Identifying Children with Autism Spectrum Disorder at 18 Months in a General Population Sample
Identifying Children with Autism Spectrum Disorder at 18 Months in a General Population Sample
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DOI：
10.1111/ppe.12114
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发表时间：
2014-05-01
影响因子：
2.8
通讯作者：
Stoltenberg, Camilla
中科院分区：
文献类型：
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作者：
Stenberg, Nina;Bresnahan, Michaeline;Stoltenberg, Camilla
背景先前对临床和高风险样本的研究表明，自闭症谱系障碍 (ASD) 的迹象可以在 1 至 2 岁之间被发现。我们在基于人群的样本中调查了 18 个月时的 ASD 迹象以及与后来的 ASD 诊断的关联。方法研究样本包括 2003 年至 2008 年出生的 52 026 名儿童，是参与挪威母子队列 (MoBa)（一项基于人群的纵向研究）和自闭症出生队列 (ABC)（一项关于 ASD 的子研究）的儿童子集。父母在 18 个月时完成了幼儿自闭症改良检查表 (M-CHAT) 中的全部 23 项。结果 M-CHAT 6 项关键项标准和 23 项标准的特异性分别为 97.9% 和 92.7%，敏感性分别为 20.8% 和 34.1%。迄今为止，在 173 名被诊断患有自闭症谱系障碍 (ASD) 的儿童中，有 60 名儿童 (34.7%) 在任一筛查标准上的得分高于截止值。似然比最高的项目是“对其他儿童感兴趣”、“向他人展示物体”和“对名字做出反应”。 结论 尽管后来被诊断为 ASD 的儿童中有三分之一是通过 M-CHAT 项目确定的，但大多数儿童在 18 个月时的筛查标准得分低于截止值。结果表明，不可能在这个年龄段检测出所有患有自闭症谱系障碍的儿童。
BackgroundPrevious research on clinical and high-risk samples suggests that signs of autism spectrum disorder (ASD) can be detected between 1 and 2 years of age. We investigated signs of ASD at 18 months in a population-based sample and the association with later ASD diagnosis.MethodsThe study sample includes 52 026 children born 2003 through 2008 and is a subset of children that participated in the Norwegian Mother and Child Cohort (MoBa), a population-based longitudinal study, and the Autism Birth Cohort (ABC), a sub-study on ASD. Parents completed all 23 items from the Modified Checklist for Autism in Toddlers (M-CHAT) at 18 months.ResultsThe M-CHAT 6-critical-item criterion and the 23-item criterion had a specificity of 97.9% and 92.7% and a sensitivity of 20.8% and 34.1%, respectively. In the 173 children diagnosed with ASD to date, 60 children (34.7%) scored above the cut-off on either of the screening criteria. The items with the highest likelihood ratios were 'interest in other children', 'show objects to others' and 'response to name'.ConclusionEven though one-third of the children who later received an ASD diagnosis were identified through M-CHAT items, the majority scored below cut-off on the screening criteria at 18 months. The results imply that it might not be possible to detect all children with ASD at this age.