Improving the Early Screening Procedure for Autism Spectrum Disorder in Young Children: Experience from a Community-Based Model in Shanghai
Improving the Early Screening Procedure for Autism Spectrum Disorder in Young Children: Experience from a Community-Based Model in Shanghai
复制标题
改善幼儿自闭症谱系障碍的早期筛查程序：上海社区模式的经验
DOI：
10.1002/aur.1984
复制
发表时间：
2018-09-01
期刊：
影响因子：
4.7
通讯作者：
Xu, Xiu
中科院分区：
文献类型：
--
作者：
Li, Chunyang;Zhu, Guowei;Xu, Xiu
大多数患有自闭症谱系障碍 (ASD) 的儿童直到 4 岁时才被诊断出来，从而错过了早期干预的机会。本研究的目的是调查在社区样本的健康儿童就诊期间应用自闭症谱系障碍 (ASD) 早期筛查计划的可行性。该研究历时4年，分为两个阶段。第一阶段涉及 2014 年基本筛查模型的实施。在中国上海徐汇区进行 18 个月和 24 个月的健康儿童就诊期间，幼儿通过中国验证版幼儿自闭症检查表 (CHAT-23) 的 A 部分接受了 1 级筛查。筛查呈阳性的儿童被转介接受 CHAT-23 的 B 部分进行 2 级筛查，而那些筛查仍呈阳性的儿童则被转介接受诊断和评估。第二阶段涉及从 2015 年至 2017 年实施改进的筛查模型，并进行以下修改： (a) 在 1 级筛查中增加观察部分； (b) 对筛查结果呈阳性的家庭进行电话随访； (c) 向家庭传播有关自闭症谱系障碍的信息。结果显示，22,247 名接受筛查的儿童中有 42 名被诊断患有自闭症谱系障碍 (ASD)。 I 期 ASD 诊断率为 0.1%，II 期为 0.21%。与第一阶段相比，第二阶段的筛查阳性率和转诊一级筛查的显示率分别增加了 76.92% 和 58.43%。我们的结果表明，在适当的后勤支持下，这种二级筛查模式对于健康儿童就诊期间自闭症谱系障碍的早期筛查是可行且有效的。自闭症研究 2018，11：1206–1217。 © 2018 国际自闭症研究协会，Wiley periodicals, Inc.
Most children with autism spectrum disorder (ASD) are not diagnosed until the age of 4, thus missing the opportunity for early intervention. The objective of this study was to investigate the feasibility of an early screening program for ASD applied during well‐child visits in a community‐based sample. The study lasted for 4 years and was divided into two stages. Stage I involved the implementation of the basic screening model in 2014. Toddlers received level 1 screening via section A of the Chinese‐validated version of the Checklist for Autism in Toddlers (CHAT‐23) during 18‐ and 24‐month well‐child visits in Xuhui District, Shanghai, China. Screen‐positive children were referred to receive section B of the CHAT‐23 for level 2 screening, and those still screen‐positive were referred to undergo diagnosis and evaluation. Stage II involved the implementation of the improved screening model from 2015 to 2017 with the following modifications: (a) an added observational component in level 1 screening; (b) telephone follow‐ups with the screen‐positive families; and (c) dissemination of information on ASD to families. The results showed that 42 of 22,247 screened children were diagnosed with ASD. The ASD diagnosis rates were 0.1% in Stage I and 0.21% in Stage II. The screen‐positive rate and the show rate of referral for level 1 screening increased by 76.92% and 58.43%, respectively, in Stage II compared to Stage I. Our results suggest that with appropriate logistic support, this two‐level screening model is feasible and effective for the early screening of ASD during well‐child visits. Autism Res 2018, 11: 1206–1217. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.