발달 지연아에서 K-ASQ(Korean-Ages & Stages Quest ionnaires) 발달 선별 검사와 베일리 영유아 발달 검사의 비교
Assessment of Children with Developmental Delay: Korean-Ages & Stages Questionnaires (K-ASQ) and Bayley Scales of Infant Development test II(BSID-II)
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목 적:영유아 건강 검진에서 발달장애아를 조기 선별하기 위하여 K-ASQ 선별검사(Korean Ages & Stages Questionnaires, 부모 작성형 유아 모니터링 체계)가 사용되고 있다. K-ASQ 선별검사의 분별력을 확인하기 위하여, 본원에 발달 지연으로 내원한 아동들을 대상으로 베일리 영유아 발달검사(BSIDII)와 K-ASQ 선별검사를 병행하여 두 검사법간의 성적을 비교 분석하였다. 방 법:2008년 1월부터 2009년 8월까지 대구 가톨릭대학교 병원 소아청소년과에 발달 지연으로 내원한 월령 8개월부터 39개월 아동 129명(남아 94 명, 여아 35명)을 대상으로 베일리 영유아 발달 검사와 K-ASQ 선별 검사를 동시에 시행하였다. 베일리 영유아 발달 검사에서 산출된 인지 발달 지수에 따라 3군(심각한 지연을 보이는 70 미만인 1군, 경도의 지연을 보이는 70-84 인 2군, 정상 범위 85 이상인 3군)으로 나누어 K-ASQ 선별 검사와 비교하였다. 결 과:제 1군 81명에서 80명, 그리고 제 2군 38명에서 33명이 K-ASQ 선별 검사에서 한 개 영역이상에서 절선보다 낮은 결과를 보였다. 제 1군의 나머지 1명은 절선보다 낮은 점수를 보이는 영역은 없었으나, 근접한 점수를 보이는 영역은 있었다. 제 2군의 5명은 절선보다 낮은 점수는 없었는데, 이중 3명은 절선에 근접한 점수를 보이는 영역이 있었다. 결 론:발달 지연이 있는 아동들을 대상으로 베일리 영유아 발달 검사와 K-ASQ 선별 검사를 병행하여 비교하였을 때 높은 일치를 보였다. K-ASQ 선별 검사에서 절선 점수보다 낮은 점수를 보이는 경우 뿐 아니라, 낮은 점수는 없이 근접한 점수만을 보이는 경우에도 발달 지연을 의심하고 전문기관으로 의뢰하여야 하겠다.
Abstract
Purpose:Ages & Stages Questionnaires (K-ASQ, parents report of developmental skills) was used as a screening tool for detecting infant and young children with developmental disorder in National Health Screening Program. This study was designed for validating the effectiveness of K-ASQ in the assessment of children with developmental delay. Methods:One hundred twenty-nine children(male: 94, female: 35, age: 8-39 months) with suspected developmental delay, who visited the department of Pediatrics in Catholic University of Daegu Hospital from January 2008 to August 2009 were enrolled. They were classified into three groups according to Mental Developmental Index of Bayley Scales of Infant Development test II(BSID II)(Group I: MDI <70: significant delay, Group II: MDI 70-85: mild delay, Group III: MDI 85: within normal range), and compared with the result of K-ASQ. Results:Group I was eighty-one children. Group II was thirty-eight children. The scores of eighty children of Group I and thirty-three children of Group II fall below a given cut off score in one or more domains in K-ASQ. One child's score of group I didn't fall below a given cut off score but was adjacent to a given cut off score. Five children's scores of group II didn't fall below a given cut off score. Only three children's score of these five were adjacent to a given cut off score. Conclusion:There was relatively high correlation between the results of K-ASQ and BSID-II for infants and children with developmental delay. Our results suggest that the referral for further developmental evaluation is recommended if the scores showed below or adjacent to a given cut off score in any domain in K-ASQ.
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