한국형 Ages and Stages Questionnaire (K -ASQ) 발달선별검사의 문항 적절성 평가
The Appropriateness of the Items of Korean Ages and Stages Questionnaires (K-ASQ) Developmental Screening Test in Korean Infants and Children
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초록
목적: K-ASQ 발달선별검사는 1980년 미국의 Oregon 대학에서개발된 ASQ 2판을 한국 실정에 맞게 표준화 한 것으로 부모가 작성하는 영.유아 모니터링 시스템이다 .이검사는 2007년 11월부터 시작된 영유아 건강 검진에서 발달장애의 가능성이 있는 영유아를 조기에 선별하기 위한 선별검사도구로서 이용되고 있다 .본 연구는 새로운 영유아 발달선별검사 도구를 개발을 위한 선행연구로써 기존에실시된 K -ASQ 발달선별 검사 자료의 통계분석을 통해 K -ASQ 문항의 적절성을평가하였다 . 방법: 1,696명[남아 877명(51.7%), 여아 819(48.3%)]을 대상으로기존에 국내에서 실시된 K -ASQ 자료의 통계분석을 통하여 문항의 적절성을 평가하였다 .분석에포함된 표본은 각월령군별로 남녀가 각각 50여명씩 수집하였다 . 결과: K-ASQ 자료의 분석결과 ① 선별검사로서의 난이도 및 규준의 적절성은 K -ASQ 규준 자료와 현재 검진 대상 샘플의 점수를 비교할때 샘플의 점수가 규준보다 다소 높은 경향이 있었다 .② 요인구조의 적합도가 전반적으로 부족하였으며 특히 문제 해결 및 사회성 부분에서의 적합도가 현저히 떨어 졌다 (문제해결[x² =41.063, P＜0.01, CFI=0.929, TLI=0.834, RMSEA =0.152], 개인 -사회성[x² =55.208,P<0.01, CFI=0.817, TLI=0.573, RMSEA=0.182]). ③ 문항의 발달적 민감성을 평가한 결과 월령대에 따라 점수 차이가 유의하지 않은 문항들이 발견되었다 . 결론: 선별검사로서 K -ASQ 문항의 적절성은 대체로 양호하였으나 일부 월령대와 영역에서 다소 부족하였으며, 현재 측정 문항으로는 문제해결 및 개인 -사회성 요인을 바람직하게 추정하고 있지 못하다고 판단된다. 우리나라 영유아를 대상으로 신뢰할 수 있고 타당도 높은 새로운 영유아 발달 선별 검사 도구의 개발이 필요하겠다 .
Abstract
Purpose: Since National Health Screening Program for Infants and Children in Korea 1Department of Pediatrics, Korea University, started from November, 2007, the need to design a new tool that can timely identify College of medicine, 2Department of Pediatrics, infants and chlildren with possible delayed development has been emphasized. National Health Insurance Service Ilsan Hospital, The developmental screening devices currently used in Korea are mostly adapted Goyang, Kyunggido, 3Department of Psychology, from foreign tests and could be considered inappropriate for children growing in a Yonsei University, 4Department of Pediatrics, different cultural background. Therefore, we assessed the appropriateness of Korean-Deagu Catholic University, College of medicine, Ages and Stages Questionnaires (K-ASQ) items in Korean infants and children, as a preliminary study to develop a new developmental screening test tool. Methods: Data on K-ASQ tests that were performed in multicenters as a National Health Screening Program in Korea were analyzed to measure ① the item difficulty Seoul national University, Boramae Hospital, and norm relevance ② the goodness of fit for factor structure ③ the sensitivity of College of medicine, 8Yonsei University Human item for developmental evaluation. A total of 1,696 subjects, 877 boys (51.7%) and Behavior Research Institute, Seoul, Korea, 819 girls (48.3%) were studied and with about 50 boys and 50 girls for each age of months, the sample was relatively evenly distributed. Results: Analysis of K-ASQ data showed that ① The subjects scored higher when compared to the K-ASQ's original criteria. ② The suitability of confirmative factor structure was insufficient, especially problem solving [x²=41.063, P<0.01, CFI( Comparative Fit Index)=0.929, TLI (Turker-Lewis index)=0.834, RMSEA (Root Mean Square Error Approximation)=0.152] and personal-social domains (x²=55.208, P<0.01, CFI=0.817, TLI=0.573, RMSEA=0.182). ③ Some questions did not show significant difference in the sensitivity of item for developmental evaluation among monthly age groups. Conclusion: According to the analysis of previous K-ASQ data, the appropriateness of the questionnaires is good in general, but some questions of problem-solving and personal social domains are not appropriate. We suggested the development of a new developmental screening test tool, which is suitable for Korean infants and children.
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