中華心理衛生協會

Purpose: It is conventional to use screening tools to diagnose children with autism spectrum disorders (ASDs) in a clinical setting. However, no study has used different ASDs screening tools simultaneously to screen young children with ASDs. In the current study, we examine the validity of diagnoses based on combining multiple information sources for screening young children with ASDs. Methods: A total of 90 young children aged 24 -36 months and their caregivers were recruited between April 2012 and April 2015. They comprised two groups, including 45 with ASDs, and 45 with developmental delays. The groups were matched on chronological age, mental age, and sex ratio. The Screening Tool for Autism in Two-Year-Olds Taiwan Version (T-STAT) and the Clancy Behavior Scale (CBS) were used simultaneously to screen ASDs. The T-STAT is an interactive tool in which the examiner directly observes the social-communicative behaviors of the children in strange contexts. The CBS is a parent report questionnaire for caregivers to fill out based on the daily behaviors of their children. For the CBS, we used two criteria: sum scores of the total 14 items (CBS-14), and the critical nine items (CBS-9). Results: Using 2 as the cutoff for the T-STAT, the results yielded a sensitivity of .89, and a specificity of .84. The T-STAT had good accuracy of classification. Using 12 as the cutoff score for the CBS-14, the results indicated a sensitivity of .78, and specificity of. 71. Using the 7 as the cutoff score for the CBS-9, the results indicated a sensitivity and specificity of .76. The CBS had an acceptable classification accuracy, but the accuracy of the T-STAT was higher. Combining the T-STAT and the CBS-14 yielded a sensitivity of .97 and specificity of .96. Combining the T-STAT and the CBS-9 yielded a sensitivity of .97 and specificity of 1. The results indicated that combing multiple information sources resulted in excellent classification accuracy. Conclusions: The current study replicated prior results indicating that the T-STAT is a promising level-two screening tool for differentiating young children with ASDs from young children with developmental delays. However, the CBS is only an acceptable leveltwo screening tool. Combining the information from the two screening tools in a clinical setting yielded excellent sensitivity and specificity. However, when the results of the T-STAT and CBS are different, an interview may be needed to further clarify the diagnosis.