Otizm Spektrum Bozukluklarının Tanısında M-Chat (Modified Checklist For Autism In Toddlers) Tarama Testinin Geçerlilik-Güvenilirliği, Kayseri'De 18-24 Aylık Çocuklarda Otizm Spektrum Bozukluklarının Sıklığı ve Etiyolojide Bazı Çevresel Faktörlerin Rolü
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The objective of the first part of this study was to investigate validity and reliability of the M-CHAT and prevalence of Autism Spectrum Disorders (ASDs) in Kayseri for children aged 18-24 months. M-CHAT was performed on 2021 children aged 18-30 months in Kayseri and hinterland at 14 Family Health Centers by trained persons. Seventeen children who screened positive were evaluated by Child Psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR); two of them were diagnosed with PDD-NOS (Pervasive Developmental Disorder - Not Otherwise Specified) and one with developmental delay. Sensitivity of the M-CHAT was calculated as 100%, specificity was 76%, positive predictive value was 12%, and negative predictive value was 100%. ASDs prevelance can be accepted as 1/1000 in this region for this age group. Cronbach's alpha for the 23 items of the M-CHAT was found to be 0.69 and the test was determined to be reliable. As a result, M-CHAT screening can be used at well child visits of children aged 18-30 months. In the second part of the study we aimed to evaluate phthalate and bisphenol A (BPA) exposure in children with autism. Fifty-one children with autism (autism + PDD-NOS) were included in the study group and age and gender matched 50 healthy children in the control group. Plasma levels of di-(2-ethylhexyl)-phthalate (DEHP), mono-(2-ethylhexyl)-phthalate (MEHP) and BPA were measured by using high performance liquid chromatography (HPLC) in the study and control groups. Plasma DEHP, MEHP and BPA levels were similar in both groups. Median BPA levels (ng/ml) [5.89 (0.50-13.63)] of the children with PDD-NOS were higher than both the control group [1.12 (0.02-12.44)] and the children with autism [1.11 (0.03-12.76)] (respectively; p=0.003, p=0.003). As a result, it was considered that children with PDD-NOS may exposed to BPA more often or may be more vulnerable than children with autism and those in the control group.