摘要
目的 检验儿童孤独症评定量表(childhood autism rating scale,CARS)家长版的可靠性和有效性.方法 在上海市 3 个区招募并随机抽取 319 名儿童及其家长参与研究.基于小组讨论和德尔菲专家函询方法对原版CARS进行注释,使其易于理解并适合家长填写,形成CARS家长版.在参加 2 个课时的线上课堂后,家长根据孩子的日常表现填写量表,完成线上评估.对量表的区分度、结构效度、效标关联效度、同质性信度、重测信度和评价者间信度进行统计检验.结果 CARS家长版 15 个条目的项目区分度为 0.588～0.801.探索性因子分析示其KMO值为 0.788,Bartlett's球形检验显示P<0.001,提取 4 个公因子后累积方差解释率为 61.74%,各条目的因子载荷系数为 0.443～0.801;验证性因子分析支持 4 因子模型(χ2/df=2.834,RMSEA=0.107,GFI=0.842,CFI=0.814,AGFI=0.774,IFI=0.818,TLI=0.767).该量表与改良婴幼儿孤独症量表、儿童孤独症行为量表和孤独症诊断观察量表的效标关联效度分别为 0.41、0.69 和 0.43(P<0.01).量表的Cronbach's α系数、分半信度、重测信度和评分者间信度分别为 0.91、0.90、0.81 和 0.71.结论 CARS家长版满足测量学标准,具有良好的信效度,可用于孤独症谱系障碍儿童的居家早期筛查.
Abstract
Objective To examine the reliability and validity of the parent version of the childhood autism rating scale(CARS).Methods In 3 districts of Shanghai,319 children and their parents were recruited and randomly selected to participate in the study.Based on group discussion and Delphi expert inquiry method,the original version of CARS was annotated to make it easy to understand and suitable to fill out for parents,forming the parent version of CARS.After attending two online classes,parents filled out the scale according to their children's daily performance and completed an online assessment.The discriminant validity,structural validity,criterion-related validity,homogeneity reliability,test-retest reliability,and inter-rater reliability of the scale were statistically tested.Results The item range of discriminant validity for the 15 items of the parent version of CARS was 0.588-0.801.Exploratory factor analysis showed a KMO value of 0.788 and a Bartlett's sphere test with P<0.001.After extracting 4 common factors,the cumulative variance contribution rate was 61.74%,and the factor loading of each item was 0.443-0.801.Confirmatory factor analysis supported the 4-factor model(χ2/df=2.834,RMSEA=0.107,GFI=0.842,CFI=0.814,AGFI=0.774,IFI=0.818,TLI=0.767).The criterion-related validity of the scale was 0.41,0.69,and 0.43(P<0.01)when compared to the modified checklist for autism in toddlers(M-CHAT),autism behavior checklist(ABC),and autism diagnostic observation schedule(ADOS).The Cronbach's α coefficient,split-half reliability,test-retest reliability,and inter-rater reliability of the scale were 0.91,0.90,0.81,and 0.71,respectively.Conclusion The parent version of CARS meets the measurement standards and demonstrates good reliability and validity,making it suitable for early home screening of children with autism spectrum disorder.
维普
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