Psychometric Properties of Two Developmental Screening Instruments for Hispanic Children in the Philadelphia Region

Published:October 10, 2018DOI:



      To assess the validity of Spanish versions of the Survey of Well-being of Young Children (SWYC) Milestones and the Ages & Stages Questionnaire, Third Edition (ASQ-3), and to document the rates of developmental delays in an urban cohort of children with Hispanic parents.


      Spanish-speaking families with a child 9 to 60 months of age (N = 991) were initially screened using Spanish translations of the SWYC Milestones and the ASQ-3. A stratified random sample of 494 of these children subsequently received standardized clinical assessment to confirm the presence of developmental delays. Reverse weighting corrected for the selection bias inherent in the stratification scheme.


      Fifty-five percent of toddlers (9 to 41 months of age) and 34.8% of preschoolers (42 to 60 months of age) scored in the moderately to severely delayed range, most frequently in language. Sensitivity and specificity for toddlers with severe delays associated with the SWYC were 0.69 and 0.64, respectively, and 0.55 and 0.75 for the ASQ-3. Sensitivity and specificity for preschoolers with severe delays associated with the SWYC were 0.87 and 0.58, respectively, and 0.71 and 0.86 for the ASQ-3.


      Although psychometric properties of the Spanish translated versions are not as strong as the English versions, the findings suggest that both the SWYC Milestones and ASQ-3 represent promising tools for identifying Hispanic children with developmental delays. The rate of delays were consistent with other studies showing a high percentage of Hispanic children with developmental delays, most frequently in language skills.


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      1. Flores A. How the US Hispanic population is changing. Available at: Accessed October 22, 2018.

        • Collins BA.
        Dual language development of Latino children: effect of instructional program type and the home and school language environment.
        Early Child Res Q. 2014; 29: 389-397
        • Reardon SF
        • Galindo C.
        The Hispanic-white achievement gap in math and reading in the elementary grades.
        Am Educ Res J. 2009; 46: 853-891
        • Waldfogel J.
        The role of out-of-school factors in the literacy problem.
        Future Child. 2012; 22: 39-54
        • Avila RM
        • Bramlett MD.
        Language and immigrant status effects on disparities in Hispanic children's health status and access to health care.
        Matern Child Health J. 2013; 17: 415-423
        • Pedersen A
        • Pettygrove S
        • Meaney FJ
        • et al.
        Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children.
        Pediatrics. 2012; 129: e629-e635
        • Magnuson K
        • Duncan G
        • Lee KT
        • et al.
        Early school adjustment and educational attainment.
        Am Educ Res J. 2016; 53: 1198-1228
        • Bethell C
        • Reuland C
        • Schor E
        • et al.
        Rates of parent-centered developmental screening: disparities and links to services access.
        Pediatrics. 2011; 128: 146-155
        • Feinberg E
        • Silverstein M
        • Donahue S
        • et al.
        The impact of race on participation in part C early intervention services.
        J Dev Behav Pediatr. 2011; 32: 284-291
        • The Annie E. Casey Foundation
        The 2013 KIDS COUNT Data Book: State Trends in Child Well-Being.
        The Annie E. Casey Foundation, Baltimore, Md2013
        • Duby JC
        • Lipkin PH
        • Macias MM
        • et al.
        Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening.
        Pediatrics. 2006; 118: 405-420
        • Zuckerman KE
        • Mattox K
        • Donelan K
        • et al.
        Pediatrician identification of Latino children at risk for autism spectrum disorder.
        Pediatrics. 2013; 132: 445-453
        • El-Behadli AF
        • Neger EN
        • Perrin EC
        • et al.
        Translations of developmental screening instruments: an evidence map of available research.
        J Dev Behav Pediatr. 2015; 36: 471-483
        • Squires J
        • Bricker D.
        Ages & Stages Questionnaires®, Third Edition (ASQ®-3): A Parent-Completed Child Monitoring System.
        Brookes, Baltimore, Md2009
        • Sheldrick RC
        • Perrin EC.
        Evidence-based milestones for surveillance of cognitive, language, and motor development.
        Acad Pediatr. 2013; 13: 577-586
      2. World Health Organization. Process of translation and adaptation of instruments. Available at: Accessed February 20, 2017.

        • Bayley N.
        Bayley Scales of Infant and Toddler Development®, Third Edition (Bayley-III®).
        Pearson Education, London2005
        • Elliott CD.
        Differential Ability Scales®-II (DAS-II®).
        Pearson Education, London2007
        • Gonzalez J
        • Reid R
        • Synhorst L
        • et al.
        Pathways to disparity: language, literacy, and reading skills among migrant and non-migrant Hispanic preschool students.
        Special Issue of Multiple Voices. 2006; 9: 149-167
        • Hemphill FC
        • Vanneman A.
        Achievement Gaps: How Hispanic and White Students in Public Schools Perform in Mathematics and Reading on the National Assessment of Educational Progress.
        National Center for Education Statistics, Washington, DC2011
        • Alva SA
        • Reyes RdL.
        Psychosocial stress, internalized symptoms, and the academic achievement of Hispanic adolescents.
        J Adolesc Res. 1999; 14: 343-358
        • Eamon MK.
        Social-demographic, school, neighborhood, and parenting influences on the academic achievement of Latino young adolescents.
        J Youth Adolesc. 2005; 34: 163-174
        • Fuller J
        • Hosemann A.
        Latino education.
        Lang Linguist Compass. 2015; 9: 168-180
        • Hammer CS
        • Hoff E
        • Uchikoshi Y
        • et al.
        The language and literacy development of young dual language learners: a critical review.
        Early Child Res Q. 2014; 29: 715-733
        • Hoff E
        • Core C
        • Place S
        • et al.
        Dual language exposure and early bilingual development.
        J Child Lang. 2011; 39: 1-27
        • Mancilla-Martinez J
        • Lesaux NK.
        The gap between Spanish speakers’ word reading and word knowledge: a longitudinal study.
        Child Dev. 2011; 82: 1544-1560
        • Lindholm-Leary K.
        Bilingual and biliteracy skills in young Spanish-speaking low-SES children: impact of instructional language and primary language proficiency.
        Int J Biling Educ Biling. 2014; 17: 144-159
        • Fuller B
        • Bein E
        • Kim Y
        • et al.
        Differing cognitive trajectories of Mexican American toddlers: the role of class, nativity, and maternal practices.
        Hisp J Behav Sci. 2015; 37: 139-169
        • Guiberson M
        • Rodríguez BL.
        Measurement properties and classification accuracy of two Spanish parent surveys of language development for preschool-age children.
        Am J Speech Lang Pathol. 2010; 19: 225-237
        • Yu LM
        • Hey E
        • Doyle LW
        • et al.
        Evaluation of the Ages and Stages Questionnaires in identifying children with neurosensory disability in the Magpie Trial follow-up study.
        Acta Paediatr. 2007; 96: 1803-1808
        • Pomés M
        • Squires J
        • Yovanoff P.
        Psychometric examination of a Spanish translation of a developmental screening instrument.
        J Early Child Res. 2016; 14: 132-145
        • Sheldrick RC
        • Benneyan JC
        • Kiss IG
        • et al.
        Thresholds and accuracy in screening tools for early detection of psychopathology.
        J Child Psychol Psychiatry. 2015; 56: 936-948
        • Sheldrick RC
        • Garfinkel D.
        Is a positive developmental-behavioral screening score sufficient to justify referral? A review of evidence and theory.
        Acad Pediatr. 2017; 17: 464-470
        • Barnett WS
        • Escobar CM.
        Economic costs and benefits of early intervention.
        (In: Meisels SJ and Shonkoff, JP, eds.)Handbook of Early Childhood Intervention. Cambridge University Press, New York1990: 560-582
        • Glascoe FP.
        Screening for developmental and behavioral problems.
        Ment Retard Dev Disabil Res Rev. 2005; 11: 173-179