18-30 ay aralığındaki çocukların otizm spectrum bozukluğu açısından Değiştirilmiş Erken Çocukluk Dönemi Otizm Tarama Ölçeği Türkçe Sürümü ile değerlendirilmesi: Kesitsel çalışma
Amaç: Amerikan Pediatri Akademisi, 18 ve 24. aylarda otizme özgü tarama yapılmasını önermiştir. Bu çalışma değiştirilmiş Erken Çocukluk Dönemi Otizm Tarama Ölçeğinin (M-CHAT) geçerliliğini ve güvenilirliğini ve otizm spektrum bozukluklarının (OSB) görülme sıklığını çalışma popülasyonumuzda dört aylık bir dönemi kapsayan bir sürede araştıran kesitsel bir çalışmadır. Yöntem: Kliniğimizde Haziran 2017-Eylül 2017 tarihleri arasında 18-30 aylık toplam 471 sağlıklı çocuk tarandı. Bu değerlendirmeler bakımverenlerle yüz yüze görüşerek bir hemşire tara- fından uygulanmıştır. Ölçek değerlendirmeleri pozitif olan çocuklar psikiyatrik değerlendirme için çocuk ve ergen psikiyatri kliniğine yönlendirildi. Bulgular: Katılımcıların 264'ü erkek (%56.1) ve 207’si kızdı (%43.9). Erkek ve kızlarda ortalama yaş 24.5 ve 24 ay olarak bulundu. OSB riski M-CHAT ile 8/1.000 ve psikiyatrik değerlendirmeden sonra ise sıklık 6/1.000 olarak saptandı. Biz %100 duyarlılık, 0.95 özgüllük, 0.75'lik bir pozitif öngörü değeri, %100 negatif tahmin değeri ve 0.96 kesin ayırıcılık oranı bulduk. Test edilen grupta güvenilirlik için Cronbach-α iç tutarlılık katsayısı 23 madde için 0.96 ve altı kritik madde için 0.98 olarak bulunmuştur. Sonuç: M-CHAT, Türkiye'de farklı kültürlere sahip popülasyonlara uyarlandığında ilk basamakta OSB’li çocukları saptamak için kullanılan yararlı bir araçtır. (Anadolu Psikiyatri Derg 2019; 20(2):196-203)
Evaluation of toddlers aged between 18 and 30 months for autism spectrum disorders using the Turkish version of the modified checklist for autism in toddlers test: A cross-sectional study
Objective: American Academy of Pediatrics recommends autism-specific screening at 18 and 24 months of age.This study is a cross-sectional study involving a period of 4 months and investigating the validation and reliability ofthe Modified Checklist for Autism in Toddlers Test (M-CHAT) and the incidence of autism spectrum disorders (ASD)in our study population. Methods: Four hundred and seventy-one healthy toddlers aged 18-30 months werescreened in well-child clinic between June 2017 and September 2017. It was administered to the caregivers by anurse by face-to-face interview. Screen positive children were reffered to child and adolescent psychiatry clinic forpsychiatric evaluation. Results: Of all participants, 264 were boys (56.1%) and 207 girls (43.9%). The mean agewas found as 24.5 and 24 months in boys and girls, respectively. The risk of ASD was found as 8/1.000 with the M-CHAT and the incidence was found as 6/1.000 after the psychiatric assessment.We found a sensitivity of 100%; aspecificity of 0.95; a positive predictive value of 0.75; and a negative predictive value of 100% and accurate discri-mination rate of 0.96. Cronbach’s α reliability coefficient, which was calculated for internal consistency to determinethe reliability in the group which underwent the test was found to be 0.96 for the 23 items and 0.98 for the six criticalitems. Conclusion: M-CHAT is a useful tool in Turkey for screening children for ASD in primary care when adaptedto populations with different cultures. (Anatolian Journal of Psychiatry 2019; 20(2):196-203)
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