文化和语言多样化的儿科人群中自闭症的筛查工具：系统评价。

Screening tools for autism in culturally and linguistically diverse paediatric populations: a systematic review.

机构信息

Department of General Paediatrics, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, 4101, Australia.

Discipline of Psychiatry and Mental Health, School of Medicine, University of New South Wales, Sydney, NSW, 1466, Australia.

出版信息

BMC Pediatr. 2024 Sep 28;24(1):610. doi: 10.1186/s12887-024-05067-5.

DOI:10.1186/s12887-024-05067-5

PMID:39342198

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11437884/

Abstract

BACKGROUND

Autism Spectrum Disorder (ASD) has varying prevalence rates worldwide, often higher in culturally diverse populations. Cultural differences can affect autism symptom recognition. Language barriers and differing healthcare attitudes may delay diagnosis and intervention. Most autism screening tools were developed in Western, predominantly Caucasian populations, and their appropriateness in culturally and linguistically diverse (CALD) contexts remains uncertain. There is a lack of comprehensive data on the accuracy of these tools in identifying autism in culturally and linguistically diverse groups. Consequently, it is unclear whether current screening tools are culturally sensitive and appropriate.

METHODS

A research protocol was registered in PROSPERO (CRD42022367308). A comprehensive search of literature published from inception to October 2022 was conducted using the following databases: PubMed, Medline Complete, Scopus, PsychInfo and CINAHL Complete. The articles were screened using pre-determined inclusion and exclusion criteria. Data extracted included participant demographics, screening tool psychometric properties (validity, reliability, accuracy) and acceptability. A narrative synthesis approach was used.

RESULTS

From the initial retrieval of 2310 citations, 51 articles were included for analysis. The studies were conducted in 32 different countries with screening tools in the following languages: Chinese, Spanish, Korean, Turkish, Arabic, Kurdish, Persian, Serbian, Italian, French, Sinhala, Taiwanese, Finnish, Northern Soho, Albanian, German, Japanese, Vietnamese, Farsi, Greek and English. There was no data on acceptability of the screening tools in CALD populations. Validity, reliability, and accuracy ranged from poor to excellent with consistently high performance by screening tools devised within the populations they are intended for.

CONCLUSIONS

The review evaluated autism screening tools in culturally diverse populations, with a focus on validity, reliability, and acceptability. It highlighted variations in the effectiveness of these tools across different cultures, with high performance by tools devised specifically for the intended population, emphasizing the need for culturally sensitive screening tools. Further research is needed to improve culturally specific, reliable autism screening tools for equitable assessment and intervention in diverse communities.

摘要

背景

自闭症谱系障碍（ASD）在全球的患病率各不相同，在文化多元化的人群中往往更高。文化差异会影响自闭症症状的识别。语言障碍和不同的医疗保健态度可能会延迟诊断和干预。大多数自闭症筛查工具都是在西方、以白种人为主的人群中开发的，其在文化和语言多样化（CALD）背景下的适用性尚不确定。缺乏关于这些工具在识别文化和语言多样化群体中自闭症的准确性的综合数据。因此，目前尚不清楚这些筛查工具是否具有文化敏感性和适用性。

方法

一项研究方案在 PROSPERO（CRD42022367308）中注册。从成立到 2022 年 10 月，使用以下数据库对文献进行了全面搜索：PubMed、Medline Complete、Scopus、PsychInfo 和 CINAHL Complete。使用预先确定的纳入和排除标准对文章进行筛选。提取的数据包括参与者的人口统计学信息、筛查工具的心理测量学特性（有效性、可靠性、准确性）和可接受性。采用叙述性综合方法。

结果

从最初检索到的 2310 条引文，有 51 篇文章被纳入分析。这些研究在 32 个不同的国家进行，使用的筛查工具包括中文、西班牙文、韩文、土耳其文、阿拉伯文、库尔德文、波斯文、塞尔维亚文、意大利文、法文、僧伽罗文、台语、芬兰文、北索霍语、阿尔巴尼亚文、德文、日文、越南文、波斯语、希腊文和英文。没有关于这些筛查工具在 CALD 人群中可接受性的数据。有效性、可靠性和准确性从差到优不等，而针对其预期人群设计的筛查工具则始终表现出较高的性能。

结论

本综述评估了在文化多元化人群中使用的自闭症筛查工具，重点是有效性、可靠性和可接受性。它强调了这些工具在不同文化中的有效性存在差异，针对预期人群设计的工具表现出较高的性能，强调了需要使用具有文化敏感性的筛查工具。需要进一步研究以开发针对不同社区进行公平评估和干预的具有文化特异性、可靠的自闭症筛查工具。