以台灣版本「繁體中文兒童執行功能量表」(TC-CHEXI)檢驗自閉症類障礙、注意力不足過動症與共病患童之執行功能

Abstract

背景和目的：CHEXI已被證明是一種跨文化、免費下載、方便且心理計量特質合宜的工具，用於評估社區兒童的執行功能。本研究使用台灣版「繁體中文兒童執行功能量表」（TC-CHEXI）評估由兒科精神科醫生診斷患有自閉症類障礙、注意力不足過動症以及兩者共病的兒童的執行功能，以探索該工具如何幫助我們了解臨床樣本的執行功能。方法：共有87名兒童的主要照顧者參加；包括 18名患有自閉症類障礙的兒童（17名男孩）、46名患有注意力不足過動症的兒童（34名男孩）和23名共病診斷的兒童（22名男孩）。本研究使用注意力不足過動症兒童執行功能量表做為效標，檢驗TC-CHEXI在臨床樣本中的效標關聯效度。此外探討了TC-CHEXI與自閉症兒童行為評定量表和修訂版重複行為量表間的相關性。最後在控制了年齡、性別和智商之後比較三組的執行功能。結果：使用TC-CHEXI檢驗臨床樣本的執行功能，顯示與預期相符的執行功能障礙。此外，TC-CHEXI在臨床樣本中，被證實具有良好的效標關聯建構效度。結論：TC-CHEXI是心理計量學上可靠且有效的執行功能評估工具，可用於社區樣本，協助吾人進行自閉症類障礙與注意力不足過動症初步的篩檢。  Background and purposes: The CHEXI has been shown to be a cross-cultural, free-to-download, convenient and psychometrically proper tool to evaluate the exec-utive functioning (EF) of children in community. The present study evaluated the EF of children with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and comorbidity of ASD and ADHD as diagnosed by a pediatric psychiatrist by using the Taiwanese Traditional-Chinese CHEXI (TC-CHEXI) in or-der to explore how the tool can help us understand the EF in clinical samples. Methods: In total, the primary caregivers of 87 children participated; they com-prised 18 children with ASD (17 boys), 46 children with ADHD (34 boys), and 23 children with comorbid ASD and ADHD (22 boys). The Executive Functions Rating Scale for Children with ADHD was used to investigate the criterion-related validity of the TC-CHEXI. The correlations of the TC-CHEXI with the Behavioral Rating Scale for Children with Autism and the Repetitive Behaviors Scale-Revised were also explored. Group comparisons on their EF subcomponents were conducted with age, gender, and IQ controlled for. Results: The findings suggest that examining with the TC-CHEXI, the EF of the clinical samples comprised of ASD/ADHD were shown to be dysfunctional as expected. Furthermore, the TC-CHEXI was noted to have criteria-related construct validity in clinical settings. Conclusion: The results showed that the TC-CHEXI is a psychometrically reliable and valid EF assessment tool to be used in community settings for primary screening of ASD/ADHD.