Huang X N, Zhang Y, Feng W W, Wang H S, Cao B, Zhang B, Yang Y F, Wang H M, Zheng Y, Jin X M, Jia M X, Zou X B, Zhao C X, Robert J, Jing Jin
Section of Health and Nutrition and Water, Environment and Sanitation, United Nations Children's Fund, Beijing 100600, China.
Zhonghua Er Ke Za Zhi. 2017 Jun 2;55(6):445-450. doi: 10.3760/cma.j.issn.0578-1310.2017.06.010.
To evaluate the reliability and validity of warning signs checklist developed by the National Health and Family Planning Commission of the People's Republic of China (NHFPC), so as to determine the screening effectiveness of warning signs on developmental problems of early childhood. Stratified random sampling method was used to assess the reliability and validity of checklist of warning sign and 2 110 children 0 to 6 years of age(1 513 low-risk subjects and 597 high-risk subjects) were recruited from 11 provinces of China. The reliability evaluation for the warning signs included the test-retest reliability and interrater reliability. With the use of Age and Stage Questionnaire (ASQ) and Gesell Development Diagnosis Scale (GESELL) as the criterion scales, criterion validity was assessed by determining the correlation and consistency between the screening results of warning signs and the criterion scales. In terms of the warning signs, the screening positive rates at different ages ranged from 10.8%(21/141) to 26.2%(51/137). The median (interquartile) testing time for each subject was 1(0.6) minute. Both the test-retest reliability and interrater reliability of warning signs reached 0.7 or above, indicating that the stability was good. In terms of validity assessment, there was remarkable consistency between ASQ and warning signs, with the value of 0.63. With the use of GESELL as criterion, it was determined that the sensitivity of warning signs in children with suspected developmental delay was 82.2%, and the specificity was 77.7%. The overall Youden index was 0.6. The reliability and validity of warning signs checklist for screening early childhood developmental problems have met the basic requirements of psychological screening scales, with the characteristics of short testing time and easy operation. Thus, this warning signs checklist can be used for screening psychological and behavioral problems of early childhood, especially in community settings.
为评估中华人民共和国国家卫生和计划生育委员会（国家卫计委）制定的预警症状清单的信度和效度，以确定预警症状对幼儿发育问题的筛查效果。采用分层随机抽样方法评估预警症状清单的信度和效度，从中国11个省份招募了2110名0至6岁儿童（1513名低风险对象和597名高风险对象）。对预警症状的信度评估包括重测信度和评分者间信度。以年龄与发育进程问卷（ASQ）和盖塞尔发育诊断量表（GESELL）作为标准量表，通过确定预警症状筛查结果与标准量表之间的相关性和一致性来评估效标效度。就预警症状而言，不同年龄的筛查阳性率在10.8%（21/141）至26.2%（51/137）之间。每个对象的中位（四分位间距）测试时间为1（0.6）分钟。预警症状的重测信度和评分者间信度均达到0.7及以上，表明稳定性良好。在效度评估方面，ASQ与预警症状之间存在显著一致性，值为0.63。以GESELL作为标准，确定预警症状对疑似发育迟缓儿童的敏感性为82.2%，特异性为77.7%。总体约登指数为0.6。用于筛查幼儿发育问题的预警症状清单的信度和效度已满足心理筛查量表的基本要求，具有测试时间短、操作简便的特点。因此，该预警症状清单可用于筛查幼儿心理和行为问题，尤其是在社区环境中。
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