Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Acta Paediatr. 2021 May;110(5):1505-1512. doi: 10.1111/apa.15696. Epub 2020 Dec 15.
At present, there is no reliable method to screen for communication difficulties at age 18-months in the Swedish child health care. This study examined the psychometric properties of the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (ITC) when used at the 18-month visit in the child healthcare setting.
Children aged 16-20 months (n = 679) were screened. Children were referred for an assessment if they screened positive screen or if the parent or nurse was concerned about the child's communicative development. Two groups of positive screens were used in the analysis (n = 78 children), one based on the ITC result, and one combining the ITC with contradicting information from the nurses' informal clinical assessment.
The AUC ranged from 0.68 to 0.84. The sensitivity was 0.85, and the specificity was 0.59. When the ITC result was combined with the nurses' information, sensitivity increased to 0.88 and specificity to 0.63. The internal consistency was moderate to high, and fit indices were satisfactory.
The results suggest that the ITC can be used to identify children in need of interventions to enhance communication at 18 months of age, especially in combination with the nurse's assessment.
目前,瑞典儿童保健中尚无可靠的方法在 18 个月龄时筛查沟通障碍。本研究探讨了在儿童保健环境中进行 18 个月龄检查时使用沟通和象征性行为量表发展概况婴儿-幼儿检查表(ITC)的心理测量特性。
对 16-20 个月龄的儿童进行筛查。如果儿童筛查阳性(n=679)或父母或护士对儿童的沟通发展感到担忧,则会转介进行评估。在分析中使用了两组阳性筛查结果(n=78 名儿童),一组基于 ITC 结果,另一组将 ITC 与护士非正式临床评估的矛盾信息相结合。
AUC 范围为 0.68 至 0.84。灵敏度为 0.85,特异性为 0.59。当 ITC 结果与护士的信息相结合时,灵敏度提高到 0.88,特异性提高到 0.63。内部一致性为中等到高度,拟合指数令人满意。
结果表明,ITC 可用于识别需要干预以增强 18 个月龄儿童沟通能力的儿童,特别是与护士的评估相结合时。