贝莉-Ⅲ婴幼儿发育筛查测试在上海地区应用效度初步分析

Preliminary analysis on the validity of Bayley-Ⅲ Screening Test in Shanghai

目的对贝莉-Ⅲ婴幼儿发育筛查测试(Bayley-ⅢScreening Test)在上海地区的应用效度进行初步分析,探讨其在我国引进的可行性。方法 2017年1-4月采用横断面研究,选取上海市某区0~18月龄婴幼儿共1 073名纳入研究,采用项目水平内容效度指数(I-CVI)、单因素方差分析进行内容效度、效标效度的分析,采用Mann Kendall趋势检验分析得分随月龄的变化趋势,事后两两比较法比较相邻月龄组的得分。结果5个能区的I-CVI分别为0.920、0.953、0.953、0.963、0.982,平均I-CVI为0.954。ASQ-3(作为校标)三组等级分类中(正常、边缘和异常),认知能力、语言理解、语言表达在边缘组和异常组均低于正常组(P<0.05),但精细运动和大运动与ASQ-3存在不一致性。各能区得分随月龄呈总体上升趋势(P<0.05),女童的语言理解得分在第二年龄段较第一年龄段有所下降,但差异无统计学意义(P=0.487)。结论贝莉-Ⅲ筛查测试的认知、语言理解、语言表达三个能区具有较好的测量效度,精细运动和大运动项目需要修正并进行进一步研究。

Objective To preliminarily assess the validity of Bayley-Ⅲ Screening Test in Shanghai,and to discuss the feasibility of its adaption in China. Methods A cross-sectional study was conducted in one district in Shanghai and a total of 1 073 infants aged from 0 to 18 months were included from January to April 2017.Item-level content validity index（ICVI）and one-way ANOVA were used to analyze the content validity and criterion-related validity.The Mann-Kendall trend test was performed to assess trends of behavior development,and post-hos Least Significant Difference test was used to compare the scores of two groups with adjacent age. Results The I-CVIs of the five subtests were 0.920,0.953,0.953,0.963 and 0.982,respectively.The average I-CVI was 0.954.In the three risk categories（normal,emerging and abnormal）of ASQ-3,Bayley-Ⅲ Screening cognitive,receptive communication and expressive communication scores of ASQ-3 emerging and abnormal categories were significantly lower than those of the normal category（P〈0.05）.However,the fine motor and gross motor subtests were inconsistent with the ASQ categories.The scores of each subtests showed an increasing trend across age（P〈0.05）.But girls＇receptive communication scores decreased in the first two groups with adjacent age without significant difference（P=0.487）. Conclusion The cognitive,receptive communication and expressive communication subtests of the Bayley-Ⅲ Screening Test have good validity.However,further research and revision of the fine motor and gross motor subtests is needed.