臺灣博碩士論文加值系統

研究背景與目的: 近來，自閉症類障礙症盛行率顯著增加。然而，相較於其他國家，台灣學齡前自閉症類障礙症的盛行率偏低，一個原因是台灣的自閉症類障礙症篩檢和診斷工具不足。因此，本研究主要目的，是探究兩歲期自閉症篩檢工具 (Screening Tool for Autism in Two-Year-Olds, STAT) 和自閉症診斷觀察量表 (Autism Diagnostic Observation Schedule, ADOS)篩檢台灣24個月以下的自閉症類障礙症嬰幼兒，並於18個月後進行追蹤評估，以確認早期篩檢的短期穩定度。
方法: 本研究的參與者共有109名，在參與者兩歲前(時間點一)因發展問題而接受評估，以自閉症診斷觀察量表和兩歲期自閉症篩檢工具進行評估；經過18個月(時間點二)後進行診斷評估，確認患者診斷，並評估發展能力與問題行為。依據追蹤評估的診斷，共有50名自閉症類障礙症嬰幼兒和59名發展遲緩嬰幼兒。
結果: 研究結果發現兩歲期自閉症篩檢工具和自閉症診斷觀察量表能夠有效區分這兩群嬰幼兒。兩歲期自閉症篩檢工具，切截分數2.75，敏感度.78，特異度.83；切截分數2.5，敏感度.84，特異度.80；自閉症診斷觀察量表，敏感度.92，特異度.81。自閉症類障礙嬰幼兒時間點一，兩歲期自閉症篩檢工具分數可以預測其18個月後的語言理解、語言表達和心智年齡。時間點一的自閉症診斷觀察量表分數一樣可預測自閉症類障礙症嬰幼兒18個月後的語言理解、語言表達和心智年齡。
結論: 兩項工具都具備良好的短期穩定度，但兩歲期自閉症篩檢工具操作簡單且費時短，是值得推廣的自閉症類障礙症幼兒篩檢工具。

Background and purposes: Recently, the prevalence of Autism Spectrum Disorder (ASD) has increased dramatically. However, the prevalence of preschool children with ASD is less in Taiwan compared to Western countries. One of the reasons was few screening and diagnostic tools for assessing ASD in young children. Thus, the aim of this study was to investigate the short-term stability of the Screening Tool for Autism in Two-year-olds (STAT) and the Autism Diagnostic Observation Schedule (ADOS). We detected ASD in toddlers under the age of 2 years (Time 1), and follow-up after 18 months for making a diagnosis (Time 2).
Methods: 109 toddlers were recruited. All of participants with developmental problems before aged two (Time 1) received the assessments of the ADOS and the STAT. The clinical diagnosis was made by a multidisciplinary team after 18 months (Time 2). The developmental abilities and problem behaviors were also measured at time 2. After the confirm diagnosis at time 2, there were 50 toddlers with ASD and 59 toddlers with developmental delays (DD).
Results: The scores of each domain and total in the STAT and ADOS were higher in children with ASD than in children with DD in time 1. Based on the STAT, using cutoff score of 2.75, sensitivity reached .78 and specificity reached .83. Using cutoff score of 2.5, sensitivity reached .84 and specificity reached .80. Based on the ADOS, the results of the study yielded sensitivity of .92 and specificity of .81. The results suggested that the STAT and the ADOS (Time 1) could differentiate toddlers with ASD from toddlers with DD. The results supported that STAT could predict the receptive language, expressive language and mental age in toddlers with ASD after 18 months. In addition, ADOS could also predict the receptive language, expressive language and mental age in toddlers with ASD after 18 months.
Conclusions: Both of the tools possessed good short-term stability. However, compared to the ADOS, the STAT is a screening tool that consumes less time and the short-term stability was promising, so it is a worth-promoted screening tool for toddlers with ASD.

Chapter 1 Introduction 1
Chapter 2 Literature review 4
2.1. Autism Spectrum Disorder 4
2.1.1. Definition 4
2.1.2. Autistic symptoms 4
2.2. Diagnosis 8
2.2.1 Diagnosis of ASD 8
2.2.2. Diagnostic tools of ASD 9
2.3. Screening tools 10
2.3.1. Screening tools for ASD in Western countries 10
2.3.2. Screening tools of ASD in Taiwan 18
2.4. Diagnostic stability of ASD 22
2.4.1. Diagnostic stability 22
2.5. Prediction of autistic symptoms 24
2.5.1. Relationships between autistic symptoms and behavioral and cognitive problems 24
2.6. Purposes 26
Chapter 3 Method 29
3.1. Participants 29
3.2. Procedures 31
3.3. Measures 32
3.4. Data analysis 35
Chapter 4 Results 36
Chapter 5 Discussion 49
5.1. Validity of the STAT 49
5.2. Validity of the ADOS 50
5.3. Comparisons between the STAT and the ADOS 52
5.4. Prediction of the STAT and the ADOS 52
5.5. Conclusions and limitations 55
References 56

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