CHCIA与Gesell在孤独症谱系障碍婴幼儿早期筛查中的相关性分析

Correlation Analysis of CHCIA and Gesell in Early Screening of in Infants with Autism Spectrum Disorder

目的探究中国婴幼儿期孤独症筛查量表(the checklist for china’s infants with autism,CHCIA)及Gesell发育量表在孤独症谱系障碍(autism spectrum disorder)婴幼儿早期筛查中各维度的相关性及阳性结果的一致性,为ASD婴幼儿早期筛查及诊断提供参考与思路。方法选取于2021年1月~2022年4月在华西第二医院儿童保健门诊高度怀疑ASD或全面/语言发育迟缓的婴幼儿109例,回顾性收集幼儿基本信息、CHCIA及Gesell测评结果,对比分析两种量表测评结果的相关性及阳性结果的一致性。结果CHCIA总结果及各维度与Gesell各能区呈低度相关(除大运动能区)。CHCIA语言沟通维度与Gesell语言能区相关(r=0.445)且阳性结果一致性较高,CHCIA社交互动维度与Gesell个人社会能区相关(r=0.327)且阳性结果一致性较高,CHCIA兴趣与行为维度与Gesell相关度不大。结论Gesell可明确婴幼儿发育迟缓的能区并量化发育迟缓严重程度,联合CHCIA可显著甄别ASD婴幼儿早期兴趣狭隘与行为刻板的核心症状,可采用Gesell联合CHCIA对24月龄前ASD及全面发育迟缓、语言发育迟缓婴幼儿进行早期筛查与鉴别诊断。

Objective To explore the correlation of the Checklist for China's Infants with Autism(CHCIA)scale and Gesell development scale and understand the consistency of positive results in both scales,providing references for early screening and diagnosis of autistic spectrum disorder(ASD)infants.Methods From January 2021 to April 2022,109 infants who were highly suspected of autism or comprehensive/language development retardation in the Children's Health Clinic of West China Second Hospital were selected.The characteristics,the results of CHCIA and Gesell were collected retrospectively,and the correlation between the results of the two scales and the consistency of positive results were analyzed.Resutls CHCIA and its all dimensions are in low correlation with Gesell(except for the great motor development region).The dimension of language in CHCIA is mainly related to the language region in Gesell(r=0.445)and the positive results are highly consistent,the social interaction dimension in CHCIA is mainly related to the individual-social region in Gesell(r=0.327)and the positive results are highly consistent,and the interest-behavior dimensions in CHCIA have little correlation with Gesell.Conclusions Gesell development scale can identify the specific region of infant development retardation and quantify the severity of retardation,in combination with CHCIA which can significantly identify the core symptoms of narrow interest and stereotyped behavior in autistic infants.It is suggested that Gesell combined with CHCIA can be used for early screening and differential diagnosis of ASD and comprehensive/language development retardation in infants before 24 months age.