自閉症嬰幼兒早期篩檢與診斷指標之比較探討

本研究以一位自閉症兒童為對象，分別針對其1歲6個月與其2歲9個月的「學齡前兒童發展量表」(CCDI)報告，來做縱向的探討並分析其圓形的變化。另外，再將CCDI篩檢報告與「精神疾病診斷與統計手冊第四版」(DSM-IV)自閉症診斷標準(APA, 1994)兩者題目相互比較歸納，亦籍由文獻探討來進行相關問題之討論，了解臨床上有何特殊指標來鑑別自閉症。研究結果發現：由此份比較表及文獻探討，研究者了解到CCDI雖是一般嬰幼兒發展篩檢工具，但仍可從其八大發展領域中看出些許端倪，像是個棄在「溝通表達」、「人際社會」兩項領域，未通過的項目符合了部分DSM-IV對自閉症的診斷標準，故雖CCDI對自閉症篩檢未如CHAT、CSBS DP-嬰幼兒檢核表等篩檢工具具高敏感度，但仍可列為參考指標之一；而DSM-IV對自閉症的診斷標準雖是我國各醫院兒童心智科醫師診斷自閉症的主要依據，但在三歲前還是有不適用的地方，因此在篩檢或診斷時，還是需要相關專業人員藉著臨床上的工作經驗來進行判斷。

關鍵字

自閉症；診斷；篩檢

並列摘要

This case study is based on a child who suffers from autistic syndrome with two CCDI reports. One was taken wheri the child was two years and 9 months and the other was 1 year and 6 months. We are going to have a longitudinal discussion and analysis of the graph change. In addition, we will make a comparison between the CCDI reports and the autism syndrome DSM-IV diagnosis standard (APA, 1994) through the discussion by literature review to study what special clinical index could identify autism From the literature review and comparison, the researchers find out that we are able to detect a few links out of eight major infant developing areas even though CCDI is just a regular examining too1. For example, we can see the failed items in 'communication expression' and the 'interpersonal society' match some autism syndrome DSM-IV diagnosis standards. Therefore CCDI can be considered as one of the indexes even though CCDI is less sensitive than CHAT and CSBS DP when it comes to infant sieve examinations. Currently DSM-IV diagnosis standard is the primary basis for autism syndrome in our nation. However, it can not be applied completely on infants under 3 years old. Therefore we still need to rely on the clinical experiences of medical professionals' to do sieve analysis and diagnosis.