust only if/when the entire test is administered, ideally at periodic intervals over time.

    Second, a research design that uses only the communication domain of the ASQ-3 is flawed. The communication domain contains 3 expressive language items and 3 receptive items. Additionally, because of the overall interdependence of young children’s skills, communication items are embedded throughout the interval in other domains. For example in the intervals targeted by Wilson et al., (i.e., 24, 27, and 30 month ASQ-3) there are a total of 7 items focused on communication skills (e.g., listening, repeating, following directions) at 24 months; 10 items at 27 months, and 12 items at 30 months. Therefore analyzing only the 6 items under the domain heading is not looking at communication as broadly as does the test in its entirety.

    Third, th...

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    Conflict of Interest:
    None declared.