Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA.
A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
J Autism Dev Disord. 2019 Mar;49(3):1080-1095. doi: 10.1007/s10803-018-3810-8.
Autism Spectrum Disorder (ASD) diagnostic tools are not designed for mental ages (MA) below 12 months. Autism Diagnostic Observation Schedule (ADOS) and Childhood Autism Rating Scale (CARS) were examined in 2-year-olds with ASD-low MA (n = 53), Global Developmental Delay (GDD; n = 175), and ASD-higher MA (n = 425). ADOS and CARS demonstrated similar agreement with clinical diagnosis, but ADOS over-classified ASD in low MA, whereas CARS both over- and under-classified. All ADOS items differentiated GDD from ASD. Elementary social behaviors (e.g., eye contact, social interest) were similar across ASD groups, although advanced skills (e.g., pointing, play) were more impaired in ASD-low MA. ASD-low MA, a severe presentation, may require a modified ADOS algorithm to account for developmental delays.
自闭症谱系障碍（ASD）诊断工具并非专为 12 个月以下的心理年龄（MA）设计。本研究对 53 名 MA 较低的自闭症谱系障碍（ASD）患儿、175 名全面发育迟缓（GDD）患儿和 425 名 MA 较高的 ASD 患儿进行了自闭症诊断观察量表（ADOS）和儿童自闭症评定量表（CARS）评估。ADOS 和 CARS 与临床诊断的一致性相似，但 ADOS 在 MA 较低时过度分类 ASD，而 CARS 则过度和低估分类。所有 ADOS 项目均能将 GDD 与 ASD 区分开来。基本社交行为（如眼神接触、社交兴趣）在 ASD 组中相似，但 MA 较低的 ASD 患儿在高级技能（如指向、玩耍）方面的障碍更为严重。ASD-MA 较低的严重表现可能需要修改 ADOS 算法以考虑到发育迟缓的问题。
