Translation and use of parent-completed developmental screening test in Shanghai

As part of efforts throughout China to improve the outcomes of individuals with disabilities, the Shanghai government has launched a campaign to screen at least 95 percent of newborns. To assist in meeting this goal, the Ages & Stages Questionnaires (ASQ), Third Edition, was translated into Chinese and the feasibility of a screening system using the ASQ-Chinese translation (ASQ-C) was investigated in Shanghai. Twenty-nine primary children's healthcare clinics and several district-wide children's healthcare institutes participated. Validity and reliability of the ASQ-C were studied as well as utility in pediatric clinics as part of well child visits. Using a sample of more than 8000 caregivers and children from 3 to 66 months of age, screening cutoff scores for each of the 19 ASQ-C intervals were determined, based on two standard deviations below the mean domain score. Inter-rater agreement between ASQ-C completed by 519 parents and a professional assessor was .89. Test-retest reliability for 651 caregivers who completed two ASQ-C at a 1-4 week interval was .91. Cronbach's coefficient alpha measuring internal consistency ranged from .37 to .79. Convergent validity, measuring agreement between Bayley Scales of Infant Development, 2nd edition, and Denver II outcome categories (i.e. risk, typical) and ASQ-C outcomes (i.e. risk, typical), ranged from .57 to .94. Results from this pilot study suggest the ASQ-C is a promising screening instrument for identification of developmental problems in the Shanghai region. Implementation of a universal screening system in pediatric clinics has the potential to assist in early identification of developmental delays, referral to rehabilitative services, and improvement of developmental outcomes for young children and their families.