目的 分析年龄与发育进程问卷(ASQ-3)中文版和丹佛尔发育筛查测验(DDST)两种常用婴幼儿发育筛查量表在临床应用的结果一致性,为临床评估婴幼儿发育不良选择合适量表提供依据。方法 回顾性分析2019年4月1日—2020年4月30日期间在重庆佑佑宝贝妇儿医院儿童保健门诊就诊的355名儿童的ASQ-3中文版问卷和DDST筛查评估结果。比较两种筛查方法的阳性率,分析大运动能区、精细运动能区、语言能区和个人-社会能区4个能区发育筛查结果的一致性。结果 ASQ-3量表筛查阳性率高于DDST量表,除大运动能区外,在精细运动能区、语言沟通能区、个人-社会能区差异具有统计学意义(χ2＝28.942、6.424、60.634,P<0.05或<0.01)。Kappa检验对两种筛查方法进行一致性分析,4个能区Kappa值均在0.4以下,提示这两种发育评价筛查量表在4个能区的一致性均较低,大运动能区的Kappa值相对较高(Kappa=0.317,P<0.001)。结论 ASQ-3中文版和DDST两种婴幼儿发育筛查量表临床应用于筛查3~60月龄的婴幼儿神经发育行为,筛查结果一致性低,亟需进一步研究指导临床应用,提高婴幼儿发育筛查量表的准确性和一致性。
Abstract
Objective To explore and analyze the consistency of the subjective and objective evaluation scale-Ages and Stages Questionnaire-Third Edition (ASQ-3) and Denver Development Screening Test (DDST),in order to provide reference for the clinical assessment of children's developmental disorders. Methods A total of 355 children in Children's Health Clinic of Chongqing Youyou Baobei Children and Women's Hospital from April 1st,2019 to April 30th,2020 were selected in this study. Their record of ASQ-3 and DDST evaluation results was retrospectively collected. The screening positive rates of two assessment tools were compared,and the consistency of the two tools in gross motor function,fine motor function,language and personal-social function was analyzed. Results The screening positive rate of ASQ-3 was higher than that of DDST. Except for the motor function,the differences on the screening positive rate of fine motor,language,and personal-social function between the two tools were significant (χ2=28.942,6.424,60.634,P＜0.05). The consistency of the two screening methods was analyzed by the Kappa test. All Kappa values of the four function zones were lower than 0.4,suggesting very low consistency between ASQ-3 and DDST. The Kappa value of the motor function was relatively high compared with other zones(Kappa=0.317,P<0.001). Conclusions The consistency between ASQ-3 and DDST is low in developmental screening of children aged 3—60 months. Further researches are warranted to improve the accuracy and consistency of the infant development screening scale.
关键词
发育筛查 /
主观评估工具 /
客观评估工具 /
一致性分析
Key words
developmental screening /
subjective assessment tool /
objective assessment tool /
consistency analysis
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参考文献
[1] 夏彬,古桂雄.婴幼儿发育筛查量表的研究及应用进展[J].中国儿童保健杂志,2017,25(7):699-701.
[2] 金星明.重视儿童发育监测和筛查在儿童保健中的应用[J].中国实用儿科杂志,2016,31(10):726-729.
[3] Guralnick MJ.Early intervention for children with intellectual disabilities:an update[J].J Appl Res Intellect Disabil,2016,30(3):211-229.
[4] Glascoe FP,Martin ED,Humphrey S.A comparative review of developmental screening tests[J].Pediatrics,1990,86(4):547-554.
[5] 魏梅,卞晓燕,Jane S,等.年龄与发育进程问卷中国常模及心理测量学特性研究[J].中华儿科杂志,2015,53(12):913-918.
[6] 林森然,崔娓,古桂雄,等.婴幼儿发育行为筛查工具的研究进展[J].中国儿童保健杂志,2019,27(1):59-62.
[7] Squires J,Bricker D,Potter L.Revision of a parent-completed development screening tool:Ages and Stages Questionnaires[J].J Pediatr Psychol.1997,22(3):313-328.
[8] 朱锡翔,刘芳,Jane S,等.基于《年龄与发育进程问卷-第3版》调查的中国大陆城乡1-66个月儿童发育状况的比较[J].中国循证儿科杂志,2017,12(2):116-120.
[9] Veldhuizen S,Clinton J,Rodriguez C,et al.Concurrent validity of the Ages And Stages Questionnaires and Bayley Developmental Scales in a general population sample[J].Acad Pediatr,2015,15(2):231-237.
[10] 陈佳英,魏梅,陈孙敏,等.DenverⅡ发育筛查量表的上海标准化及其相关因素研究[J].中国儿童保健杂志,2007,15(5):476-478.
[11] Ga HY,Kwon JY.A comparison of the korean-ages and stages questionnaires and denver developmental delay screening test[J].Ann Rehabil Med,2011,35(3):369-374.
[12] Srinithiwat B,Ularntinon S.Concurrent validity of the Ages&Stages Questionnaires,Third Edition,Thai-version (ASQ-3 Thai) with the Denver Developmental Screening Test Ⅱ (DDST-Ⅱ) in developmental screening of 18,24,and 30 months old children at Queen Sirikit National Institute of Child Health[J].J Med Assoc Thai,2014,97(Suppl 6):6-13.
[13] De-Andres-Beltran B,Rodriguez-Fernandez AL,Gueita-Rodriguez J,et al.Evaluation of the psychometric properties of the Spanish version of the Denver Developmental Screening Test Ⅱ[J].Eur J Pediatr,2015,174 (3):325-329.
[14] Rydz D,Srour M,Oskoui M,et al.Screening for developmental delay in the setting of a community pediatric clinic:a prospective assessment of parent-report questionnaires[J].Pediatrics,2006,118(4):e1178-1186.
基金
重庆市区域医学重点学科建设基金(2019-132)
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