journal1 ›› 2018, Vol. 26 ›› Issue (3): 262-265.DOI: 10.11852/zgetbjzz2018-26-03-09

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Efficacy evaluation of autism screening in toddlers by using the M-CHAT-R/F combined with Ages and Stages Questionnaire

LUO Mei-fang1, GUO Cui-hua1, CAO Mu-qing1, WANG Xu-xiang1, HUANG Sai-jun2, JING Jin1   

  1. 1 Department of Maternal and Child Health,School of Public Health,Sun Yat-Sen University,Guangzhou,Guangdong 510080,China
    2 Department of Child Health Care,Foshan Maternal and Child Health Care Hospital,Foshan,Guangdong 528000,China
  • Received:2017-11-20 Online:2018-03-10 Published:2018-03-10
  • Contact: JING Jin,


罗美芳1, 郭翠华1, 曹牧青1, 王旭祥1, 黄赛君2, 静进1   

  1. 1 中山大学公共卫生学院妇幼系,广东 广州 510080
    2 佛山市妇幼保健院儿童保健科,广东 佛山 528000
  • 通讯作者: 静进,
  • 作者简介:罗美芳(1993-),女,湖南人,硕士在读,主要研究方向为儿童心理行为发育与诊疗。
  • 基金资助:

Abstract: Objective To evaluate the efficacy of screening of autism spectrum disorders (ASDs) by using the Modified Checklist for Autism in Toddlers-Revised with Follow Up (M-CHAT-R/F) combined with the Ages and Stages Questionnaire-Third Edition(ASQ-3),in order to provide scientific basis for early identification of autism. Methods Totally 291 toddlers aged 16~30 months who have conducted routine health care in six hospitals and with positive screening Results of M-CHAT-R were enrolled in this study from August 2016 to March 2017,and the parents were invited to fill out ASQ-3 to assess the children's development of communication (C),gross motor (GM),,fine motor (FM),problem solving (SP),and personal-social (PS).Meanwhile,these children were referred to specialists for diagnostic evaluations according to DSM-5.The positive predictive value (PPV) for ASD of M-CHAT-R/F alone and that of M-CHAT-R/F combined with ASQ-3 were compared. Results A total of 53 of the 291 toddlers were diagnosed with ASD.The PPV for ASD of M-CHAT-R was 0.18.The communication domain of ASQ-3 had the highest suspicious developmental delay rate in both M-CHAT-R screening positive group and ASD group,followed by PS domain.The PPV for ASD detection could be increased to 0.43 using communication and PS domains as predictors on the basis of M-CHAT-R.Without follow-up interview,ASQ-3 could greatly improve the PPV of M-CHAT-R (0.43 vs.0.18,P<0.001). Conclusions M-CHAT-R combined with ASQ-3 could improve the screening effcacy of toddlerhood ASD.It is recommended to conduct assessment by ASQ-3 for toddlers with positive screening Results of M-CHAT-R.

Key words: screening, autism spectrum disorder, Modified Checklist for Autism in Toddlers-Revised with Follow Up, Ages and Stages Questionnaire, positive predictive value

摘要: 目的 探索和评价附后续访谈的改良版婴幼儿孤独症筛查量表(M-CHAT-R/F)联合年龄与发育进程问卷第三版(ASQ-3)筛查幼儿孤独症谱系障碍(ASD)的效果,为孤独症的早期识别提供指导。方法 以2016年8月-2017年3月在全国6家医院儿童保健科做常规保健,并且M-CHAT-R初筛阳性(筛查分数≥3分)的291名16~30月龄儿童为研究对象,由家长填写与儿童月龄相匹配的 ASQ-3问卷,测评儿童在沟通(C)、粗大动作(GM)、精细动作(FM)、解决问题(SP)、个人-社会(PS)等能区的发展水平。初筛阳性儿童由专科医师进一步根据DSM-5进行确诊。比较ASQ-3联合M-CHAT-R/F与单独使用M-CHAT-R/F对ASD筛查的阳性预测值(PPV)。结果 291例M-CHAT-R/F初筛阳性儿童中最终确诊ASD患儿53例,M-CHAT-R初筛对于ASD筛查的PPV为0.18。在初筛阳性、确诊者中,ASQ-3五大能区可疑发育迟缓率最高的均为C能区,其次为PS,将C和PS能区均不通过作为预测因子,其在M-CHAT-R初筛阳性群体中对于ASD筛查的PPV为0.43,在未做后续访谈前,可显著提高M-CHAT-R筛查ASD的PPV(0.43 vs 0.18,P<0.001)。结论 ASQ-3联合M-CHAT-R/F可提高对婴幼儿ASD筛查的阳性预测值,建议对M-CHAT-R/F筛查阳性的婴幼儿辅以ASQ-3评估。

关键词: 筛查, 孤独症谱系障碍, 改良版婴幼儿孤独症筛查量表, 年龄与发育进程问卷, 阳性预测值

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