「台北市學前兒童發展檢核表第二版」對入小學後適應問題之預測效度

The Predictive Validities of the Taipei Preschooler Developmental Checklist 2nd Version on Adaptive Behavior Problems after Entering Primary School

鄭玲宜(Ling-Yee Cheng) ； 廖華芳(Hua-Fang Liao) ； 鄒國蘇(Kou-Su Tsou)

《台灣醫學》 18卷1期 (2014/01) Pp. 1-11

https://doi.org/10.6320/FJM.2014.18(1).01

摘要

The use of Taipei Preschooler Developmental Checklist 2nd version (Taipei II) for early detection of developmental delay for children has been conducted for many years in Taiwan. However, the information of its predictive validity was unknown. Purpose: to investigate the predictive validity of the Taipei II on the adaptive behavior problem at school age. Methods: The original dataset for developing the Taipei II was investigated. Children who had been screened with one subscale of the Taipei II at 4-, 5-, or 6-year age, entered the primary school (grade 1-3) at the beginning of 2007 and living in Taipei area were the target population. We successfully followed up 310 children. The name, birth date, telephone of the target children were used to match the dataset of the Special Education Information Network to obtain the information of special educationneeds. For those who did not use special education resources, the Vineland Adaptive Behavior Scale (VABS) was used to define the problem of adaptive behaviors. Two predictive criteria were used to analyze the predictive validities of the Taipei II. Criteria I was students under special education or regular class students with percentile rank of VABS less than 16 (including both suspect and definite adaptive problems) and Criteria II was students under special education or regular class students with percentile rank of VABS less than 5 (definite adaptive problems only). The predictive validity indices included: the area under the receiver operating characteristic curve (AUC), sensitivities, specificities, multilevel likelihood ratios and the correlation coefficients between Taipei II scores and VABS total scores. Results: The predictive validities of the Taipei II on school adaptive problem were acceptable with AUC=0.82-0.95 (p＜0.001). The positive likelihood ratios of Taipei II with multiple cutoff strategies were greater than 20 indicating high diagnostic impact. Using cut-off strategy B (failure item numbers of 2 or 1 failure star item) to predict adaptive problems at school age, positive likelihood ratios were 5.1-7.5 and negative likelihood ratios of 0.08-0.48. The Taipei II scores were significantly correlated with the VABS standard scores (rs=0.50-0.57). Our result indicate that the predictive validities of Taipei II subscales for children aged 4-6 year were acceptable. The multiple likelihood ratios of multiple cutoff points could help clinicians make clinical decision more precisely.

關鍵字

篩選測試 ； 切截點 ； 發展遲緩 ； 兒童 ； 適應行為

並列摘要

The use of Taipei Preschooler Developmental Checklist 2nd version (Taipei II) for early detection of developmental delay for children has been conducted for many years in Taiwan. However, the information of its predictive validity was unknown. Purpose: to investigate the predictive validity of the Taipei II on the adaptive behavior problem at school age. Methods: The original dataset for developing the Taipei II was investigated. Children who had been screened with one subscale of the Taipei II at 4-, 5-, or 6-year age, entered the primary school (grade 1-3) at the beginning of 2007 and living in Taipei area were the target population. We successfully followed up 310 children. The name, birth date, telephone of the target children were used to match the dataset of the Special Education Information Network to obtain the information of special educationneeds. For those who did not use special education resources, the Vineland Adaptive Behavior Scale (VABS) was used to define the problem of adaptive behaviors. Two predictive criteria were used to analyze the predictive validities of the Taipei II. Criteria I was students under special education or regular class students with percentile rank of VABS less than 16 (including both suspect and definite adaptive problems) and Criteria II was students under special education or regular class students with percentile rank of VABS less than 5 (definite adaptive problems only). The predictive validity indices included: the area under the receiver operating characteristic curve (AUC), sensitivities, specificities, multilevel likelihood ratios and the correlation coefficients between Taipei II scores and VABS total scores. Results: The predictive validities of the Taipei II on school adaptive problem were acceptable with AUC=0.82-0.95 (p＜0.001). The positive likelihood ratios of Taipei II with multiple cutoff strategies were greater than 20 indicating high diagnostic impact. Using cut-off strategy B (failure item numbers of 2 or 1 failure star item) to predict adaptive problems at school age, positive likelihood ratios were 5.1-7.5 and negative likelihood ratios of 0.08-0.48. The Taipei II scores were significantly correlated with the VABS standard scores (rs=0.50-0.57). Our result indicate that the predictive validities of Taipei II subscales for children aged 4-6 year were acceptable. The multiple likelihood ratios of multiple cutoff points could help clinicians make clinical decision more precisely.

並列關鍵字

developmental screening ； cutoff strategy ； developmental delay ； child ； adaptive behavior