Developmental evaluation at age 4: Validity of an Italian parental questionnaire


Anna Maria Dall'Oglio, Unit of Clinical Psychology and Neuropsychology, Child Neuropsychiatry, IRCCS Paediatric Hospital Bambino Gesù, Piazza S. Onofrio 4, 00165 Rome, Italy. Fax: +39 06 68592450; email:


Aim:  To validate an Italian parental questionnaire designed to evaluate the neuropsychological and behavioural developmental status of 4-year-olds and identify children in need of further evaluation.

Methods:  The questionnaire (Questionario per la valutazione dello Sviluppo di bambini a 4 anni – Genitori (QS4-G) ) consisted of 93 questions divided into 10 areas: language, visual-motor abilities, memory/attention, fine and gross motor and self-help abilities, lateralisation, social skills, stress, sleep, alimentation and evacuation. It was distributed to 263 parents of 4-year-olds: 94 healthy preterm (gestational age <33 weeks and/or <1500 g, without major neurosensory damage); 44 children with developmental disorders and 125 children with typical development. Cognitive and neuropsychological evaluations were performed using standardised tests.

Results:  The internal consistency of the areas was adequate (Cronbach's alpha: 0.69–0.79). The correlation coefficients (r=|0.30|–|0.68|) with standardised tests (Griffiths, Vineland and neuropsychological tests) indicated a good concurrent validity. The receiver operating characteristic curve, for predicting a Griffiths Quotient less than 81, showed an area under the curve of 0.90 and a high diagnostic and discriminatory capacity (sensitivity of 0.88 and specificity of 0.84) for the optimal cut-off (value 48.4).

Conclusion:  The QS4-G seems to be a valid tool for identifying 4-year-old children at risk for low or borderline cognitive development and/or problematic behaviour who need a complete assessment. It can describe individual neuropsychological profiles. QS4-G is not a diagnostic tool. It is useful for outcome studies in preterm children and in other pathologies. It could also be useful for preschooler prevention programmes.