The psychometric properties of the Ages & Stages Questionnaires for use as population outcome indicators at 2.5 years in England: A systematic review

Background: Early identification of children with potential development delay is essential to ensure access to care. The Ages & Stages Questionnaires (ASQ) are used as population outcome indicators in England as part of the 2.5 year review.

Method: The aim of this article was to systematically review the worldwide evidence for the psychometric properties of the ASQ third edition (ASQ-3TM) and the Ages & Stages Questionnaires®: Social-Emotional (ASQ:SE). Eight electronic databases and grey literature were searched for original research studies available in English language, which reported reliability, validity, or responsiveness of the ASQ-3TM or ASQ:SE for children aged between 2 and 2.5 years. Twenty studies were included. Eligible studies used either the ASQ-3TM or the ASQ:SE and reported at least one measurement property of the ASQ-3TM and/or ASQ:SE. Data were extracted from all papers identified for final inclusion, drawing on Cochrane guidelines.

Results: Using ‘positive’, ‘intermediate’, and ‘negative’ criteria for evaluating psychometric properties, results showed ‘positive’ reliability values in 11/18 instances reported, ‘positive’ sensitivity values in 13/18 instances reported, and ‘positive’ specificity values in 19/19 instances reported.

Conclusions: Variations in age or language versions used, quality of psychometric properties, and quality of papers resulted in heterogeneous evidence. It is important to consider differences in cultural and contextual factors when measuring child development using these indicators. Further research is very likely to have an important impact on the interpretation of the ASQ-3TM and ASQ:SE psychometric evidence.