A Study On The Application Of Autism Screening Scale

【Objectives】To screen for autism spectrum disorders(ASDs) among children aged 18-24 months in Luwan District of Shanghai,and to evaluate the validity and feasibility of CHAT-23 as a screening instrument.【Methods】1)The 18-24 months-old children who accepted vaccination and conventional medical examination in community hospitals of Luwan District during Dec.2008 to Feb.2009 were investigated with CHAT-23 self-administered questionnaires by asking the parents to fill the questionnaires on the spot,sending the questionnaires by mail and inquiring on the phone.2) The children screened positive on the questionnaires were called to attend Section B interviews and intellectual assessments in our hospital,and children with a high risk for ASDs were called to attend regular follow-up visits.3) To calculate the sensitivity,specificity and positive predictive value(PPV) of CHAT-23 self-administered questionnaire.Autistic children aged below four years old (diagnosed by Child Health Care Department of Children's Hospital of Fudan University) were recruited as the patient group,and the non-autistic children from communities were recruited as the control group.4) Some family situations of the false-positive group and negative group were collected to explore the influencing factors for false-positive.【Results】1) 484 children were screened in total,covering 90.5%of the children in Luwan District.In result,58 children(12%of the whole group) were screened positive on the questionnaires,including 24 girls and 34 boys.The mean age of them is 21.23±2.32 months(18.00-25.17 months). 2) Among the 32 children attending Section B interview and intellectual assessment,6 children still got a positive result,and the other 26 children got a negative result.After further assessments to the 32 children,we considered 21 of them normal,2 with mental retardation,7 with language delay(4 of them had a mental age below 18 months).And 2 children with a high risk for ASDs were called to attend regular follow-up visits.3) In our screening,the sensitivity and specificity of CHAT-23 self-administered questionnaires were 0.941 and 0.884,respectively.The PPV for CHAT-23 self-administered questionnaires plus Section B interview was 50%among community children.4) Through the rank sum test between family situations of the false-positive group and negative group,the educational level of parents and the person filling out the questionnaire were considered as the influencing factor for false-positive.The parents and the person filling out the questionnaire of lower educational level may cause false-positive.【Conclusions】CHAT-23 is an applicable autism screening scale for primary health care institutions.It can effectively find out the children with the risk of ASDs, timesavingly and costlessly.So it can be used at 18- and 24-months well-child visits.