Schonhaut B Luisa, Buron K Verónica, Aguilera E Roxana, Vargas B Lorena
Universidad del Desarrollo, Santiago, Chile.
Andes Pediatr. 2023 Aug;94(4):425-435. doi: 10.32641/andespediatr.v94i4.4901.
Early detection and referral of autism spectrum disorder (ASD) are key in promoting the development of affected children. Recently, a law was enacted that indicates screening for ASD in health care services. This law represents a challenge for pediatricians working in outpatient care. The objective of this study is to review the usefulness of ASD screening in questionnaires and scales validated in Chile for the screening of psychomotor development, socio-emotional development and specific screening for ASD. The screening of psychomotor development evaluates general performance from an early age, indicating the first signs of delay, with a higher probability of ASD if there are indicators in the social and language domains. Social-emotional questionnaires can be applied early, including questions about signs of ASD, nevertheless, they are not routinely used in pediatric care in Chile. The specific ASD screening scales validated in Chile are the Modified Checklist for Autism in Toddlers (M-CHAT), the Quantitative Checklist for Autism in Toddlers Q-CHAT (Q-CHAT) and the Autism Mental Status Exam (AMSE), for infants older than 15/18 months, with promising psychometric properties. It is recommended to complement clinical observation with general tests for screening psychomotor development, social-emotional development and specific scales for ASD screening, continuously throughout childhood. The implementation of online questionnaires should optimize their coverage and interpretation. Monitoring and early intervention are essential while confirming a diagnosis, regardless of the affected domain.
自闭症谱系障碍(ASD)的早期发现和转诊对于促进受影响儿童的发育至关重要。最近,一项法律颁布,规定在医疗保健服务中对ASD进行筛查。这项法律对从事门诊护理工作的儿科医生构成了挑战。本研究的目的是回顾在智利经过验证的用于筛查心理运动发育、社会情感发育以及ASD特异性筛查的问卷和量表中ASD筛查的有用性。心理运动发育筛查从幼年时期评估总体表现,指出延迟的最初迹象,如果在社交和语言领域有指标,则患ASD的可能性更高。社会情感问卷可以早期应用,包括有关ASD迹象的问题,然而,它们在智利的儿科护理中并非常规使用。在智利经过验证的ASD特异性筛查量表包括用于15/18个月以上婴儿的《幼儿自闭症改良检查表》(M-CHAT)、《幼儿自闭症定量检查表》(Q-CHAT)和《自闭症精神状态检查》(AMSE),具有良好的心理测量特性。建议在儿童期全程持续地用心理运动发育、社会情感发育的一般测试以及ASD筛查的特异性量表来补充临床观察。在线问卷的实施应优化其覆盖范围和解读。无论受影响的领域如何,在确诊时监测和早期干预都是必不可少的。