台灣學齡前自閉症類群障礙兒童篩檢工具：文獻回顧

Screening Tools for Autism Spectrum Disorder in Preschool Children in Taiwan: A Literature Review

吳進欽(Chin-Chin Wu)；陳昭芬(Chao-Fen Chen)

自閉症類群障礙症 ； 特異度 ； 敏感度 ； 篩檢 ； autism spectrum disorder ； specificity ； sensitivity ； screening

若瑟醫護雜誌

13卷1期（2019 / 06 / 01）

23 - 37

繁體中文

背景與目的：自閉症類群障礙症篩檢工具分兩個層次，層次一用在社區篩檢，層次二用在高風險群篩檢。本文回顧台灣學齡前自閉症類群障礙兒童篩檢工具的研究。方法：本研究回顧可以用在學齡前自閉症類群障礙兒童，已經在期刊發表的自閉症類群障礙症篩檢工具的研究，及正式出版的篩檢工具。本文針對篩檢工具的適用年齡、切截分數、敏感度與特異度，依據層次一與層次二的分類進行介紹。結果：台灣目前學齡前自閉症類群障礙兒童篩檢工具，層次一有五項，層次二有七項。層次一篩檢工具，「學步期自閉症篩檢問卷」與「中文版泛自閉症篩檢量表」敏感度與特異度皆為優良；層次二篩檢工具，「台灣版兩歲期自閉症篩檢工具」與「兒童期自閉症評估量表」敏感度與特異度屬於理想到優良。三項層次一篩檢工具運用在高風險樣本的篩檢，敏感度介於尚可到理想。兩項層次二篩檢工具，其對照組為一般發展兒童，高風險樣本篩檢標準需要再檢驗。結論：台灣自閉症類群障礙症篩檢工具適用3歲以下的幼兒不多，特別是行為觀察的工具。未來的研究，可以重覆驗證目前的篩檢工具或發展新的篩檢工具。

Background and purpose: Screening tools for autism spectrum disorder (ASD) can be divided into two levels. Level 1 screening tools are used for screening in communities, whereas Level 2 refers to those used for screening high risk samples. In this study we reviewed the literature that investigated the utility of the ASD screening instruments for preschool-aged children in Taiwan. Methods: We reviewed the articles published in scholarly journals that explored the adaptability of the screening tools for ASD in preschool-aged children as well as the manuals for ASD screening instruments. We present the information regarding the age range, cutoff scores, sensitivity, and specificity of each available screening tool for ASD in Taiwan. Results: Currently, there are 12 screening tools for ASD that are suitable for preschool-aged children in Taiwan. Among those, 5 belong to Level 1 and the rest are categorized as Level 2. Both the Toddler Autism Screening Questionnaire and the Autism Spectrum Rating Scales Chinese version, which are Level 1 screening tools for ASD, showed excellent sensitivity and specificity. Among the Level 2 instruments, both the Screening Tool for Autism in Two-Year-Olds and the Childhood Autism Rating Scale demonstrated good or excellent sensitivity and specificity. There are three Level 1 screening tools that could be utilized to detect autism in high risk children with fair or good sensitivity and specificity. However, there are two Level 2 screening tools that their reference groups are made up of typically-developed individuals. Therefore, their cutoff scores used to detect at-risk ASD in high risk sample might need to be revised. Conclusion: In Taiwan, there are few screening tools for ASD that could apply to children under 3, especially those used for interactive behavior observation. Researchers need to periodically examine the currently accessible screening tools or develop new ones in the future.

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