Bernie Charmaine, Montgomery Alicia, Sealy Louise, Descallar Joseph, Dissanayake Cheryl, Jalaludin Bin, Murphy Elisabeth, Woolfenden Sue, Williams Katrina, Eapen Valsamma
Southern Cross University, Gold Coast, QLD, Australia.
Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
J Autism Dev Disord. 2025 May 15. doi: 10.1007/s10803-025-06859-z.
To examine accuracy of two-tiered surveillance to detect developmental disability and autism in a multicultural birth cohort; a subset of the Watch Me Grow Study. Surveillance tools were used at or soon after 18 months of age, including the Parents' Evaluation of Developmental Status (PEDS), the Ages and Stages Questionnaire (ASQ-3), and the revised Modified Checklist for Autism in Toddlers (M-CHAT-R/F). Children with and without identified concerns were assessed between 18 and 23 months using the Mullen Scales of Early Learning (MSEL) and the Autism Diagnostic Observation Schedule-2 (ADOS-2). Sensitivity and specificity of the surveillance tools used in isolation and in combination in this cohort ranged from 51 to 87% (n = 165). Some children (n = 21) who were not identified with high likelihood of difficulties were later assessed as having probable developmental disability. Adding the M-CHAT-R/F did not significantly improve autism likelihood identification in comparison with tiered developmental surveillance. There was highly variable sensitivity and specificity of combined tools for tiered developmental surveillance in this cohort. There remains a need in Australia to improve methods of, and engagement in, developmental screening and surveillance that includes detection of concerns in community and primary healthcare settings.
在一个多元文化出生队列中，对用于检测发育障碍和自闭症的两级监测的准确性进行研究；这是“关注我成长研究”的一个子集。在18个月龄时或之后不久使用监测工具，包括《父母发育状况评估量表》（PEDS）、《年龄与发育阶段问卷》（ASQ - 3）以及修订后的《幼儿自闭症修正检查表》（M - CHAT - R/F）。对有和没有确定问题的儿童在18至23个月之间使用《莫伦早期学习量表》（MSEL）和《自闭症诊断观察量表第二版》（ADOS - 2）进行评估。在该队列中，单独使用和联合使用的监测工具的敏感性和特异性范围为51%至87%（n = 165）。一些未被确定有高困难可能性的儿童（n = 21）后来被评估为可能患有发育障碍。与分层发育监测相比，添加M - CHAT - R/F并没有显著提高自闭症可能性的识别。在该队列中，用于分层发育监测的联合工具的敏感性和特异性差异很大。在澳大利亚，仍然需要改进发育筛查和监测的方法以及参与度，包括在社区和初级卫生保健环境中发现问题。
