「中文版泛自閉症篩檢量表」2～5歲幼兒短版之信效度分析

隨著泛自閉症障礙（autism spectrum disorder）盛行率逐年增加，相關的診斷與療育之研究成為全球關注的議題。泛自閉症障礙的特質在孩子2歲左右就會逐漸顯露，早期療育的介入可以協助泛自閉症障礙的孩子獲得有效進步，而且介入年齡愈早愈好。大部分的診斷與篩檢工具都適用於3歲以上的孩童，然而近年來的泛自閉症篩檢指標研究與篩檢工具發展，逐漸開始針對2歲的兒童。其中，「泛自閉症篩檢量表」為2009年所發展的一項信效度高且適用範圍較廣的篩檢工具。在臺灣，由於缺乏適合臨床使用的工具，泛自閉症障礙篩檢並非健兒門診中的常規發展篩檢之一，在醫療院所中也少見針對泛自閉症障礙的標準化評估。故本研究將「泛自閉症篩檢量表」幼兒短版中文化，並檢驗其在臺灣使用的信效度。本研究採方便取樣，共招募了165組家長及其2歲至5歲11個月的孩童，分為族群樣本組135組（其中隨機抽樣30組做為對照組）及泛自閉症障礙組30組。165 位家長都填寫了「中文版泛自閉症篩檢量表」2～5 歲幼兒短版，並隨機抽樣對照組及泛自閉症障礙組的60位孩童接受了「自閉症兒童心理教育評核」（第三版）的評估。結果顯示，「中文版泛自閉症篩檢量表」2～5歲幼兒短版的內在一致性佳（.94），與「自閉症兒童心理教育評核」（第三版）的結果也有中度相關性（-.63）。中文版心理計量與英文版相比也有良好結果，雖然中文版切截分數與英文版有所不同，但經由調整後，更適合在臺灣使用。經由本研究的翻譯及檢驗，「中文版泛自閉症篩檢量表」2～5歲幼兒短版具有良好信效度，是適用於基層醫療及健兒門診篩檢泛自閉症障礙的標準化篩檢工具。

關鍵字

早期篩檢；泛自閉症障礙；「泛自閉症篩檢量表」；層級一篩檢

並列摘要

The prevalence of autism spectrum disorders (ASD) is increasing globally at an annual rate. According to the literature reviews, the symptoms of ASD could be found out when the children are as young as 2 years old. The benefits and importance of the early intervention for children with ASD have been estimated. Children with ASD could have more improvement if they could have the intervention services earlier. The researchers now focus on the development of evaluation tools for children at the age of two. The Autism Spectrum Rating Scales (ASRS) is a standard ASD screening tool for both level 1 and 2 screening. In this research, we translated the ASRS: short form (2-5 years) into Mandarin. After the questionnaire was refined by the feedback of experts and parents, 165 parents filled the Chinese version of ASRS: short form (2-5 years) including 30 parents of children with ASD. The results showed that the Chinese version of ASRS: short form (2-5 years) has good internal reliability, good responsiveness, and moderate Pearson correlation coefficient with PEP-3. The cut-off point was different between the Chinese and English versions, but it was fit into a cultural environment in Taiwan after the adjustment. The findings of this research provide considerable and valuable information about the instruments and offer suggestions for future research. For future research, we need to use larger samples across different cities in Taiwan. In the future, we can build the norm of Chinese version of ASRS: short form (2-5 years) in Taiwan. Therefore, ASRS could be not only be used as a standard level 1 screening tool in primary care setting, but also help to build a system of ASD screening, which we need to develop in Taiwan as soon as possible.