JP7253782B2 - Developmental disorder possibility evaluation device and developmental disorder possibility evaluation method - Google Patents

Description

TECHNICAL FIELD The present invention relates to a developmental disorder possibility evaluation device and a developmental disorder possibility evaluation method for evaluating the possibility of a developmental disorder.

In recent years, as interest in support for developmental disabilities has increased worldwide, the Act on Support for Persons with Developmental Disabilities was enacted in Japan in 2004, demonstrating the importance of detecting developmental disabilities as early as possible and providing developmental support. there is

As a device used for such early detection of developmental disorders, for example, a diagnostic image is displayed on the display unit, and the viewpoint of the subject in the display area of the display unit is detected from the captured image captured by the imaging unit. , a developmental disorder diagnosis support device that evaluates the degree of a developmental disorder of a subject based on a detected viewpoint is known (see, for example, Patent Document 1).

JP 2014-071779 A

However, in order to discover a developmental disorder using the diagnostic support device as described above, it is necessary to sequentially perform a series of detection operations for each target person. It is difficult to inspect in a short period of time.

In view of the above points, it is an object of the present invention to facilitate evaluation of the possibility of developmental disorders for a large number of subjects.

In order to achieve the above objects, the present invention
A developmental disorder possibility evaluation device for evaluating the possibility of a developmental disorder,
Evaluate each test data of the ASSQ test, ADHD-RS test, DCDQ test, SDQ-T test, and PSI-C test, and obtain the evaluation results of each test data that serve as indices for obtaining the results of each test. an inspection data evaluation unit;
a developmental disorder possibility evaluation unit that obtains an index indicating the possibility of a developmental disorder based on the evaluation results of each test data;
characterized by having

This makes it possible to easily evaluate the possibility of developmental disorders for a large number of subjects. In addition, by combining the evaluation results of each test data, which serves as an index for obtaining the results of these tests, it is possible to easily and appropriately evaluate the possibility of developmental disorders.

ADVANTAGE OF THE INVENTION According to this invention, possibility of a developmental disorder can be easily evaluated with respect to many subjects.

It is a block diagram which shows the functional structure of a developmental disability possibility evaluation apparatus. FIG. 4 is an explanatory diagram schematically showing the contents of processing performed by the device for evaluating the possibility of developmental disorders;

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described in detail based on the drawings.

The developmental disorder possibility evaluation device of this embodiment is configured by a computer in which software is installed, for example, and has a functional configuration as shown in FIG.

In the figure, an input unit 110 receives the input of each examination data. It consists of an input device such as a reader and character recognition device, a network interface that receives data sent via the Internet from a personal computer or smartphone, and a reading device that reads data stored in advance in a storage device. .

The test data evaluator 120 includes an ASSQ test data evaluator 121, an ADHD-RS test data evaluator 122, a DCDQ test data evaluator 123, an SDQ-T test data evaluator 124, and a PSI-C test data evaluator 125. For each examination, the evaluation results of each examination data obtained in the process of obtaining the results of each examination are obtained based on the responses from, for example, the persons to be evaluated who are 5 years old. Specifically, for example, the score of each test is calculated, the cutoff is determined, and the like.

Here, the above developmental disorders are used in medical terms and refer to all disorders classified as so-called neurodevelopmental disorders (symptoms). Diagnostic criteria are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) created by the American Psychiatric Association (APA). ), it is described as a neurodevelopmental disorder. These include Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Developmental Coordination Disorder (DCD), and Intellectual Disability (ID). Furthermore, there is the International Statistical Classification of Diseases and Related Health Problems (ICD) created by the World Health Organization (WHO) as diagnostic criteria widely used in Japan. The 10th edition (ICD-10) is used.Developmental disorders in ICD-10 are F70-79 intellectual disability <mental retardation>, F80-89 psychological development disorders, F90-99 childhood <child> and behavioral and emotional disorders that usually develop in adolescence, and although the diagnostic criteria will be revised in the future, synonymous disorders will continue to exist.

Details of each of the above inspections are as follows.

ASSQ: The original version is "The high-functioning Autism Spectrum Screening Questionnaire" (Mr. Ehlers, Mr. Gillberg, Mr. Wing, 1999). It is a test using a questionnaire created for the purpose of screening high-functioning (high-intelligence) ASD.

ADHD-RS: The official name is "Attention-deficit hyperactivity disorder - Rating Scale -IV". The original version is "ADHD Rating Scale" (DuPaul, 1991). It is a test using a questionnaire that complies with the diagnostic criteria and can comprehensively evaluate the inattention symptoms and hyperactivity/impulsivity symptoms of attention deficit hyperactivity disorder.

DCDQ: Originally "Developmental Coordination Disorder Questionnaire" (Wilson, B. N, 2009). The Japanese version was created by Mr. Nakai, Mr. Miyachi, and Mr. Okada (2011). It is a test using a questionnaire that can evaluate fine and gross motor skills and general coordination in infants and early adolescents.

SDQ: Originally from Strengths and Difficulties Questionnaire (Goodman R., 1997). It is a test using a questionnaire that can evaluate the difficulties and strengths of children. -P for - for Parent, -T for - for Teacher.

PSI: Originally "Parenting Stress Index (PSI)" (Richard R. Abidin, 1983). As the most effective tool for measuring parental childcare stress, this test uses a questionnaire that has been translated into more than 25 languages around the world and used in a variety of research and clinical settings. There are -C (7 items of child aspects) and -P (8 items of parent aspects).

The developmental disorder possibility evaluation unit 130 obtains an index indicating the possibility of developmental disorder based on the evaluation of the test data by each of the evaluation units. Specifically, for example, if any of (Criteria 1) to (Criteria 4) shown below and shown in FIG.
(Criterion 1) The evaluation result of the ASSQ inspection data is equal to or higher than the predetermined first ASSQ evaluation standard (for example, 19 points) (original scale cutoff).
(Criterion 2) The evaluation result of PSI-C inspection data exceeds a predetermined PSI-C evaluation criterion (eg, 75%).
(Criteria 3) The evaluation result of SDQ-T test data is equal to or higher than the predetermined SDQ-T evaluation criteria (for example, 18 points for boys and 13 points for girls), and
(Criteria 3-a) Whether the evaluation result of the ASSQ inspection data is equal to or higher than the predetermined second ASSQ evaluation criteria (for example, 9 points),
(Criterion 3-b) one or more of each scale in the ADHD-RS test data evaluation results (eg, 3 items) is a cutoff, or (criterion 3-c) DCDQ test data evaluation results (eg, 4 items) are cutoffs.
(Criterion 4) Any of the following applies.

(Criterion 4-a) Two or more of the scales of the evaluation results (for example, 3 items) of the above ADHD-RS test data are cutoffs.

(Criterion 4-b) One of the scales of the evaluation results of the ADHD-RS test data (for example, 3 items) is a cutoff, and the evaluation result of the ASSQ test data is a predetermined third ASSQ evaluation standard (for example, 9 points) or more.

It should be noted that the setting of each cut-off value and evaluation criterion value can be set according to the area, age, screening criteria, and the like.

The output unit 140 outputs the evaluation result by the developmental disorder possibility evaluation unit 130. Specifically, for example, it is displayed on the display unit, printed by the printing unit, transmitted via the Internet, etc., or stored in a storage device. It is designed to perform memory to.

When evaluation was performed based on actual data using the device for evaluating the possibility of developmental disorders as described above, the following results were obtained.

That is, based on the algorithm corresponding to the above criteria using ASSQ, ADHD-RS, DCDQ, SDQ-T, and PSI-C as test examples 1 to 4 of 4 cases, the index indicating the possibility of developmental disorder is more than a predetermined children (hereinafter referred to as “risk children”) were extracted. The following (Table 1) shows the number of children subject to screening for each test, the number (and %) of screening returned, the number and percentage of at-risk children extracted by the above algorithm, and the number of children who underwent secondary health checkups. (and %) indicates the number and percentage of children with developmental disabilities diagnosed with developmental disorders at the secondary health checkup, and the percentage of children with developmental disabilities to the extracted number of children at risk. In addition, as a control example, using the original cutoff for ASSQ, ADHD-RS, DCDQ, and SDQ, when any one of the questionnaires exceeded the cutoff was extracted as a risk child (in the case of the old algorithm ) shows an example.

Compared to the old algorithm for the target cases, the above algorithms for test cases 1 to 4 show a decrease in the extraction rate of children at risk, but the percentage of children diagnosed with developmental disorders in the secondary medical examination. is increasing. In other words, it is possible to increase the possibility of being diagnosed with a developmental disorder while reducing the number of people undergoing secondary medical examinations, thus increasing the efficiency of screening.

It is presumed, for example, qualitatively and/or quantitatively, that the efficiency of screening can be increased by the above-mentioned criteria by the following mechanism. For example, ASSQ ≥ 19 points, which is Criterion 1, has a specificity of 0.90 and a sensitivity of 0.62 (Ehlers et al., 1999). It is very likely that there is. Criterion 2, PSI-C (Parental Stress-Child Aspects) > 75%, is the level at which parenting stress is considered to be significantly high, and parents of children with developmental disabilities are significantly higher than parents of healthy children. Because it requires a standard, it is an effective scale for finding the risk of developmental disorders. Criterion 3 refers to a score above the SDQ-T (teacher rating) cutoff and any of the ASSQ, ADHD-RS, and DCDQ subscales above the cutoff. Even if a person has the characteristics of a developmental disorder, it does not meet the diagnostic criteria unless it interferes with daily life. For this reason, the combination of the SDQ-T rating by the kindergarten teacher, which can objectively evaluate children's sociability, and a scale that indicates the characteristics of developmental disorders is effective in extracting at-risk children. Criterion 4 extracts two or more ADHD-RS including ASSQ and subscales with a cutoff value or higher. Since the comorbidity of ASD and ADHD is 60% to 70%, it is possible to extract at-risk children who may be overlooked by other criteria.

By combining the evaluation results of each test data obtained in the process of obtaining the results of each test as described above, it is possible to easily increase the possibility of identifying at-risk children that cannot be detected by a single test. It is also possible to easily increase the possibility of not extracting children who are not developmentally disabled, who tend to be extracted when the mere test results themselves of multiple tests are used in the disjunction condition. Therefore, it is possible to easily evaluate the possibility of a developmental disorder for a large number of subjects, and to easily perform an appropriate evaluation of the possibility of a developmental disorder. Therefore, it is possible to conduct a more detailed evaluation intensively on subjects for whom an evaluation index has been calculated that indicates that the possibility of developmental disorders is relatively high.

110 input unit 120 test data evaluation unit 121 ASSQ test data evaluation unit 122 ADHD-RS test data evaluation unit 123 DCDQ test data evaluation unit 124 SDQ-T test data evaluation unit 125 PSI-C test data evaluation unit 130 developmental disorder possibility evaluation Unit 140 Output unit

Claims (4)

A developmental disorder possibility evaluation device for evaluating the possibility of a developmental disorder,
Evaluate each test data of the ASSQ test, ADHD-RS test, DCDQ test, SDQ-T test, and PSI-C test, and obtain the evaluation results of each test data that serve as indices for obtaining the results of each test. an inspection data evaluation unit;
a developmental disorder possibility evaluation unit that obtains an index indicating the possibility of a developmental disorder based on the evaluation results of each test data;
has
The Developmental Disorder Possibility Evaluation Department
If the evaluation result of the ASSQ inspection data is equal to or higher than the predetermined first ASSQ evaluation criteria,
If the evaluation result of the PSI-C test data exceeds the predetermined PSI-C evaluation criteria,
The evaluation result of the SDQ-T test data is a predetermined SDQ-T evaluation standard or more, and the evaluation result of the ASSQ test data is a predetermined second ASSQ evaluation standard or more, or the ADHD-RS test one or more of each scale of the data evaluation result is a cutoff, or one or more of each scale of the DCDQ test data evaluation result is a cutoff, or
Two or more of the scales of the evaluation results of the ADHD-RS test data are cutoffs, or one of the scales of the evaluation results of the ADHD-RS test data is a cutoff, and A developmental disorder possibility evaluation device characterized by evaluating that the possibility of developmental disorder is high when the evaluation result of the ASSQ test data is equal to or higher than a predetermined third ASSQ evaluation standard. The developmental disorder possibility evaluation device according to claim 1 ,
The developmental disorder possibility evaluation device, wherein the SDQ-T evaluation criteria are set according to the sex of the person to be evaluated. A developmental disorder possibility evaluation method for evaluating the possibility of a developmental disorder,
Evaluate each test data of the ASSQ test, ADHD-RS test, DCDQ test, SDQ-T test, and PSI-C test, and obtain the evaluation results of each test data that serve as indices for obtaining the results of each test. an inspection data evaluation step;
a developmental disorder possibility evaluation step for obtaining an index indicating the possibility of a developmental disorder based on the evaluation results of each test data;
on the computer , and
The above developmental disorder possibility evaluation step includes:
If the evaluation result of the ASSQ inspection data is equal to or higher than the predetermined first ASSQ evaluation criteria,
If the evaluation result of the PSI-C test data exceeds the predetermined PSI-C evaluation criteria,
The evaluation result of the SDQ-T test data is a predetermined SDQ-T evaluation standard or more, and the evaluation result of the ASSQ test data is a predetermined second ASSQ evaluation standard or more, or the ADHD-RS test one or more of each scale of the data evaluation result is a cutoff, or one or more of each scale of the DCDQ test data evaluation result is a cutoff, or
Two or more of the scales of the evaluation results of the ADHD-RS test data are cutoffs, or one of the scales of the evaluation results of the ADHD-RS test data is a cutoff, and A developmental disorder possibility evaluation method , wherein the evaluation result of the ASSQ test data is equal to or higher than a predetermined third ASSQ evaluation standard, and the possibility of the developmental disorder is evaluated to be high. The developmental disorder possibility evaluation method according to claim 3 ,
A developmental disorder possibility evaluation method, wherein each of the test data is for a 5-year-old child.

Images