摘要
目的:在引进改良婴幼儿孤独症量表(M-CHAT)基础上,对该量表的评分方法进行修订,检验修订评分方法后量表的信效度。方法:保留量表原来所有条目内容,将其中的22个条目的 "是/否"二级评分改为"从不/偶尔/有时/经常"四级评分,分值相应地设定为3、2、1、0分。条目11、18、20、22为逆向条目,分值设置方向相反;条目16评分"是/否",设定为0、1分,从而形成M-CHAT中文修订版。对93名符合美国精神障碍诊断与统计手册第4版诊断标准的孤独症患儿进行M-CHAT中文修订版评定,其中56名患儿同时评定儿童孤独症评定量表(CARS),以检验其校标效度。52名患儿2～4周后再次进行M-CHAT中文修订版评定,以检测重测信度。对85名正常儿童进行M-CHAT中文修订版评定。共有117名被试(56名孤独症儿童,61名正常对照)的2位家长同时单独对被试进行M-CHAT中文修订版评定,以检测评分者信度。结果:M-CHAT中文修订版单项评分者信度的组内相关系数(ICC)为0.41～1,总分评分者信度相关系数为0.89(P均<0.01)。单项重测信度ICC为0.15～1,总分重测信度相关系数为0.83(均P<0.01,项目10除外)。内部一致性检验Cronbachα系数为0.90(P<0.01)。M-CHAT中文修订版有2个条目与总分间相关系数分别为-0.35、-0.13;其余21个条目与总分间相关系数在0.13～0.84之间(均P<0.01)。M-CHAT中文修订版总分与CARS量表总分之间相关系数为0.49(P<0.01)。当总分界限分定为17分时,M-CHAT中文修订版灵敏度为0.91,特异度为0.81。结论:M-CHAT中文修订版的信、效度均优于M-CHAT中文版,更适用于儿童孤独症的早期筛查。
Objective： To revise the scoring method of the Chinese Version of the Modified Checklist for Au- tism in Toddlers （M-CHAT）, and investigate its reliability and validity. Methods： The Chinese revised version of M-CHAT included all questions of the Chinese version of M-CHAT, but the answers of 22 items changed from ＂yes / no＂ to＂ never / occasionally / sometimes / often＂. The score of these items correspondingly changed from ＂1/0＂ to ＂3/2/1/0＂ except for items 11, 18, 20 and 22 which scores were adverse. The score of item 16 was still ＂0/1＂. Ninety-three outpatient children diagnosed as autistic disorder according to the Diagnostic and Statistical Manual of Mental Disorders-IV（DSM-IV） were included, all of them were evaluated by the Chinese revised version of MCHAT, fifty-six of them were evaluated by the Childhood Autism Rating Scale （CARS） to investigate the criterion validity, fifty-two of them were re-evaluated by the Chinese revised version of M-CHAT again 2 - 4 weeks later to investigate the test-retest reliability. Eighty-five normal children were evaluated by the Chinese revised version of M-CHAT. Two caregivers of 117 subjects, including 56 autistic children and 61 normal children, fulfilled the Chi- nese revised version of M-CHAT separately at the same time to investigate the inter-rater liability. Results： The sin- gle itemis intraclass correlation coefficients （ICC） of inter-rater reliability ranged from 0.41 to 1. The inter-rater re- liability correlation coefficient of total score was 0. 89, P 〈 0.01. The single item＂ s ICC of test-retest reliability ranged from 0. 15 to 1, and the correlation coefficient of test-retest reliability of total score was 0. 83 （Ps 〈 0. 01 ex- cept item 10）. The internal consistency coefficient of the scale was 0. 90, P 〈 0. 01. All correlation coefficients of the content validity were positive except two which were -0. 35 and -0. 13, and the coefficients ranged from 0. 13 to 0. 84, P 〈 0. 01. The criterion validity coefficients of M-CHAT with CARS was 0. 49, P 〈 0.01. When the cutoff point was set at 17, the sensitivity was 0. 91, and the specificity was 0. 81. Conclusions： The reliability and validity of the Chinese revised version of M-CHAT are superior to that of the Chinese version of M-CHAT and it is more suitable for the early screening of autism.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2012年第6期476-480,共5页
Chinese Mental Health Journal
