Comparison of the Survey of Well-being of Young Children (SWYC) with the Ages and Stages Questionnaires (ASQ-3): Parents Report questionnaires

Abstract

The American Academy of Pediatrics (AAP) recommends the use of parent-report questionnaires to monitor child development. Licensing costs are a limitation to the universal implementation of the Ages and Stages Questionnaire (ASQ-3) validated in Chile. The Developmental Milestones of the Survey of Well-being of Young Children (DM-SWYC) are free and available to use. There are no validation studies in the Hispanic population outside the United States.

Objective: To evaluate the validity of the DM-SWYC compared to the ASQ-3 for the assessment of psychomotor development in Chilean infants in their first year of life.

Methodology: Cross-sectional diagnostic tests pilot study. Parents of children aged 4-8-12 months seen at Clínica Alemana in Santiago sequentially completed the ASQ-3 and SWYC online between March 2023 and March 2025. Incomplete questionnaires were excluded. The reliability, concurrent validity, and psychometric properties of the DM-SWYC were analyzed, using the ASQ-3 as a reference.

Results: A total of 1,470 valid assessments were obtained. Cronbach’s alpha was 0.59 for the DM-SWYC and 0.81 for the ASQ- 3. A significant correlation of r = 0.67 was observed, with areas under the curve (AUC) between 82.1 and 83.7%. The sensitivity of the DM-SWYC was 0.77-0.81, and the specificity was 0.68- 0.73, after adjusting the cutoff point. When comparing repeated or similar questions from both questionnaires, there was a tendency toward more positive responses with the ASQ-3 and more “sometimes” responses with the DM-SWYC.

Conclusions: The electronic DM-SWYC demonstrated psychometric properties that support its use in monitoring the development of infants of upper-middle socioeconomic backgrounds in Chile. Further studies are needed to validate it in a nationally representative population.