中華心理衛生協會

Purpose: The purpose of this study is to investigate the short-term predictive accuracy of the Screening Tool for Autism in Two-Year-Olds Taiwan Version (T-STAT) and the Clancy Behavior Scale (CBS) in detecting autism spectrum disorder (ASD) in toddlers before age 2. The T-STAT is an interactive tool that allows an examiner to assign a classification to ASD in toddlers, and the CBS is a parent-report questionnaire for caregivers to fill out based on the daily behaviors of their children. We examined the relationship between a child’s T-STAT and CBS scores at the initial assessment and the child’s language ability, behavioral problems, and autistic symptoms at 18 months follow-up. Methods: Participants included 50 toddlers aged 18 to 24 months, 25 with ASD and 25 with developmental delays. All toddlers were first recruited for participation between June 2012 and June 2014, and the follow up were executed between December 2013 and December 2015. Both the T-STAT and CBS were used to evaluate each toddler at an initial assessment. Eighteen months later, the measures of children’s language ability, behavioral problems, and autistic symptoms were administered to the same participants whose diagnoses were also confirmed at the time. Results: The T-STAT classification had high short-term predictive accuracy (76~88%). However, the CBS classification had poor short-term predictive accuracy (40~76%). For the toddlers with ASD, the T-STAT score significantly correlated with language ability and autistic symptoms, and the CBS score significantly correlated with externalizing behavioral problems. For toddlers with developmental delays, only the CBS score significantly correlated with externalizing behavioral problems. Conclusions: The results indicated high short-term predictive accuracy for both tests for toddlers with ASD before age 2, supporting previous assertions that the T-STAT is a promising level-two screening tool for differentiating toddlers with ASD from toddlers with developmental delays. The finding that the T-STAT score correlated with language ability and autistic symptoms, and the CBS score correlated with externalizing behavioral problems indicates that parents think of autistic symptoms as behavioral characters instead of impairments. Parents need education regarding early signs of ASD to enhance their ability to recognize early indicators. The next step for future research is to replicate these findings with a larger cohort of participants.