Predictive value of the Ages and Stages Questionnaire® for school performance and school intervention in late preterm- and term-born children.

Background: The new health supervision guidelines emphasize the importance of surveillance or a formal developmental screening test at 4 years, one of the most used tests is Ages & Stages Questionnaire. Nevertheless, there is still not enough evidence whether these tools will be useful to predict future school performance (SP).

Objectives: The objectives of this study were to evaluate the Ages & Stages Questionnaire 3rd edition 48-month interval (ASQ3-48) translated to Spanish for predicting the need for school intervention (SI) and poor SP at 8-9 years of age, in late preterm infants (LPIs) and term-born infants (Terms) and to compare the prevalence of SI and poor SP in the two groups.

Methods: Data were collected from a cohort of 75 LPIs and 58 Terms assessed with ASQ3-48 and with a further assessment of academic results at 8-9 years, through a standardized school test of the Education Department of Catalonia. SI data were obtained through a parent report. Area under the curve (AUC), sensitivity, specificity and predictive values were calculated, and logistic regression analysis was used.

Results: The prevalence of poor SP was 12.8%, without statistically significant differences between LPIs and Terms. LPIs had higher SI than Terms (29.3% vs. 10.3%, P = 0.001). AUC for poor SP was 0.73 and for receiving SI was 0.56 without differences between the two groups. The sensitivity of the ASQ3-48 for poor SP was 41%, for specificity 92%, and for receiving SI 14% and 89%, respectively. Poor SP was related to having positive screening in the ASQ3-48 (OR 6.5 [95% CI, 1.9-22.2]) while having received SI was related to late prematurity (OR 3.6 [95% CI, 1.3-9.6]).

Conclusions: The ASQ3-48 shows acceptable predictive properties for poor SP but not for receiving SI. No differences were found in SP between LPI and Term cohorts, but LPIs are likelier to require SI.