Assessing social-emotional development in infants and toddlers using parent-reports: Comparing the ASQ-SE-NL to the Social-Emotional Scale of the Bayley-III-NL

Background: The Ages and Stages Questionnaire Social-Emotional (ASQ-SE) is a parent-report screening instrument designed to assess children's social-emotional development and detect those at risk for delay or problems. Psychometric properties of this questionnaire have been studied before, but the ASQ-SE has never been compared to the Social-Emotional Scale of the Bayley-III (Bayley-III-SE). Aim: To compare the Dutch ASQ-SE (ASQ-SE-NL) to the Dutch Bayley-III-SE (Bayley-III-NL-SE; criterion measure). Method: A Dutch community sample of mothers with children aged 3–41 months (n = 1014) filled out both questionnaires. Cut-off scores for the ASQ-SE-NL were determined using: 1) >1 SD above the mean and 2) ROC curves. For the Bayley-III-NL, Dutch norm scores were used. Results: Specificity (70.8% and 88.5%) and screen-out accuracy (0.65 and 0.77) of the ASQ-SE-NL were good. Sensitivity was only sufficient (70.6%) when using ROC curves and only for the ASQ-SE-NL ≥18 months age versions. Screen-in accuracy was insufficient (<0.49). Positive predictive value was 34.7% and 32.7%, and negative predictive value was 87.5% and 92.3%. False positive cases on the ASQ-SE-NL scored significantly lower on the Bayley-III-NL-SE than true negative cases. Conclusion: Using the Bayley-III-NL-SE as the criterion, the ASQ-SE-NL performed well in identifying children not at risk for delay or problems. The ASQ-SE-NL sufficiently detected children at risk for delay or problems in the ≥18 months ASQ-SE-NL age versions when cut-off scores were determined by ROC curves. The ASQ-SE-NL can be used in a monitoring routine, but early rescreening is advised after a positive test result, given the number of false positive results.