孤独症筛查量表(CHAT-23)的应用研究

Study on the application of Autism Screening Scale(CHAT-23)

【目的】研究CHAT-23作为孤独症筛查量表在中国内地的可行性及有效性并探索一套适合于初级儿童医疗保健机构使用的筛查流程。【方法】选取卢湾区18-24月龄儿童作为筛查对象,运用CHAT-23量表对其进行ASDs筛查;选择孤独症谱系障碍患儿为病例组,正常儿童为对照组,计算CHAT-23家长填写问卷的灵敏度、特异度及阳性预测值;部分儿童家长重新填写问卷,计算问卷的重测信度。【结果】卢湾区共筛查了484人,发现2名疑似孤独症谱系障碍患儿;该问卷的灵敏度及特异度分别为0.941和0.884。问卷加Section B当面访谈的阳性预测值为50%;该问卷的重测信度（kappa值）为0.50。【结论】CHAT-23孤独症筛查量表灵敏度和特异度均较高,是一种适用于初级医疗保健机构的孤独症筛查量表,适合在中国内地推广。

【Objective】 To evaluate the validity and feasibility of CHAT-23 as a screening instrument in China's Mainland. 【Methods】 To screen the 18~24 months old children for ASDs with CHAT-23 in Luwan District.To calculate the sensitivity,specificity and positive predictive value（PPV） of CHAT-23 parental questionnaire,autistic children were recruited as the patient group,and normal children from were recruited as the control group.Make some parents of the children fill CHAT-23 parental questionnaires again and calculate the retest reliability（kappa value）. 【Results】 2 children were found to be a high risk for ASDs among the 484 children.The sensitivity and specificity of CHAT-23 parental questionnaires were 0.941 and 0.884.The PPV for CHAT-23 parental questionnaires plus section B interview was 50%.The kappa value of CHAT-23 parental questionnaire was 0.50. 【Conclusions】 CHAT-23 has good sensitivity and specificity.It＇s an applicable Autism Screening Scale for primary health care institutions,and suitable to promote in China's Mainland.