【摘要】 目的:简化改良婴幼儿孤独症量表(M-CHAT)中文修订版,并检验简化后其效度和信度。方法:删去M-CHAT中文修订版中既往研究显示效度或信度较差的5个条目(条目1、3、11、16和18),剩余的18个条目重新编号,各条目的内容和评分方法不变,形成M-CHAT中文简化版。以临床诊断作为金标准,与178例被试(93例孤独症儿童,85例正常儿童)的M-CHAT中文简化版筛查结果进行对比以检验效度。共有117例被试(56例孤独症儿童,61例正常儿童)的2位家长同时单独对被试进行M-CHAT中文简化版评定,以检测评分者信度;共有52例孤独症儿童的家长在2~4周后再次评定M-CHAT中文简化版,以检测重测信度。结果:当筛查界限分为13分时,M-CHAT中文简化版的灵敏度和特异度分别为92%和83%。阳性预测值为82.7%,阴性预测值为89.2%。M-CHAT中文简化版单项评分者信度kappa系数为0.41~0.75,均P<0.01;总分评分者信度kappa系数为0.90(P<0.01)。条目8的单项重测信度kappa系数为0.15,P>0.05;其余条目单项重测信度kappa系数为0.47~0.80,P<0.01;总分重测信度kappa系数为0.81,P<0.01。内部一致性检验Cronbachα系数为0.94,P<0.01。结论:M-CHAT中文简化版的效度和信度可能优于M-CHAT中文版及M-CHAT中文修订版,值得在早期孤独症筛查工作中推广。更多还原

【Abstract】 Objective: To simplify the Chinese revised version of the Modified Checklist for Autism in Toddlers( M-CHAT) and investigate its validity and reliability. Methods: Five items w ith poor validity or reliability of the Chinese revised version of M-CHAT w ere deleted,including item 1,3,11,16 and 18,and the remainder items w ere reordered to form the Chinese simplified version of M-CHAT. The content and score method of the remainder items w ere not changed. With clinical diagnosis as the gold standard,comparison to the screening results of the Chinese simplified version of M-CHAT of 178 subjects( 93 autistic children and 85 normal children) w as used to test the validity. Tw o caregivers of 117 subjects,including 56 autistic children and 61 normal children,fulfilled the Chinese simplified version of M-CHAT separately at the same time to investigate the inter-rater reliability. Fifty-tw o of them w ere re-evaluated by the Chinese simplified version of M-CHAT again 2- 4 w eeks later to investigate the test-retest reliability. Results: When the cutoff point w as set at 13,the sensitivity w as 92%,and the specificity w as83%. The positive predictive value( PPV) and the negative predictive value( NPV) of the Chinese simplified version of M-CHAT w ere 82. 7% and 89. 2%, respectively. The kappa values of inter-rater reliability of each item ranged from 0. 41 to 0. 75( P < 0. 01). The kappa value of inter-rater reliability of total score w as 0. 90, P <0. 01. The kappa value of test-retest reliability of item 8 w as 0. 15( P > 0. 05). The kappa values of test-retest reliability w ere 0. 81 for total scores and 0. 47- 0. 80 for other items. The Cronbach α of internal consistency coefficient of the scale w as 0. 94( P < 0. 01). Conclusion: The validity and reliability of the Chinese simplified version of M-CHAT are better than that of the Chinese version of M-CHAT and the Chinese revised version of M-CHAT. It is useful to apply the Chinese simplified version of M-CHAT w idely in the early screening of autism.更多还原