社交沟通问卷在孤独症谱系障碍一级筛查中的应用  

The Application of Social Communication Questionnaire in Primary Screening for Children with Autism Spectrum Disorders(ASDs)

作　　者：刘静[1] 徐秀[1] 

机构地区：[1]复旦大学附属儿科医院儿童保健科,上海201102

出　　处：《中国科学：生命科学》2015年第8期739-747,共9页Scientia Sinica(Vitae)

基　　金：上海市公共卫生人才培养计划(批准号:GWDTR201220);上海市公共卫生重点学科项目(批准号:12GWZX0301)资助

摘　　要：孤独症谱系障碍是一类以社会交往障碍为核心表现的儿童脑发育疾病.近年来,孤独症谱系障碍的早期筛查已得到广泛的研究.本研究旨在探讨社交沟通问卷在孤独症谱系障碍一级筛查中的应用情况.选取上海市4家幼儿园的学龄前期儿童作为筛查对象,运用社交沟通问卷对其进行孤独症谱系障碍的筛查.结果发现,2名儿童为孤独症谱系障碍疑似患儿,疑似患病率为2.3/1000.选择孤独症谱系障碍患儿为病例组,所有参与问卷一级筛查的非孤独症儿童为对照组,计算问卷的灵敏度和特异度.结果显示,问卷灵敏度和特异度分别为0.74和0.93.对问卷得分在普通人群中的分布及问卷项目的回答模式进行分析,结果发现,普通人群中社会沟通能力问卷（SCQ）总分为0~20,x为8.74±3.9,呈近似正态分布.超过70%的对照组儿童在SCQ量表一些问题的评定上呈孤独症阳性并且项目回答阳性率高于病例组.综上所述,SCQ手册所推荐的问卷截断值可能并不适合于一级筛查,适当降低问卷的截断值可能会提高问卷的有效性.问卷中的一些项目并不能很好地区分孤独症谱系障碍儿童和其他儿童.ASD is a common neurodevelopmental disorder whose core symptom includes impaired reciprocal social interaction. In recent years, the early detection of ASDs has been widely studied. The aim of this study is to evaluate the validity of Social communication questionnaire（SCQ）as the primary screening instrument in China's Mainland. In this study, SCQ was completed by parents of children attending four kindergardens in Shanghai. Among the children screened, 2 children was found to show a high risk for ASDs. In our small samples, the estimated prevalence of ASD is 2.3/1000. Autism spectrum disorders children were recruited as the patient group, the non-ASDs children participating in the screen were selected as the control group. The sensitivity and specificity of SCQ were 0.74 and 0.94. Analying the distribution of questionnaire scores and the response pattern of items, we found that total SCQ scores ranged from 0 to 20, the mean is 8.74, SD=3.9, and nearly normally distributed. Some items on the questionnaire were answered as‘autism-positive’for up to 70% of children in the control group and surpassed the patient group. In conclusion, the cutoff score recommend by the SCQ manual may be too high for using it as a primary screening tool. Lowering the cutoff score may improve the sensitivity. Some items in the SCQ are not useful in discriminating ASD and normal children.

关 键 词：孤独症谱系障碍 筛查量表 一级筛查 学龄前期儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学]