2－3歲自閉症幼兒篩檢量表的發展：T-STAT的初究

Development of a Screening Tool for Autism in Two-Year-Olds, Taiwan Version (T-STAT): A Preliminary Study

10.30074/FJMH.201203_25(1).0005

姜忠信(Chung-Hsin Chiang)；吳進欽(Chin-Chin Wu)；劉俊宏(Jiun-Horng Liu)；侯育銘(Yuh-Ming Hou)

篩檢 ； 自閉症幼兒 ； 發展遲緩幼兒 ； Screening ； Autism ； Developmental delay ； Young children

中華心理衛生學刊

25卷1期（2012 / 03 / 01）

135 - 154

繁體中文

研究目的：本研究的主要目的，是修訂兩歲期自閉症篩檢工具（Screening Toolfor Autism in Two-Year-Olds, STAT, Stone, Coonrod, & Ousley, 2000; Stone, Coonrod,Turner, & Pozdol, 2004）為台灣版本，簡稱T-STAT，適用於層次二的自閉症篩檢工具。本研究報告為初步的結果。研究方法：本研究的樣本是34名生理年齡在24-36個月之間的自閉症類及發展遲緩幼兒。兩組幼兒皆為17名，在生理、心理年齡、性別、及社經水準上皆加以配對。修訂STAT為T-STAT的工作，評估作業維持測量遊戲、要求、相互注意協調能力及模仿能力等四項領域，但將原STAT中測量相互注意協調能力及模仿能力的題項，各做一題的更動，其餘題項不變，計分方式與STAT相同。研究結果：初步的結果發現，不論是STAT或T-STAT，在遊戲、要求及相互注意協調能力等領域皆能有效區分兩組，但模仿能力領域則未有明顯的區辨力。此外，若以STAT的切截分數來做分類，則不論STAT或T-STAT，與自閉症觀察診斷量表（Autism diagnostic observation scale, ADOS, Lord,Rutter, DiLavore, & Risi, 1999）間所建立的敏感度與精確度達94.1%及82.4%；STAT或T-STAT，與臨床診斷間的敏感度與精確度亦達94.1%及82.4%。研究結論：初步的結果顯示，不論是STAT或T-STAT，在篩檢自閉症類幼兒上尚稱滿意；是否這項結果在較大的樣本，及對非典型自閉症的篩檢效果仍佳，需要進一步研究探究。

Purpose: The purpose of the study was to modify the Screening Tool for Autism in Two-Year-Olds (STAT, Stone et al., 2000; 2004) for Taiwan, called the T-STAT, for level-2 screening of young children with autism spectrum disorder. Methods: Thirty-four young children with autism spectrum disorders and developmental delay were recruited (MEAN AGE: 28.18months old, boy/girl= 28/6). Each group had 17 children aged 24-36 months matched for chronological age, mental age, gender, and socio-economic status. Adapted from the STAT, the T-STAT maintained all of the items in the play and request domains, but substituted one item from joint attention domain and one from the imitation domain. The coding algorithm was the same for the STAT and the T-STAT. Results: The initial data revealed that both the STAT and the T-STAT can appropriately discriminate children with autism spectrum disorders and developmental delay on the domains of play, request, and joint attention, but not on the imitative domain. When using a score of 2 as a cutoff, agreement between the STAT or T-STAT and the ADOS (Autism Diagnostic Observation Scales, Lord, et al., 1999) was acceptable; the sensitivity and specificity were 94.1% and 82.4%, respectively. The results of the agreement between the STAT and T-STAT and clinical diagnosis using the DSM-IV-TR (APA, 2000) were the same as the data shown by the ADOS. Conclusions: Our preliminary data demonstrated that the STAT and T-STAT as level 2 screening tools for autism spectrum disorders is promising. Further studies are needed to test more participants with both typical and atypical autism and to clarify the utility of the STAT and T-STAT in young children aged 2 to 3 with autism spectrum disorders. In addition, longitudinal work is needed to understand the stability of the diagnosis.

1. 吳進欽、姜忠信、侯育銘(2005)。自閉症兒童的立即模仿與延遲模仿之研究。中華心理衛生學刊，18(2)，1-24。
   連結：
2. 吳進欽、姜忠信、虞燕婷(2010)。自閉症類幼兒社會注意力的探究。中華心理學刊，52(1)，57-74。
   連結：
3. 姜忠信、宋維村(2005)。自閉症嬰幼兒的早期診斷：文獻回顧。臨床心理學刊，2(1)，1-10。
   連結：
4. Stone, W. L., & Ousley, O. Y. (2003). The working manual of Screening tool for autism in two-year-olds(STAT). Unpublished manuscript from TRIAD, Vanderbilt University Press..
5. American Psychiatric Association(2000).Diagnostic and Statistical Manual of Mental Disorders (4th ed-TR.).Washington DC:Author.
6. Bailey, A.,Phillips, W.,Rutter, M.(1996).Autism: towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives.Journal of Child Psychology and Psychiatry,37,89-126.
7. Baird, G.,Charman, T.,Baron-Cohen, S.,Cox, A.,Swettenham, J.,Wheelwright, S.,Drew, A.(2000).A screening instrument for autism at 18 months of age: A 6-year follow-up study.Journal of the American Academy of Child and Adolescent Psychiatry,39,694-702.
8. Baron-Cohen, S.,Allen, J.,Gillberg, C.(1992).Can autism be detected at 18 months? The needle, the haystack, and the CHAT.British Journal of Psychiatry,161,839-843.
9. Baron-Cohen, S.,Cox, A.,Baird, G.,Swettenham, J.,Nightingale, N.,Morgan, K.,Charman, T.(1996).Psychological markers in the detection of autism in infancy in a large population.British Journal of Psychiatry,168,158-163.
10. Carter, A.(2002).Assessing social-emotional and behavior problems and competencies in infancy and toddlerhood: available instruments and directions for application.Emotion regulation and developmental health: infancy and early childhood,New York:
11. Chiang, C. H.,Soong, W. T.,Lin, T. L.,Rogers, S. J.(2008).Nonverbal communication skill in young children with autism.Journal of Autism and Developmental Disorder,38,1898-1906.
12. Filipek, P. A.,Accardo, P. J.,Ashwal, S.,Baranek, G. T.,Cook, E. H., Jr.,Dawson, G.,Volkmar, F. R.(2000).Practice parameter: screening and diagnosis of autism: report of the quality standards subcommittee of the American Academy of Neurology and the Child Neurology Society.Neurology,55,468-479.
13. Kleinman, J. M.,Robins, D. L.,Ventola, P. E.,Pandey, J.,Boorstein, H.,Esser, E.,Fei, D.(2008).The modified checklist for autism in toddlers: a follow-up study investigating the early detection autism spectrum disorders.Journal of Autism and Developmental Disorder,38,827-839.
14. Landa, R. J.,Holman, K. C.,Garrett-Mayer, E.(2007).Social and communication development in toddlers with early and later diagnosis of autism spectrum disorders.Archives of General Psychiatry,64,853-864.
15. Lord, C.,Rutter, M.,DiLavore, P. C.,Risi, S.(1999).Autism Diagnostic Observation Schedule.LA:WPS.
16. Mullen, E.(1995).Mullen Scales of Early Learning.Cranston, RI:T.O.T.A.L. Child, Inc..
17. Ozonoff, S.,Losif, A. M.,Baguio, F.,Cook, I. C.,Hill, M. M.,Hutman, T.,Young, G. S.(2010).A prospective study of the emergence of early behavioral signs of autism.Journal of American Academy of Child and Adolescent Psychiatry,49,256-266.
18. Robins, D. L.,Fein, D.,Barton, M. L.,Green, J. A.(2001).The modified checklist for autism in toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders.Journal of Autism and Developmental Disorders,31,131-144.
19. Rogers, S.(2009).What are infant siblings teaching us about autism in infancy?.Autism Research,2,125-157.
20. Rogers, S. J.,Hepburn, S. L.,Stackhouse, T.,Wehner, E.(2003).Imitation performance in toddlers with autism and those with other developmental disorders.Journal of Child Psychology and Psychiatry,44,763-781.
21. Stone, W. L.,Coonrod, E. E.,Turner, L. M.,Pozdol, S. L.(2004).Psychometric properties of the STAT for early autism screening.Journal of Autism and Developmental Disorders,34,691-701.
22. Stone, W. L.,Coonrod, E.,Ousley, O. Y.(2000).Screening tool for autism in two-year-olds(STAT): development and preliminary data.Journal of Autism and Developmental Disorders,30,607-612.
23. Stone, W. L.,Ousley, O. Y.,Littleford, C.(1997).Motor imitation in young children with autism: what's the object?.Journal of Abnormal Child Psychology,25,475-485.
24. Stone, W. L.,Ousley, O. Y.,Yoder, P. J.,Hogan, K. L.,Hepburn, S. L.(1997).Nonverbal communication in two- and three-year-old children with autism.Journal of Autism and Developmental Disorders,27,677-696.
25. Stone, W.,McMahon, C. R.,Henderson, L. M.(2008).Use of the screening tool for autism in two-year-olds (STAT) for children under 24 months.Autism,12,557-573.
26. Swinkels, S. H.,Dietz, C.,van Daalen, E.,Kerkhof, I. H.,van Engeland, H.,Buitelaar, J. K.(2006).Screening for autistic spectrum in children aged 14 to 15 months. I: the development of the Early Screening of Autistic Traits Questionnaire (ESAT).Journal of Autism and Developmental Disorders,36,723-732.
27. Volkmar, F. R.(Ed.),Paul, R.(Ed.),Klin, A.(Ed.),Cohen, D.(Ed.)(2005).Handbook of autism and developmental disorders.New Jersey:John Wiley & Sons.
28. Wetherby, A.,Prizant, B.(2002).Communication and symbolic behavior scales developmental profile-first normed edition.Baltimore, MD:Paul H. Brookes.
29. Wetherby, A.,Wood, J.,Allen, L.,Cleary, J.,Dickinson, H.,Lord, C.(2004).Early indicators of autism spectrum disorders in the second year of life.Journal of Autism and Developmental Disorders,34,473-493.
30. 黃毅志(1998)。台灣地區新職業分類的建構與評估。調查研究，5，5-32。
31. 蔡文哲(1999)。行政院國家科學委員會專題計畫成果報告行政院國家科學委員會專題計畫成果報告,行政院國家科學委員會。
32. 謝清芬、宋維村、徐澄清(1983)。自閉症：克氏行為量表的效度與研究。中華民國神經精神醫學會會刊，9(1)，17-26。

1. 陳奕臻,洪楹佳,吳進欽(2019)。修訂版學步期自閉症檢核表在不同場域篩檢自閉症類群障礙症幼兒的正確率。特殊教育研究學刊，44(3)，33-61。
2. 陳昭芬,吳進欽(2019)。台灣學齡前自閉症類群障礙兒童篩檢工具：文獻回顧。若瑟醫護雜誌，13(1)，23-37。
3. 侯育銘、李羽涵、吳進欽、朱慶琳(2015)。結合多重訊息來源篩檢3歲以下自閉症類群疾患幼兒。中華心理衛生學刊，28(4)，605-630。
4. 侯育銘、吳進欽、朱慶琳(2016)。2歲前自閉症類群障礙症早期篩檢：18個月後追蹤。中華心理衛生學刊，29(4)，327-356。
5. 姜忠信、侯育銘、林姿伶、吳進欽、朱慶琳(2014)。T-STAT評估18~24個月自閉症類嬰幼兒效度探究。中華心理衛生學刊，27(4)，621-644。
6. 姜忠信、侯育銘、吳進欽(2013)。兩歲前自閉症類疾患嬰幼兒篩檢工具：文獻回顧。中華心理衛生學刊，26(4)，549-568。
7. 姜忠信、吳進欽(2011)。自閉症類幼兒標準化發展測驗的表現。應用心理研究，51，15-40。
8. 李沿澈、李羽涵、吳進欽(2016)。自閉症類群疾患幼兒語言能力相關因素：共享式注意力與模仿。中華心理學刊，58(3)，187-206。
9. 李沿澈、李羽涵、吳進欽(2016)。自閉症類群障礙幼兒共享式注意力和語言能力、心智能力、適應功能及自閉症症狀的關係。中華心理衛生學刊，29(3)，227-259。
10. 林玲伊、阮麗敏(2015)。「中文版泛自閉症篩檢量表」2~5 歲幼兒短版之信效度分析。測驗學刊，62(1)，25-44。
11. 林昇億,吳進欽,朱慶琳(2019)。自閉症類群障礙與發展遲緩幼兒共享式注意力與模仿能力的表現。特殊教育研究學刊，44(3)，1-31。
12. 姚淑芬、侯育銘、吳進欽、朱慶琳(2014)。克氏行為量表篩檢4歲以下自閉症類疾患兒童效度探究。中華心理衛生學刊，27(1)，131-161。
13. (2012)。T-STAT評估學齡前自閉症類兒童效度的探究。教育與心理研究，35(1)，81-98。
14. (2014)。兒童期自閉症評量表診斷自閉症類幼兒的效度。教育與心理研究，37(1)，37-59。