题名

克氏行為量表篩檢4歲以下自閉症類疾患兒童效度探究

并列篇名

Validity of the Clancy Behavior Scale for Detecting Autism Spectrum Disorders in Children Younger than 4 Years Old

DOI

10.30074/FJMH.201403_27(1).0005

作者

吳進欽(Chin-Chin Wu)；朱慶琳(Ching-Lin Chu)；侯育銘(Yuh-Ming Hou)；姚淑芬(Shu-Fen Yao)

关键词

自閉症類疾患 ； 克氏行為量表 ； 早期診斷 ； 敏感度 ； 特異度 ； autism spectrum disorder ； Clancy Behavior Scale ； early diagnosis ； sensitivity ； specificity

期刊名称

中華心理衛生學刊

卷期/出版年月

27卷1期（2014 / 03 / 01）

页次

131 - 161

内容语文

繁體中文
中文摘要

研究目的：目前篩檢4歲以下自閉症類疾患兒童與發展遲緩兒童的工具不多，這個問題會妨礙自閉症類疾患兒童的早期診斷與早期療育工作。因此，本研究目的探討家長填寫的篩檢問卷「克氏行為量表（Clancy Behavior Scale）」，運用在篩檢4歲以下自閉症類疾患兒童的效度。研究方法：152名生理年齡介於18-47個月之間的兒童，包括：62名自閉症類疾患兒童與90名發展遲緩兒童，由家長填寫克氏行為量表。研究結果：本研究發現克氏行為量表，在篩檢4歲以下自閉症類疾患兒童的效度尚佳。使用訊號偵測理論決定最佳切截分數，以總分12作為切截分數，敏感度與特異度分別是.74與.73。以判別分析的結構矩陣，找出9題關鍵題目。一樣使用訊號偵測理論決定9題關鍵題目的最佳切截分數，以總分7作為切截分數，敏感度與特異度分別是.76與.76。本研究結果顯示以簡版的克氏行為量表進行篩檢，敏感度與特異度優於全部14題。因此，本研究建議用9題版作為篩檢版本，採用4題版作為初步篩檢。研究結論：本研究初步結果支持克氏行為量表可以用來當作自閉症類疾患兒童層次二篩檢工具，後續需要更多的受試者來驗證克氏行為量表的篩檢效度及篩檢指標。
英文摘要

Purpose: Few screening tools exist that are specific for distinguishing autism spectrum disorders (ASD) from developmental delay (DD) in children under four years old. The availability of such a tool would reduce the difficulty of early diagnosis and aid early intervention for children with ASD. The current study applied the Clancy Behavior Scale, a parent-report questionnaire, to detect ASD in children under four. Methods: Parents of 152 children from 18 to 47 months old, including 62 children with ASD and 90 children with DD, completed the measure. Results: Analysis of the data indicated that the Clancy Behavior Scale is a promising screening tool. Using a signal detection procedure, a score of 12 was used as the cut-off to distinguish children with ASD from those with DD. The sensitivity and specificity were .74 and .73, respectively. Using a discriminant analysis structure matrix, we selected 9 of the 14 items of the Clancy Behavior Scale as critical items. Using a signal detection procedure again, a score of 7 was used as the cut-off for the 9 critical items to distinguish young children with ASD from those with DD. Both the sensitivity and specificity of short form were .76 and .76, respectively. The results supported the utility of applying the short form Clancy Behavior Scale to detect ASD in young children; both the sensitivity and specificity were better than with the 14-item measure. We suggest that the 9-item form be used to assess, and that 4 items be used for the initial screening. Conclusions: The current preliminary data demonstrated that the Clancy Behavior Scale can be used as a level-two screening tool for children under four with ASD. Future studies are needed to recruit a larger sample size and to validate the accuracy of using the Clancy Behavior Scale to diagnose and screen young children with ASD.
主题分类 社會科學 > 心理學
参考文献
  1. 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：
  2. 姜忠信、吳進欽、劉俊宏、侯育銘(2012)。2-3歲自閉症幼兒篩檢量表的發展：T-STAT的初究。中華心理衛生學刊，25(1)，135-154。
    連結：
  3. 姜忠信、宋維村(2005)。自閉症嬰幼兒早期診斷：文獻回顧。臨床心理學刊，2(1)，1-10。
    連結：
  4. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217-250.
  5. American Psychiatric Association(2000).Diagnostic and statistical manual of mental disorders.Washington DC:American Psychiatric Association.
  6. Baird, G.,Simonoff, E.,Pickles, A.,Chandler, S.,Loucas, T.,Meldrum, D.,Charman, T.(2006).Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP).Lancet,368(9531),210-215.
  7. Baranek, G. T.(1999).Autism during infancy: A retrospective video analysis of sensory-motor and social behaviors at 9-12 months of age.Journal of Autism and Developmental Disorders,29(3),213-224.
  8. Barbaro, J.,Dissanayake, C.(2013).Early markers of autism spectrum disorders in infants and toddlers prospectively identified in the social attention and communication study.Autism,17(1),64-86.
  9. 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.
  10. Barton, M. L.,Dumont-Mathieu, T.,Fein, D.(2012).Screening young children for autism spectrum disorders in primary practice.Journal of Autism and Developmental Disorders,42(6),1165-1174.
  11. Berument, S. K.,Rutter, M.,Lord, C.,Pickles, A.,Bailey, A.(1999).Autism screening questionnaire: Diagnostic validity.British Journal of Psychiatry,175,444-451.
  12. Brian, J.,Bryson, S. E.,Garon, N.,Roberts, W.,Smith, I. M.,Szatmari, P.,Zwaigenbaum, L.(2008).Clinical assessment of autism in high-risk 18-month-olds.Autism,12(5),433-456.
  13. Bryson, S. E.,Rogers, S. J.,Fombonne, E.(2003).Autism spectrum disorders: Early detection, intervention, education, and psychopharmacological management.Canadian Journal of Psychiatry,48(8),506-516.
  14. Centers for Disease Control and Prevention(2012).Prevalence of Autism Spectrum Disorders-Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008.MMWR Surveillance Summaries,61(3),1-19.
  15. Chawarska, K.,Klin, A.,Paul, R.,Macari, S.,Volkmar, F.(2009).A prospective study of toddlers with ASD: Short-term diagnostic and cognitive outcomes.Journal of Child Psychology and Psychiatry,50(10),1235-1245.
  16. 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(10),1898-1906.
  17. Chiang, C. H.,Wu, C. C.,Hou, Y. M.,Chu, C. L.,Liu, J. H.,Soong, W. T.(2013).Development of T-STAT for early autism screening.Journal of Autism and Developmental Disorders,43(5),1028-1037.
  18. Chlebowski, C.,Green, J. A.,Barton, M. L.,Fein, D.(2010).Using the Childhood Autism Rating Scale to diagnose autism spectrum disorders.Journal of Autism and Developmental Disorders,40(7),787-799.
  19. Clancy, H.,Dugdalei, A.,Rendle-Shortt, J.(1969).The diagnosis of infantile autism.Developmental Medicine and Child Neurology,11(4),432-442.
  20. Constantino, J. N.,Przybeck, T.,Friesen, D.,Todd, R. D.(2000).Reciprocal social behavior in children with and without pervasive developmental disorders.Journal of Developmental and Behavioral Pediatrics,21(1),2-11.
  21. Dawson, G.,Munson, J.,Estes, A.,Osterling, J.,McPartland, J.,Toth, K.,Carver, L.,Abbott, R.(2002).Neurocognitive function and joint attention ability in young children with autism spectrum disorder versus developmental delay.Child Development,73(2),345-358.
  22. Dawson, G.,Toth, K.,Abbott, R.,Osterling, J.,Munson, J.,Estes, A.,Liaw, J.(2004).Early social attention impairments in autism: social orienting, joint attention, and attention to distress.Developmental Psychology,40(2),271-283.
  23. De Giacomo, A.,Fombonne, E.(1998).Parental recognition of developmental abnormalities in autism.European Child and Adolescent Psychiatry,7(3),131-136.
  24. Dietz, C.,Swinkels, S.,van Daalen, E.,van Engeland, H.,Buitelaar, J. K.(2006).Screening for autistic spectrum disorder in children aged 14-15 months. II: Population screening with the Early Screening of Autistic Traits Questionnaire (ESAT). Design and general findings.Journal of Autism and Developmental Disorders,36(6),713-722.
  25. Ehlers, S.,Gillberg, C.,Wing, L.(1999).A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children.Journal of Autism and Developmental Disorders,29(2),129-141.
  26. Estes, A.,Munson, J.,Dawson, G.,Koehler, E.,Zhou, X. H.,Abbott, R.(2009).Parenting stress and psychological among mothers of preschool children with autism and developmental delay.Autism,13(4),375-387.
  27. Estes, A.,Olson, E.,Sullivan, K.,Greenson, J.,Winter, J.,Dawson, G.,Mnuson, J.(2013).Parenting-related stress and psychological distress in mothers of toddlers with spectrum disorders.Brain and Development,35(2),133-138.
  28. Fernell, E.,Hedvall, A.,Westerlund, J.,Höglund Carlsson, L.,Eriksson, M.,Barnevik Olsson, M.,Gillberg, C.(2011).Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study.Research in Developmental Disabilities,32(6),2092-2101.
  29. 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(4),468-479.
  30. Fombonne, E.(2009).Epidemiology of pervasive developmental disorders.Pediatric Research,65(6),591-598.
  31. Gardner, L. M.,Murphy, L.,Campbell, J. M.,Tylavsky, F.,Palmer, F. B.,Graff, J. C.(2013).Screening accuracy for risk of autism spectrum disorder using the Brief Infant-Toddler Social and Emotional Assessment (BITSEA).Research in Autism Spectrum Disorders,7(5),591-600.
  32. Glascoe, F. P.(2005).Screening for developmental and behavioral problems.Mental Retardation and Developmental Disabilities,11(3),173-179.
  33. Gray, K. M.,Tonge, B. J.,Brereton, A. V.(2006).Screening for autism in infants, children, and adolescents.International Review of Research in Mental Retardation,32,197-227.
  34. Griffith, E. M.,Pennington, B. F.,Wehner, E., A.,Rogers, S. J.(1999).Executive functions in young children with autism.Child Development,70(4),817-832.
  35. Itzchak, E. B.,Zachor, D. A.(2009).Change in autism classification with early intervention: Predictors and outcomes.Research in Autism Spectrum Disorders,3(4),967-976.
  36. Kleinman, J. M.,Robins, D. L.,Ventola, P. E.,Pandey, J.,Boorstein, H. C.,Esser, E. L.,Fein, D.(2008).The Modified Checklist for Autism in Toddlers: A follow-up study investigating the early detection of autism spectrum disorders.Journal of Autism and Developmental Disorders,38(5),827-839.
  37. Kogan, M. D.,Blumberg, S. J.,Schieve, L. A.,Boyle, C. A.,Perrin, J. M.,Ghandour, R. M.,van Dyck, P. C.(2009).Prevalence of parent-reported diagnosis of autism spectrum disorder among children in the US, 2007.Pediatrics,124(5),1395-1403.
  38. Koyama, T.,Inokuchi, E.,Inada, N.,Koroda, M.,Moriwaki, A.,Katagiri, M.,Kamio, Y.(2010).Utility of the Japanese version of the checklist for autism in toddlers for predicting pervasive developmental disorders at age 2.Psychiatry and Clinical Neurosciences,64(3),330-332.
  39. Landa, R. J.,Holman, K. C.,O'Neill, A. H.,Stuart, E. A.(2011).Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: A randomized controlled trial.Journal of Child Psychology and Psychiatry,52(1),13-21.
  40. Lord, C.,Rutter, M.,DiLavore, P. C.,Risi, S.(1999).Autism Diagnostic Observation Schedule (ADOS).LA:Western Psychological Services.
  41. Lotter, V.(1966).Epidemiology of autistic conditions in young children: I. Prevalence.Social Psychiatry,1(3),124-137.
  42. Malhi, P.,Singhi, P.(2011).Follow up of children with autism spectrum disorders: Stability and change in diagnosis.Indian Journal of Pediatrics,78(8),941-945.
  43. Mullen, E.(1995).Mullen Scales of Early Learning.Cranston, RI.:T.O.T.A.L. Child, Inc.
  44. Norris, M.,Lecavalier, L.(2010).Screening accuracy of level 2 autism spectrum disorders rating scales: A review of selected instruments.Autism,14(4),263-284.
  45. Noterdaeme, M.,Hutzelmeyer-Nickels, A.(2010).Early symptoms and recognition of pervasive developmental disorders in Germany.Autism,14(6),575-588.
  46. Nygren, G.,Cederlund, M.,Sandberg, E.,Gillstedt, F.,Arvidsson, T.,Carina Gillberg, I.,Gillberg, C.(2012).The prevalence of autism spectrum disorders in toddlers: A population study of 2-year-old Swedish children.Journal of Autism and Developmental Disorders,42(7),1491-1497.
  47. Osterling, J. A.,Dawson, G.,Munson, J. A.(2002).Early recognition of 1-year-old infants with autism spectrum disorder versus mental retardation.Development and Psychopathology,14(2),239-251.
  48. Osterling, J.,Dawson, G.(1994).Early recognition of children with autism: A study of first birthday home videotapes.Journal of Autism and Developmental Disorders,24(3),247-257.
  49. Ozonoff, S.,Goodlin-Jones, B. L.,Solomon, M.(2005).Evidence-based assessment of autism spectrum disorders in children and adolescents.Journal of Clinical Child and Adolescent Psychology,34(3),523-540.
  50. Risi, S.,Lord, C.,Gotham, K.,Corsello, C.,Chrysler, C.,Szntmari, P.,Pickles, A.(2006).Combining information for multiple sources in the diagnosis of autism spectrum disorders.Journal of the American Academy of Child and Adolescent Psychiatry,45(9),1094-1103.
  51. 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(2),131-144.
  52. Rogers, S. J.,DiLalla, D. L.(1990).Age of symptom onset in young children with pervasive developmental disorders.Journal of the American Academy of Child and Adolescent Psychiatry,29(6),863-872.
  53. 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(5),763-781.
  54. Rutter, M.,LeCouteur, A.,Lord, C.(2003).Autism Diagnostic Interview-Revised (ADI-R).LA:Western Psychological Services.
  55. Saint-Georges, C.,Cassel, R. S.,Cohen, D.,Chetouani, M.,Laznik, M.,Masteo, S.,Muratori, F.(2010).What studies of family home movies can teach us about autistic infants: A literature review.Research in Autism Spectrum Disorders,4(3),355-366.
  56. Samadi, S. A.,Mahmoodizadeh, A.,McConkey, R.(2012).A national study of the prevalence of autism among five-year-old children in Iran.Autism,16(1),5-14.
  57. Scott, F. J.,Baron-Cohen, S.,Bolton, P.,Brayne, C.(2002).The CAST (Childhood Asperger Syndrome Test): Preliminary development of UK screen for mainstream primary-school children.Autism,6(1),9-31.
  58. Seymour, M.,Wood, C.,Giallo, R.,Jellett, R.(2013).Fatigue, stress and coping in mothers of children with an autism spectrum disorder.Journal of Autism and Developmental Disorders,43(7),1547-1554.
  59. Snow, A. V.,Lecavalier, L.(2008).Sensitivity and specificity of the Modified Checklist for Autism in Toddlers and the Social Communication Questionnaire in preschooler suspected of having pervasive developmental disorders.Autism,12(6),627-644.
  60. 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(6),691-701.
  61. Stone, W. L.,Mcmahon, C. R.,Henderson, L. M.(2008).Use of the Screening Tool for Autism in Two-year-olds (STAT) for children under 24 months: an exploratory study.Autism,12(5),557-573.
  62. Strauss, K.,Vicari, S.,Valeri, G.,D'Elia, L.,Arima, S.,Fava, L.(2012).Parent inclusion in early intensive behavioral intervention: the influence of parental stress, parent treatment fidelity and parent-mediated generalization of behavior targets on child outcomes.Research in Developmental Disabilities,33(2),688-703.
  63. Swets, J. A.(1998).Measuring the accuracy of diagnostic systems.Science,240(4857),1285-1293.
  64. Tsai, W. C.,Soong, W. T.,Shyu, Y. I.(2012).Toddler Autism Screening Questionnaire: Development and potential clinical validity.Autism,16(4),340-349.
  65. Veness, C.,Prior, M.,Bavin, E.,Eadie, P.,Cini, E.,Reilly, S.(2012).Early indicators of autism spectrum disorders at 12 and 24 months of age: A prospective, longitudinal comparative study.Autism,16(2),163-177.
  66. Volkmar, F. R.(Ed.),Paul, R.(Ed.),Klin, A.(Ed.),Cohen, D.(Ed.)(2005).Handbook of autism and pervasive developmental disorders.NJ:John Wiley & Sons.
  67. Wetherby, A. M.(Ed.),Prizant, B. M.(Ed.)(2000).Autism spectrum disorders: A transactional developmental perspective.Baltimore:Brookes.
  68. Wetherby, A. M.,Prizant, B. M.(2002).Communication and Symbolic Behavior Scales developmental profile- first normed edition.Baltimore, MD:Paul H. Brookes.
  69. Wetherby, A. M.,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(5),473-493.
  70. Wiggins, L. D.,Baio, J.,Rice, C.(2006).Examination of the time between first evaluation and first autism spectrum diagnosis in a population-based sample.Journal of Developmental and Behavioral Pediatrics,27(2 Suppl),79-87.
  71. Wong, V.,Hui, L. H. S.,Lee, W. C.,Leung, L. S.,Ho, P. K.,Lau, W. L.,Fung C. W.,Chung, B.(2004).A modified screening tool for autism (Checklist for Autism in Toddlers [CHAT- 23] for Chinese children.Pediatrics,114(2),166-176.
  72. Woolfenden, S.,Sarkozy, V.,Ridley, G.,Williams, K.(2012).A systematic review of the diagnostic stability of autism spectrum disorder.Research in Autism Spectrum Disorders,6(1),345-354.
  73. Wu, C. C.,Chiang, C. H.,Hou, Y. M.(2011).A two time point study of imitative abilities in children with autism spectrum disorders.Journal of Applied Research in Intellectual Disabilities,24(1),39-49.
  74. Zwaigenbaum, L.,Bryson, S.,Rogers, T.,Roberts, W.,Brain, J.,Szatmari, P.(2005).Behavioral manifestations of autism in the first year of life.International Journal of Developmental Neuroscience,23(2-3),143-152.
  75. 余麗樺、郭乃文、潘秀琴(1998)。盧─尼神經心理測驗組中文修訂版的信效度研究。台灣精神醫學，12(4)，365-378。
  76. 吳進欽、姜忠信、侯育銘、劉俊宏、朱慶琳(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。
  77. 張正芬、王華沛(2005)。「自閉症兒童行為檢核表」之編製及相關研究。特殊教育研究學刊，28，145-166。
  78. 陳韻如、雷庚玲、鄭欣宜、王麗娟、柯乃綺、黃奕偉、蔡文哲(2009)。自閉症兒童氣質與親職壓力之個別差異。中華心理學刊，51(2)，175-196。
  79. 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。
被引用次数
  1. 陳庭筠,吳進欽,甘如晶(2018)。克氏行為量表篩檢自閉症類群障礙嬰幼兒的效度探究。臨床心理學刊，12(1/2)，35-51。
  2. 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。
  3. 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。
  4. 陳昭芬,吳進欽(2021)。克氏行為量表篩檢自閉症類群障礙症幼兒：追蹤研究。若瑟醫護雜誌，15(1)，6-19。
  5. 陳昭芬,吳進欽(2023)。自閉症類群障礙症幼兒社會功能的發展：縱貫研究。若瑟醫護雜誌，17(1)，6-20。
  6. 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。
  7. 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。
  8. 廖御圻,詹雅雯,楊建銘,郭乃文,許文耀,姜忠信,花茂棽,林耀盛,林宜美,吳英璋,王韋婷(2019)。科學家與實務者：台灣臨床心理學的共時性顧後瞻前。中華心理學刊，61(4)，361-392。
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