A Study On The Comparison Of Early Screening Instruments And Risk Factors Of Preschool Children Autism

Objective:To investigate the effectiveness of two introduced non-standarded screening instruments for Autism, Early Autism Screening Items and Pictural Autism Screening Scale for Infant and Toddlers, and the main risk factors of Autism.Methods:With the multistage stratified sampling,we randomly selected 400 normal children and 25 autism children as study samples.We screened 425 children with three scales,which were EASI,PASS-IT and Modified Checklist for Autism in Toddlers.The Modified Checklist for Autism(M-CHAT) was a standard screening instrument for Autism. We evaluated the validity of EASI and PASS-IT with some indicators.We also used the t test andχ2 test for the single-factor analysis,and used the nonconditional logistic regression for the multi-factor analysis. In this study,we adapted Diagnostic and statistical manual of mental disorder 4th ed as gold standard.Results:The sensitivity of EASI and PASS-IT was superior to M-CHAT, was 80.00%,88.00% and 72.00% respectively, but the differences were not significant; the specificity was inferior,was 75.00%, 64.25% and 94.50% respectively, and the differences were significant.The combined screening effectiveness of the three instruments was superior to any single one.The sensitivity of parallel test was the maximum,was 92.00%;and the specificity of series test was the maximum,was 98.25%. All the other evaluated indicators of series test, such as positive likelihood ratio, diagnostic index,Youden index,crude accuracy,positive predictive value and negative predictive value, were superior to any other screening result.We also found that sex is man,retarded birth and non-breastfeeding before six months were the main risk factors of autism. Children's father with higher education level and children always playing with parents or other kids had the preventive effect against autism.Conclusion:It was feasible to combine the two new instruments with the M-CHAT in the differentiating autism children from the general population, in that it had a superior effctiveness.The autism had something with children's health, pregnant and perinatal factors and the parents' eduction backgrouds.We should pay more attenion to the prevention of autism and enhance the health care of women and children.