以色列幼儿自闭症谱系障碍两种筛查方法的比较

A Comparison Between Two Screening Approaches for ASD Among Toddlers in Israel.

机构信息

Department of Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Ministry of Health, Jerusalem, Israel.

出版信息

J Autism Dev Disord. 2020 May;50(5):1553-1560. doi: 10.1007/s10803-018-3711-x.

DOI:10.1007/s10803-018-3711-x

PMID:30099656

Abstract

Systematic screening of autism spectrum disorder (ASD) can improve early diagnosis of ASD. We compared the efficacy of two ASD screening methods, the Global Developmental Screening (GDS), and the Modified Checklist for Autism in Toddlers-Revised, with Follow-Up (M-CHAT/F) in 1591 toddlers of ages 18-36 months from 35 government-funded clinics in south Israel. The M-CHAT/F performed better than the GDS in detecting toddlers with ASD (sensitivity: 70.0% vs. 50.0%, and specificity: 98.2% vs. 96.6% respectively). Both methods had an equivalent performance in detecting other forms of developmental delays (sensitivity = 63%; and specificity ~ 98%). In addition, remarkable inter-nurse variation was observed in the GDS referral decisions. Thus, employment of the M-CHAT/F in the Israeli health system may improve early detection of ASD among toddlers.

摘要

系统筛查自闭症谱系障碍（ASD）可以提高 ASD 的早期诊断率。我们比较了两种 ASD 筛查方法，即全球发育筛查（GDS）和改良婴儿自闭症检查表修订版，随访版（M-CHAT/F），在以色列南部 35 家政府资助的诊所中对 1591 名 18-36 个月大的幼儿进行了研究。M-CHAT/F 在检测患有 ASD 的幼儿方面比 GDS 更有效（灵敏度：分别为 70.0%和 50.0%，特异性：分别为 98.2%和 96.6%）。这两种方法在检测其他形式的发育迟缓方面表现相当（灵敏度=63%，特异性~98%）。此外，在 GDS 的转介决策中观察到显著的护士间差异。因此，在以色列卫生系统中使用 M-CHAT/F 可能会提高幼儿 ASD 的早期发现率。