Diagnostic and Nosological Study on Developmental Disorders Related to Infantile Autism

为了进行这项研究，我们开发了三个评级量表。第一个，儿童孤独症评定量表-东京版（CARS-TV）表现出令人满意的分类效度的DSM-III诊断组。克朗巴赫的α是0.87。平均评分者间可靠性（r）为0.62。其次，东京孤独症行为量表（TABS）显示出令人满意的重测信度（总分的r为.94）。克朗巴赫的α为0.78。儿童孤独症（IA）的TABS总分显著高于其他五个DSM-III组。TABS和CARS-TV的总分之间的r值为0.59。第三，孤独症倾向量表（CAT）对DSM-III组有较好的分半信度和同时效度，57例其他广泛性发育障碍（OPDDs）的CARS-TV总分显著低于39例IA。在两个CARS-TV量表中，OPDDs的受损程度显著低于IA：视觉反应和一般印象。总的和9个项目的TABS评分表明，OPDD是显着低于IA受损。发展消退前的15个崩解性精神病（DP）的情况下，比性别和年龄匹配的30个IA有类似的回归。但在一半以上的DP中，这并不完全正常，因为一些这样的历史案例。回归后，DP的智力发展水平显著低于IA。DP和IA之间的总CARS-TV评分无显著差异。建议将ICD-10中崩解性障碍（DP的新名称）诊断标准中退化前的“明显正常发育”改为“正常或接近正常发育”。“虽然OPDD在智力和自闭症障碍方面似乎比IA更温和，但它仍然是多种情况的混合物，需要更精确的划分。

To conduct this study, we developed three rating scales. The first one, the Childhood Autism Rating Scale--Tokyo Version (CARS-TV) demonstrated satisfactory taxonomic validity on DSM-III diagnostic groups. Cronbach's alpha was .87. An average interrater reliability (r) was .62. The next, the Tokyo Autistic Behavior Scale (TABS) showed a satisfactory test-retest reliability (r for the total score was .94). Cronbach's alpha was .78. The total TABS score was significantly higher in infantile autism (IA) than in other five DSM-III groups. A value of r between total scores of the TABS and the CARS-TV was .59. The third, the Checklist for Autistic Tendency (CAT) showed satisfactory split-half reliability and concurrent validity to the DSM-III groups.The total CARS-TV score was significantly lower in 57 Other Pervasive Developmental Disorders (OPDDs) than in 39 IAs. OPDDs were significantly less impaired than IAs in two CARS-TV scales : Visual responsiveness and general impressions. The total and nine item TABS scores indicated that OPDD was significantly less impaired than IA.Development before regression was better in 15 disintegrative psychosis (DP) cases than sex- and age-matched 30 IAs having had similar regression. But it was not entirely normal in more than half of the DPs as some of such historical cases. After regression, DPs had significantly lower mental development level than IAs. The total CARS-TV score did not differ significantly between DPs and IAs. We suggested a phrase "apparent normal development" before regression in the diagnostic criteria for disintegrative disorder (a new name for DP) in ICD-10 draft be replaced with "normal or near normal development." Although OPDD seems milder in intellectual and autistic impairments than IA, it is still a mixture of diverse conditions that need more precise division.