Ages and Stages Questionnaire

The Ages and Stages Questionnaire is a parent completed developmental screening tool for children aged 1 to 60 months. It has age specific questionnaires covering five domains: communication, gross motor, fine motor, problem solving and personal social. A separate social emotional questionnaire is available.

Parents complete the questionnaire in about 10 to 15 minutes. Each domain is scored against age specific cut offs, and the result indicates whether the child is developing as expected or needs monitoring or referral.

Usage. It is used in primary care and early years settings for routine surveillance and for identifying children who need further assessment.

Indications. Routine developmental surveillance at scheduled ages, parental concern, and follow up after a high risk birth.

Preparation and technique. The questionnaire is completed by a parent or carer in a private setting. The age interval closest to the child's corrected age is selected, and the parent answers each item as yes, sometimes or not yet.

Contraindications and precautions. The questionnaire is not valid for children with a major sensory impairment without adaptation, and interpretation is limited where the parent cannot read the language used.

Interpretation.

• Each domain score is compared with an age specific cut off.
• A score over the cut off indicates typical development in that domain.
• A score in the monitoring zone, close to the cut off, indicates that the child is watched and the questionnaire is repeated.
• A score under the cut off indicates that further assessment is needed.

Causes of an under-cut-off result. Developmental delay, sensory impairment, language disorder, neuromotor disorder, and environmental factors. Parental misunderstanding of items can cause false results.

Critical values and findings needing immediate action. A failing score in several domains with concerns about loss of skills requires prompt medical review.

Limitations and artefacts. Parent report depends on the parent's understanding, literacy and expectations. The tool is a screen and does not establish a diagnosis. Cut offs are set for specific age intervals, so the timing of the questionnaire affects the result.

Follow up tests. Repeat questionnaire at the next interval, formal developmental assessment, audiology, and vision screening where indicated.

Special groups. Preterm infants are assessed using corrected age. Children with known developmental conditions are assessed with tools suited to their needs.