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克氏行為量表篩檢自閉症類群障礙症幼兒:追蹤研究

Using the Clancy Behavior Scale for Detecting Autism Spectrum Disorder in Toddlers: A Follow-up Study

摘要


背景與目的:自閉症類群障礙症早期介入的效果,彰顯早期篩檢的重要性。然而,台灣自閉症類群障礙症幼兒早期篩檢的追蹤研究不多。因此,藉由追蹤研究的方式,本研究目的探究「克氏行為量表(Clancy Behavior Scale)」用在臨床場域篩檢3歲以下幼兒的長期正確率。方法:時間點一,參與者為18至36個月的發展問題幼兒100名,由主要照顧者填寫克氏行為量表。時間點二,第一次評估經過5年後進行追蹤評估確認診斷,家長再次填寫克氏行為量表。參與者的診斷分別是46名自閉症類群障礙症兒童與54名非自閉症類群障礙幼兒。結果:時間點一,克氏行為量表完整14題,以10分作為切截分數,長期敏感度.83,長期特異度.46;簡版九題,以5分作為切截分數,長期敏感度.80,長期特異度.48。時間點二,克氏行為量表完整14題,以7分作為切截分數,敏感度.72,特異度.48;簡版九題,以4分作為切截分數,敏感度.78,特異度.56。結論:本研究發現克氏行為量表簡版九題的正確率相對較為理想。研究結果可以作為執行自閉症類群障礙症篩檢與診斷的參考。

並列摘要


Purposes: Background and purpose: The effectiveness of early intervention in autism spectrum disorder (ASD) highlights the importance of early diagnosis. However, there are few follow-up studies for examining longitudinal accuracy of early screening in young children with ASD in Taiwan. Thus, this follow-up study investigated the utility of the Clancy Behavior Scale (CBS) in detecting ASD in young children before 36 months of age. Methods: Participants included 100 young children with developmental problems aged 18 to 36 months and their caregivers who completed CBS (Time 1). After a period of 5 years, children underwent follow-up assessment and finalized the diagnosis and their caregivers who completed CBS again (Time 2). Finally, participants were 46 children with ASD and 54 children with non-ASD. Results: Time 1, using a score of 10 of the 14 CBS items, the longitudinal sensitivity and specificity were .83 and .46, respectively. Using a score of 5 of the 9 CBS critical items, the longitudinal sensitivity and specificity were .80 and .48, respectively. Time 2, using a score of 7 of the 14 CBS items, the sensitivity and specificity were .72 and .48, respectively. Using a score of 4 of the 9 CBS critical items, the sensitivity and specificity were .78 and .56, respectively. Conclusion: the findings oh this study suggested that the 9 CBS critical items showed better accuracy. This current study provided implications for screening and diagnosis in ASD.

參考文獻


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: Authors, 2013.
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