中国婴幼儿期孤独症筛查量表的编制及信效度检验

目的 编制中国婴幼儿期孤独症筛查量表(CHCIA),用于12~24个月龄的儿童进行孤独症筛查,并检验其信效度。方法 2016年11月—2018年5月,在国内华北、华南、华西、华东、西南地区共抽取病例组(包括孤独症和发育迟缓儿童)和正常儿童组各60例,采用CHCIA量表进行评定。一周以后,对病例组进行复测,两次评定数据用于量表重测信度评价。同时,运用该量表在北京、深圳、青岛、西安、重庆、贵阳6个城市儿童保健门诊对5 369名儿童进行筛查,对量表得分大于界限分的儿童进行随访,至其2岁以上时由专科医生进行确诊。结果 量表的重测信度、评分者一致性信度均大于0.9分,表明信度较好;量表各维度及总分在孤独症组、发育迟缓组和正常儿童组间差异统计学意义,表明量表分效度较好。当量表的筛查界限划定为J值时,诊断界限划定为Z值时,量表的灵敏度、特异度、阳性预测值均达到理想状态。在儿童保健门诊对正常儿童的运用中,15例量表评定为孤独症的儿童,在随访中都得到了确诊,表明量表效标效度较好。结论 该量表设计较合理,信效度均较理想,符合量表的编制要求,可用于儿童孤独症的筛查和诊断。同时,该量表题目较少,使用方便,具有较高的临床推广使用价值。

Development and reliability and validity test of Checklist for Chinese Infants with Autism

Objective To develop the Checklist for Chinese Infants with Autism (CHCIA) for children aged 12-24 months,and to test its reliability and validity. Methods A total of 60 children in case group(including autism children and children with language development retardation) and 60 normal children were selected in northern,southern,western,eastern and southwest of China from November 2016 to May 2018.All participants were assessed with CHICA and case group were reassessed in one week,re-test reliability was analyzed by the correlation of the two results.Meantime,5 369 children were screened with CHICIA in the child health care clinic in Beijing,Shenzhen,Qingdao,Xi'an,Chonqging and Guiyang. Children who scored more than the critical value were followed up till 2 years old. Results Coefficients of the test-retest reliability and evaluator consistency were both more than 0.9. There were significant differences on CHCIA scores in each dimension among autism group,development retardation group and normal group,indicating good discriminate validity of the scale. When critical value for screening was set up as J,diagnostic value as Z,the sensitivity,specificity,and positive predictive value all reached ideal state. Finally 15 children sreened as autism by CHICA were diagnosed with autism in the follow-up,indicating the criterion validity of CHICA was good. Conclusions The CHICA scale is well designed with good reliability,validity and criterion validity,and is qualified as a screening and diagnostic tool for autism children. Meantime,it has few items and is easy to use,which can be widely used in clinics.