Division of Child Neurology and Psychiatry, Stella Maris Scientific Institute, University of Pisa, Italy.
Epidemiol Psychiatr Sci. 2011 Dec;20(4):329-38. doi: 10.1017/s204579601100045x.
To study the potential use of child behaviour checklist (CBCL) 1.5-5 scales for the early identification of preschoolers at risk of autism.
CBCL scores of three groups of preschoolers were compared: (1) an experimental group of 101 preschoolers with autism spectrum disorder (ASD); (2) a control group of 95 preschoolers with other psychiatric disorders (OPD); (3) a control group of 117 preschoolers with typical development (TD). One-way analysis of variance (ANOVA), logistic regression with odds ratio (OR) and receiver operating characteristic (ROC) analyses were performed.
ANOVA revealed that ASD and OPD had significantly higher scores in almost all CBCL scales than TD. ASD presented significantly higher scores than OPD on Withdrawn, Attention Problems and Pervasive Developmental Problems (PDP) scales. Logistic regression analysis demonstrated that these same CBCL scales have validity in predicting the presence of an ASD towards both TD and OPD. ROC analysis indicated high sensitivity and specificity for PDP (0.85 and 0.90) and Withdrawn (0.89 and 0.92) scales when ASD is compared to TD. Specificity (0.60 for PDP and 0.65 for Withdrawn) decreases when comparing ASD and OPD CONCLUSIONS: The PDP and Withdrawn scales have a good predictive validity so that they could be proposed as a first-level tool to identify preschoolers at risk of autism in primary care settings. Problems regarding the lower specificity when comparing ASD v. OPD are discussed.
研究儿童行为检查表（CBCL）1.5-5 量表在早期识别自闭症风险学龄前儿童中的潜在应用。
比较了三组学龄前儿童的 CBCL 评分：（1）101 名自闭症谱系障碍（ASD）学龄前儿童实验组；（2）95 名有其他精神障碍（OPD）的学龄前儿童对照组；（3）117 名有典型发育（TD）的学龄前儿童对照组。采用单因素方差分析（ANOVA）、比值比（OR）的逻辑回归和受试者工作特征（ROC）分析。
方差分析显示，ASD 和 OPD 在几乎所有 CBCL 量表上的得分均显著高于 TD。ASD 在退缩、注意力问题和广泛性发育障碍（PDP）量表上的得分显著高于 OPD。逻辑回归分析表明，这些相同的 CBCL 量表在预测 ASD 与 TD 和 OPD 同时存在时具有有效性。ROC 分析表明，与 TD 相比，PDP（0.85 和 0.90）和退缩（0.89 和 0.92）量表具有较高的敏感性和特异性。当 ASD 与 OPD 进行比较时，特异性（PDP 为 0.60，退缩为 0.65）降低。
PDP 和退缩量表具有良好的预测有效性，因此可以作为在初级保健环境中识别自闭症风险学龄前儿童的一级工具。讨论了在比较 ASD v. OPD 时特异性较低的问题。
