社交反应量表简版在中国孤独症儿童中的适用性研究

Assessing accuracy of social responsiveness scale short form for screening autism spectrum disorder in Chinese children

目的分析社交反应量表简版(social responsiveness scale short form,SRS-SF)的信效度,探讨其在中国孤独症儿童群体中的适用性。方法选取符合《精神障碍诊断与统计手册》第5版(Diagnostic and Statistical Manual of Mental Disorders,5th edition,DSM-5)诊断标准的孤独症谱系障碍(autism spectrum disorder,ASD)患儿140例,以及非孤独症谱系障碍(Non-ASD)儿童58例为研究对象。由父母或主要照养人根据孩子的情况填写SRS以及长处和困难问卷(strength and difficulty questionnaire,SDQ)家长版,并选取其中42例儿童的父母或主要照养人间隔3个月再次填写SRS,依据SRS-SF的条目内容对所得的数据进行信效度与受试者工作特征曲线(receiver operating characteristic curve,ROC)分析,以评估SRS-SF的适用性。结果①SRS-SF的内部一致性系数Cronbach'sα为0.879,重测系数为0.511;②SRS-SF各因子及总分与SRS之间呈高度正相关(r=0.853~0.960,P<0.001);③SRS-SF总分与SDQ中的困难总分以及亲社会行为呈中度相关(|r|=0.349~0.585,P<0.001);④ASD组的SRS-SF各因子及总分均高于Non-ASD组(t=-8.367^-2.841,P<0.01);⑤SRS-SF的ROC曲线下面积以及灵敏度高于SRS。结论SRS-SF在中国ASD儿童群体中具有良好的信效度,可作为一种有效的ASD早期筛查工具。

Objective To evaluate the validity and reliability of the social responsiveness scale short rorm(SRSSF)and assess its accuracy for screening autism spectrum disorder(ASD)in Chinese children.Methods Parents or caregivers of 140 clinical children who were diagnosed as having ASD based on Diagnostic and Statistical Manual of Mental Disorders(5th edition)(DSM-5)and 58 clinical children without ASD(Non-ASD)to complete the social responsiveness scale(SRS)and the parent version of strength and difficulty questionnaire(SDQ).And 42 of them completed SRS retest after 3 months.Internal consistency reliability,test-retest reliability,constructive validity and discriminate validity were used to evaluate the validity and reliability of the SRS-SF based on the SRS data.The receiver operating characteristic curve(ROC)was used to assess the accuracy of SRS-SF for screening autism spectrum disorder in Chinese children,compared with SRS.Results For the whole SRS-SF,the Cronbach'sαcoefficients were 0.879 and the test-retest coefficients were 0.511.The scores of the whole SRS-SF and its three factors were highly positively correlated with those of SRS(r=0.853~0.960,P<0.001).The scores of the whole SRS-SF was moderately correlated with those of the total difficulties and prosocial behaviors of the parent version of SDQ(|r|=0.349~0.585,P<0.001).SRS-SF had good discriminate validity among ASD and Non-ASD control groups(t=-8.367^-2.841,P<0.01).The results in receiver operating characteristic analysis showed SRS-SF was slightly better than SRS in sensitivity(SRS-SF 0.783 vs SRS 0.704)and areaunder-the-curve(SRS-SF 0.833 vs SRS 0.829).Conclusion These results suggest that SRS-SF has acceptable reliability and validity,and can be another useful tool for screening ASD in Chinese children.