Abstract: Objective To explore the association between social-emotional problems and the preliminary screening risk of autism spectrum disorders (ASD) in children aged 16-30 months, so as to provide reference for figuring out the high risk characteristics and early screening ASD. Methods A survey was conducted on 542 children who came to Fangshan Maternal and Children Health Hospital for routine health care from January 2018 to November 2019. Children's primary caregivers completed the Ages and Stages Questionnaire:social-emotional (ASQ-SE) for the children's age group under the guidance of trained doctors. On the same day or at adjacent times,primary caregivers were instructed to complete Modified Checklist for Autism in Toddlers-Revised with Follow Up (M-CHAT-R/F) under the guidance of doctors who were unaware of the ASQ-SE results. The correlation between ASQ-SE scores and M-CHAT-R scores was analyzed. Results Children with abnormal social emotion scored significantly higher on M-CHAT-R than children with normal social emotion (U_{18 months}=5 004. 00,U_24months=5 491. 50,U_{30 months}=409. 00,P＜0. 001). A higher proportion of children with abnormal social emotion were at risk of ASD as preliminary screened by M-CHAT-R (18 months:86. 96%,24 months:90%,30 months:80%). ASQ-SE scores were positively correlated with M-CHAT-R scores (r_{18 months}=0. 724,r_{24 months}=0. 693,r_{30 months}=0. 783,P＜0. 01). Conclusions Most of the children with social-emotional problems are at risk of ASD,and should be given more concern to,especially to younger children with social-emotional problems. Moreover,it is recommended that doctors should adopt the M-CHAT-R/F scale for ASD preliminary screening according to the actual situation.

Key words: early screening, autism spectrum disorder, Ages and Stages Questionnaire, social emotion, Modified Checklist for Autism in Toddlers-Revised with Follow Up

摘要： 目的 探讨16~30月龄儿童社交情绪问题与孤独症谱系障碍(Autism Spectrum Disorders,ASD)初筛患病风险之间的关系,为基层医院尽早发现儿童ASD高危特征,从而尽早进行ASD的初筛提供参考。方法 对2018年1月-2019年11月来北京市房山区妇幼保健院做常规保健的542名儿童进行调查。儿童家长在培训过的医护人员的指导下填写儿童所在月龄组的ASQ-SE问卷。在同一天或相邻时间内,由对ASQ-SE筛查结果不知情的医护人员指导家长完成M-CHAT-R/F。对ASQ-SE与M-CHAT-R分数的相关性进行分析。结果 社交情绪异常儿童在M-CHAT-R上的分数高于社交情绪正常儿童,差异具有统计学意义(U_18月龄组=5 004.00,U_24月龄组=5 491.50,U_30月龄组=409.00,P<0.001)。社交情绪异常儿童中,用M-CHAT-R初筛发现有ASD患病风险的人数比例较高(18月龄组为86.96%,24月龄组为90%,30月龄组为80%);ASQ-SE分数与M-CHAT-R分数呈正相关(r_18月龄组=0.724,r_24月龄组=0.693, r_30月龄组=0.783,P ＜0.01)。结论 社交情绪异常的儿童中大多数具有ASD的患病风险,应引起重视。尤其是小年龄段社交情绪异常的儿童,建议儿童保健科医生根据实际情况,对儿童采用M-CHAT-R/F量表进行ASD初筛。

关键词: 早期筛查, 孤独症谱系障碍, 年龄与发育进程问卷, 社交情绪, 改良版婴幼儿孤独症筛查量表