Screening for autism in older and younger toddlers with the Modified Checklist for Autism in Toddlers
Screening for autism in older and younger toddlers with the Modified Checklist for Autism in Toddlers
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DOI：
10.1177/1362361308094503
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发表时间：
2008-09-01
期刊：
影响因子：
5.2
通讯作者：
Fein, Deborah
中科院分区：
文献类型：
--
作者：
Pandey, Juhi;Verbalis, Alyssa;Fein, Deborah
修改后的幼儿自闭症检查表（M-CHAT）用于筛选年龄较小（16-23个月）和较大（24-30个月）的高风险和低风险幼儿。拒绝随访率无组间差异，但低龄/低危儿童家长拒绝随访率高于高危儿童家长。诊断ASD的PPP值为：年轻/高风险0.79，年长/高风险0.74，年轻/低风险0.28，年长/低风险0.61，在低风险组中PPP值因年龄而异。然而，所有组中的大多数儿童都被诊断患有发育障碍。症状严重程度在各组间无明显差异。认知和适应性测试显示出最小的组间差异。因此，较大和较小的幼儿具有相似的症状和发育迟缓；低风险儿童24个月时的PPP优于18个月时的PPP；然而，这些孩子仍然极有可能表现出发育障碍。临床决策应平衡早期识别和较低特异性的M-CHAT筛查对年轻/低风险组。
The Modified Checklist for Autism in Toddlers (M-CHAT) was used to screen younger (16-23 months) versus older (24-30 months) high- and low-risk toddlers. Refusal rates for follow-up interview showed no group differences, but parents of younger/low-risk children were more likely to refuse evaluation than parents of high-risk children. PPP for an ASD diagnosis was: younger/high-risk 0.79, older/high-risk 0.74, younger/low-risk 0.28, and older/low-risk 0.61, with PPP differing by age within the low-risk group. Most of the children in all groups, however, were diagnosed with a developmental disorder. Symptom severity generally did not differ among groups. Cognitive and adaptive measures showed minimal group differences. Therefore, older and younger toddlers had similar symptomatology and developmental delays; PPP for ASD is better at 24 than 18 months for low-risk children; however, these children are still highly likely to show a developmental disorder. Clinical decision making should balance early identification against the lower specificity of M-CHAT screening for the younger/low-risk group.