Using the Childhood Autism Rating Scale to Diagnose Autism Spectrum Disorders
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This study investigated the childhood autism rating scale (CARS) as a tool for ASD diagnoses for 2-year-old (n = 376) and 4-year-old (n = 230) children referred for possible autism. The cut-off score to distinguish autistic disorder from PDD-NOS was 32 in the 2-year-old sample (consistent with Lord in J Child Psychol Psychiatry Allied Discipl, 36, 1365–1382, 1995), and 30 in the 4-year-old sample, with good sensitivity and specificity at both ages. The cut-off score to distinguish ASD from non-ASD at both ages was 25.5, with good sensitivity and specificity. Results confirm the utility of the CARS in distinguishing autistic disorder from PDD-NOS, and distinguishing ASD from other developmental disorders and typical development and suggest that an ASD cutoff around 25, which is in common clinical use, is valid.
- Adrien, J., Perrot, A., Sauvage, D., Leddet, I., Larmande, C., & Barthelemy, C. (1992). Early symptoms in autism from family home movies. Evaluation and comparison between 1st and 2nd year of life using I.B.S.E. scale. Acta Paedopsychiatrica, 55(2), 71–75.
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. (Text revision).
- Baron-Cohen, S., Allen, J., & Gillberg, C. (1992). Can autism be detected at 18 months? The needle, the haystack, and the CHAT. The British Journal of Psychiatry, 161(6), 839–843. CrossRef
- Buitelaar, J., Van der Gaag, R., Klin, A., & Volkmar, F. (1999). Exploring the boundaries of pervasive developmental disorder not otherwise specified: Analyses of data from the DSM-IV autistic disorder field trial. Journal of Autism and Developmental Disorders, 29, 33–43. CrossRef
- Chakrabarti, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children. Journal of the American Medical Association, 285, 3093–3099. CrossRef
- Charman, T., & Baron-Cohen, S. (2006). Screening for autism spectrum disorders in populations: Progress, challenges, and questions for future research and practice. In T. Charman & W. Stone (Eds.), Social and communication development in autism spectrum disorders (pp. 63–82). New York: Guilford Press.
- Chlebowski, C., Barton, M., Hodgson, S., & Fein, D. (2008). Does the CARS cutoff score influence agreement among diagnostic instruments for autism spectrum disorders and clinical judgment in preschool aged children? Poster presented at the meeting of the American Academy of Clinical Neuropsychology, Boston, MA.
- Chlebowski, C., Barton, M., Hodgson, S., & Fein, D. (2009). Diagnostic stability of autism spectrum disorder diagnoses made before age 2. Poster presented at the International Meeting for Autism Research, Chicago, Illinois.
- Cicchetti, D. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6, 284–290. CrossRef
- Cicchetti, D., & Sparrow, S. (1981). Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior. American Journal of Mental Deficiency, 86, 127–137.
- Cicchetti, D. V., Volkmar, F., Klin, A., & Showalter, D. (1995). Diagnosing autism using ICD-10 criteria: A comparison of neural networks and standard multivariate procedures. Child Neuropsychology, 1, 26–37. CrossRef
- de Bildt, A., Sytema, S., Ketelaars, C., Kraijer, D., Mulder, E., Volkmar, F., et al. (2004). Interrelationship between Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) classification in children and adolescents with mental retardation. Journal of Autism and Developmental Disorders, 34, 129–137. CrossRef
- Eaves, R., & Milner, B. (1993). The criterion-related validity of the childhood autism rating scale and the autism behavior checklist. Journal of Abnormal Child Psychology, 21, 481–491. CrossRef
- Filipek, P., Accardo, P., Baranek, G., Cook, E., Dawson, G., Gordon, B., et al. (1999). The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Developmental Disorders, 29, 437–482. CrossRef
- Kleinman, J., Ventola, P., Pandey, J., Verbalis, A., Barton, M., Hodgson, S., et al. (2008). Diagnostic stability in very young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 606–615. CrossRef
- Klin, A., Lang, J., Cicchetti, D., & Volkmar, F. (2000). Brief report: Interrater reliability of clinical diagnosis and DSM IV criteria for autistic disorder: Results of the DSM IV Field Trial. Journal of Autism and Developmental Disorders, 30, 163–167. CrossRef
- Lord, C. (1995). Follow-up of two-year-olds referred for possible autism. Journal of Child Psychology and Psychiatry and Allied Disciplines, 36, 1365–1382. CrossRef
- Lord, C., Risi, S., Lambrecht, L., Cook, E. H. J., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223. CrossRef
- Lord, C., Storoschuk, S., Rutter, M., & Pickles, A. (1993). Using the ADI-R to diagnose autism in preschool children. Infant Mental Health Journal, 14, 234–252. CrossRef
- Luteijn, E., Serra, M., Jackson, S., Steenhuis, M., Althaus, M., Volkmar, F., et al. (2000). How unspecified are disorders of children with a pervasive developmental disorder not otherwise specified? A study of social problems in children with PDD-NOS and ADHD. European Child and Adolescent Psychiatry, 9, 168–179. CrossRef
- Matson, J., & Boisjoli, J. (2007). Differential diagnosis of PDD-NOS in children. Research in Autism Spectrum Disorders, 1, 75–84. CrossRef
- Mullen, E. M. (1995). Mullen scales of early learning: AGS edition. Circle Pines, MN: American Guidance Service.
- Nordin, V., Gillberg, C., & Nydén, A. (1998). The Swedish version of the childhood autism rating scale in a clinical setting. Journal of Autism and Developmental Disorders, 28, 69–75. CrossRef
- Perry, R. (1998). Misdiagnosed ADD/ADHD: Rediagnosed PDD. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 113–114. CrossRef
- Perry, A., Condillac, R., Freeman, N., Dunn-Geier, J., & Belair, J. (2005). Multi-site study of the childhood autism rating scale (CARS) in five clinical groups of young children. Journal of Autism and Developmental Disorders, 35, 625–634. CrossRef
- Perry, A., & Freeman, N. (1996). Psychometric properties of the Childhood Autism Rating Scale (CARS). Poster presented at the Ontario Association on Developmental Disabilities Research Special Interest Group Research Day, Toronto, ON.
- Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F. (2004). Childhood autism rating scale (CARS) correspondence and conflicts with DSM-IV criteria in diagnosis of autism. Journal of Autism and Developmental Disorders, 34, 703–708. CrossRef
- Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., et al. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 45, 1094–1103. CrossRef
- Robins, D., Fein, D., Barton, M., & Green, J. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131–144. CrossRef
- Saemundsen, E., Magnusson, P., Smari, J., & Sigurdarddottir, S. (2003). Autism diagnostic interview—revised and the childhood autism rating scale: Convergence and discrepancy in diagnosing autism. Journal of Autism and Developmental Disorders, 33, 319–328. CrossRef
- Schopler, E., Reichler, R., & DeVellis, R. (1980). Toward objective classification of childhood autism: Childhood autism rating scale (CARS). Journal of Autism and Developmental Disorders, 10, 91–103. CrossRef
- Schopler, E., Reichler, R., & Rochen Renner, B. (1988). The childhood autism rating scale. Western Psychological Services.
- Spitzer, R., & Siegel, B. (1990). The DSM-III-R field trial of pervasive developmental disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 29, 855–862. CrossRef
- Stone, W., Lee, F., Ashford, L., Brisie, J., Hepburn, S., & Coonrod, E. (1999). Can autism be diagnosed accurately in children under three? Journal of Child Psychiatry Psychology and Allied Disciplines, 40, 219–226. CrossRef
- Tachimori, H., Osada, H., & Kurita, H. (2003). Childhood autism rating scale-Tokyo version for screening pervasive developmental disorders. Psychiatry and Clinical Neuroscience, 57, 113–118. CrossRef
- Tidmarsh, L., & Volkmar, F. (2003). Diagnosis and epidemiology of autism spectrum disorders. The Canadian Journal of Psychiatry/La Revue canadienne de psychiatrie, 48, 517–525.
- Ventola, P., Kleinman, J., Pandey, J., Barton, M., Allen, S., Green, J., et al. (2006). Agreement among four diagnostic instruments for autism spectrum disorders in toddlers. Journal of Autism and Developmental Disorders, 36, 839–847. CrossRef
- Volkmar, F., Klin, A., Siegel, B., & Szatmari, P. (1994). Field trial for autistic disorder in DSM-IV. American Journal of Psychiatry, 151, 1361–1367.
- Using the Childhood Autism Rating Scale to Diagnose Autism Spectrum Disorders
Journal of Autism and Developmental Disorders
Volume 40, Issue 7 , pp 787-799
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