[Reliability and validity of warning signs checklist for screening psychological, behavioral and developmental problems of children].

Objective: To evaluate the reliability and validity of warning signs checklist developed by the National Health and Family Planning Commission of the People's Republic of China (NHFPC), so as to determine the screening effectiveness of warning signs on developmental problems of early childhood. Method: Stratified random sampling method was used to assess the reliability and validity of checklist of warning sign and 2 110 children 0 to 6 years of age(1 513 low-risk subjects and 597 high-risk subjects) were recruited from 11 provinces of China. The reliability evaluation for the warning signs included the test-retest reliability and interrater reliability. With the use of Age and Stage Questionnaire (ASQ) and Gesell Development Diagnosis Scale (GESELL) as the criterion scales, criterion validity was assessed by determining the correlation and consistency between the screening results of warning signs and the criterion scales. Result: In terms of the warning signs, the screening positive rates at different ages ranged from 10.8%(21/141) to 26.2%(51/137). The median (interquartile) testing time for each subject was 1(0.6) minute. Both the test-retest reliability and interrater reliability of warning signs reached 0.7 or above, indicating that the stability was good. In terms of validity assessment, there was remarkable consistency between ASQ and warning signs, with the Kappa value of 0.63. With the use of GESELL as criterion, it was determined that the sensitivity of warning signs in children with suspected developmental delay was 82.2%, and the specificity was 77.7%. The overall Youden index was 0.6. Conclusion: The reliability and validity of warning signs checklist for screening early childhood developmental problems have met the basic requirements of psychological screening scales, with the characteristics of short testing time and easy operation. Thus, this warning signs checklist can be used for screening psychological and behavioral problems of early childhood, especially in community settings.目的： 对国家卫生和计划生育委员会组织研发的"儿童心理行为发育问题预警征象"(简称"预警征")筛查表开展信度和效度评估，验证预警征筛查表对儿童心理行为发育问题早期筛查的实效性。 方法： 采取分层随机抽样方法，从全国11个省市抽取低危人群1 513名，高危人群597名，累计2 110名0～6岁儿童进行国家卫生和计划生育委员会组织研发的预警征的信度和效度评估。其中信度评估包括重测信度、测试者间信度评估。以年龄与发育进程问卷(ASQ)和盖瑟尔发育量表(GESELL)为校标量表，通过检验预警征与效标量表测定结果的相关性和一致性，评估校标效度。 结果： 不同年龄点预警征筛查阳性率为10.8%(21/141)～26.2%(51/137)，每例研究对象筛查所需时间中位数为1 min(四分位间距0.6 min)。重测信度及测试者信度的相关系数均达到0.7及以上，表明预警征筛查结果的稳定性较好。在效度评估上，预警征与ASQ测评结果高度一致，一致性Kappa值为0.63。以GESELL为效标，预警征筛查发现可疑发育偏异儿童的灵敏度为82.2%，特异度为77.7%，总体Youden指数为0.6。 结论： 预警征筛查的信度和效度已达到了心理学筛查量表评估的基本要求，并且筛查花费时间少、内容简洁，可用于广大基层开展儿童早期心理行为发育偏异的早期筛查工作。.