目的 评估中文版量化的婴幼儿孤独症筛查量表(Q-CHAT)的信度和效度,以期为孤独症谱系障碍(ASD)的早期筛查提供合适的工具。方法 2019年7月-2020年1月分别采用量化的婴幼儿孤独症筛查量表(Q-CHAT)和儿童孤独症评定量表(CARS)对符合《精神障碍诊断和统计手册》第5版(DSM-5)ASD诊断标准的91例18~48月龄的患儿(ASD组)、45例年龄匹配的其他发育障碍患儿(DD组)以及60名正常发育儿童(TD组)进行评估和比较。结果 Q-CHAT量表的重测信度较高(r=0.89),Cronbach's α系数为0.67(P<0.05)。Q-CHAT评分与CARS总分显著相关(r=0.44,P<0.001), Q-CHAT量表各项目评分与CARS总分的相关系数为0.22~0.60之间。ROC分析显示曲线下面积为0.87,最大灵敏度(0.71)和特异性(0.92),Q-CHAT量表临界得分为45分。ASD组患儿Q-CHAT量表得分显著高于对照组(t=9.42,P<0.01),说明Q-CHAT量表区分效度较好。结论 Q-CHAT量表具有较好的信效度,可用于ASD患儿的早期筛查。
Abstract
Objective To assess the reliability and validity of the Chinese version of the Quantitative Checklist for autism in toddlers (Q-CHAT), so as to provide an appropriate tool for early screening of autism spectrum disorder(ASD). Methods From July 2019 to January 2020, a total of 91 18- to 48-month-old ASD children diagnosed by DSM-5, alongside 45 age-matched individuals with other developmental disabilities (DD) and 60 typically developed (TD) children were screened by the Q-CHAT and Childhood Autism Rating Scale (CARS). Results The test-retest reliability was satisfactory (r=0.89).In addition, the Cronbach's α coefficient for internal reliability was 0.67(P<0.05).The Q-CHAT score was significantly correlated with the total CARS score (r=0.44, P<0.001).And correlation coefficients of 0.22—0.60 were obtained between the Q-CHAT score and total CARS score for various items.ROC analysis of ASD versus unaffected control subjects showed an area under the curve of 0.87, yielding maximum sensitivity (0.71) and specificity (0.92) with a cutoff of 45 points.Q-CHAT scores were significantly higher in ASD children compared with control children(t=9.42, P＜0.01), revealing sufficient discriminant validity. Conclusion Chinese version of Q-CHAT can be used for early screening of ASD children in urban Mandarin Chinese speaking populations with acceptable reliability and validity.
关键词
孤独症谱系障碍 /
量化的婴幼儿孤独症筛查量表 /
信度 /
效度 /
婴幼儿
Key words
autism spectrum disorder /
Quantitative Checklist for Autism in Toddlers /
reliability /
validity /
infants and toddlers
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