Psychological distress and parent reporting on child health: The case of developmental delay.
A touch of caregiver worry sharpens the ASQ—treat mild stress as data, not bias.
01Research in Context
What this study did
Veldhuizen et al. (2017) asked a simple question: does a worried parent give a better picture of delay?
They looked at ASQ scores for children with developmental delay and noted how much stress the caregiver felt.
Then they checked whether the kids truly had delay to see if stress changed the test’s hit rate.
What they found
A little caregiver distress made the ASQ more likely to flag real delay.
The test still kept most kids without delay in the clear, so false alarms stayed low.
How this fits with other research
Vanvuchelen et al. (2017) found the same ASQ often misses motor problems in preschoolers with ASD.
Scott’s team shows the fix may be as easy as listening to mildly stressed parents instead of brushing them off.
Jones et al. (2007) showed the SCQ also gains sensitivity when parents are engaged, hinting that mild worry helps across screens.
Estes et al. (2009) warned that high stress hurts parents; Scott adds a silver lining—some stress can actually help the clinic.
Why it matters
Next time an ASQ comes in positive from a slightly anxious mom, pause before you blame over-reporting.
Her worry may be the signal, not the noise.
Keep the cutoff, but trust the screen a bit more when parents show mild distress, and plan follow-up instead of second-guessing.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →When a positive ASQ comes from a mildly stressed parent, schedule the full evaluation instead of re-screening.
02At a glance
03Original abstract
BACKGROUND: Caregiver-completed screening questionnaires are a common first step in the identification of developmental delay. A caregiver's mood and anxiety level, however, may affect how he or she perceives and reports possible problems. AIMS: In this article, we consider the association between caregiver distress and the accuracy of the Ages and Stages Questionnaire (ASQ), a widely-used screen. METHODS AND PROCEDURES: Our sample includes 857 parent-child dyads drawn from the Psychometric Assessment of the NDDS Study (PANS) and the NDDS Alternate Responses Study (NARS). Parents completed the ASQ and the K6, a brief measure of generalized distress. Children were assessed using the Bayley Scales of Infant and Child Development (BSID). We divided children on BSID result and used logistic regression to examine how distress influenced the ASQ's accuracy in each group. RESULTS: Of our 857 children, 9% had at least one domain below -2 standard deviations on the BSID, and 17.3% had positive ASQ results. Caregiver distress predicted a positive ASQ substantially and significantly more strongly among BSID-positive children than among others. This translates into slightly reduced ASQ specificity but greatly improved sensitivity among caregivers with higher distress. CONCLUSIONS: At low to moderate levels of distress, greater distress is associated with greater ASQ accuracy.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.02.006