Screening Children for Developmental and Socioemotional Concerns: A Comparison of Father Assessments Using the PEDS and ASQ Scales

Background: Early detection of child developmental concerns presents an important opportunity to engage fathers of young children. As demographics shift, fathers and father figures assume increased primary caregiving responsibilities for infants and young children including monitoring of development. The majority of children with developmental delays are not identified until school entrance. Early identification of parental concerns provides an avenue for engagement with pediatric health providers and early learning specialists. The American Academy of Pediatrics recommends several brief, validated screens, two of which are widely used in practice: the Parent Evaluation of Developmental Status (PEDS) and the Ages & Stages Questionnaire (ASQ). But, these scales use different approaches; the PEDS asks about developmental concerns generally and the ASQ asks about specific child skills. There is currently scant research on father assessment of child development using these screening tools. The purpose of this study was to examine agreement in these two screening tools in a sample of fathers of children in Head Start/Early Head Start (HS/EHS).

Methods: Data were collected as part of a larger study on a fatherhood support program implemented in a HS/EHS setting. As part of baseline data collection, fathers (N = 102) reported concerns about child development using the 10-item PEDS. During the same time period, HS/EHS professional staff used the ASQ to assess each child’s skills in 5 areas of development. Both the PEDS and the ASQ scales use cutoff scores for “failed” screens to identify children at risk for developmental delays. McNemar’s test and kappa coefficients were calculated to examine agreement between the two screening tools.

Results: Based on self-reported PEDS screening, 45% of fathers reported concerns with their child’s development. When using the ASQ child skills screening, 15% of study children were in the range of concern. Overall, 61% of fathers had agreement between the PEDS and ASQ screening results (either both “passed” or both “failed”). Results from McNemar’s test indicate significant disagreement between the two screening tools (S = 18.9, p < .001) and the kappa statistic suggests no relationship between the two variables (κ = .16, 95% CI [-.01, .33]).

Implications: We found evidence of discordance between two developmental screening tools used with fathers of children in HS/EHS. However, these findings are similar to prior studies assessing screening in primary care with other low-income parent populations. This is concerning because different groups of children may be identified for services depending on which screening tool is used in practice. Specifically, asking fathers about general concerns with development (PEDS) yields a larger and different group of children compared to asking about specific child behavioral skills (ASQ). In practice, successful engagement of fathers may begin with screening for and addressing their concerns about development. Further research exploring how fathers assess child development should consider screening practices that support fathers’ communication of child development concerns.