天津市18～34个月儿童预警征筛查阳性结果追踪评估

Follow-up evaluation of positive results of early warning signs screening of 18-34 months children in Tianjin City

目的对在儿童发育问题预警征象筛查中为阳性的18~34个月儿童进行进一步诊断分析,追踪其发育异常的具体情况,分析筛查阳性的原因。方法对18~34个月在社区预警征筛查阳性的病例,在三级儿童机构进行GESELL、ABC量表分析,统计分析各种发育异常的临床特征及与筛查条目之间的相关性。结果在445例筛查阳性的结果中,全面发育落后的119例,孤独症谱系障碍例100例,语言发育落后88例,精细动作发育落后17例,发育可疑43例,未见异常的25例。18-3和24-2阳性儿童中,孤独症谱系障碍的诊断率最高;18-2阳性儿童中,全面发育落后、孤独症谱系障碍和语言发育落后诊断最多,但此项也是假阳性率最高的条目。结论开展预警征筛查十分重要,可以早期发现、及时干预影响儿童心理行为发育的各种不利因素,减少心理行为发育的偏移,有利于儿童的健康发展。

Objective To further diagnose and analyze 18-34 months children who were positive in early warning signs screening of children's development problems, to track the specific situation of their developmental abnormalities and to analyze the reasons for positive screening. Methods The GESELL and ABC scales were used to analyze 18-34 months positive cases of early warning signs in community. The clinical characteristics of various developmental abnormalities and the correlation between the items of screening were analyzed. Results In 445 cases with positive screening, there were 119 children with global developmental delay(GDD), 100 cases with autism spectrum disorder(ASD), 88 cases with language developmental delay, 17 cases with fine motor delay, 43 cases with developmental atypia, and 25 cases without abnormality. The items most relevant to ASD were 18-3 and 24-2. Among the 18-2 positive children, the most frequently diagnosed items were GDD, ASD and language developmental delay, but this item also had the highest false positive rate. Conclusion The early warning signs screening is a very useful screening tool, which could lead to early evaluation and timely intervention, and reduce the deviation of psychological and behavioral development, and be conducive to the healthy development of children.