Factor Analysis of the Childhood Autism Rating Scale in a Sample of Two Year Olds with an Autism Spectrum Disorder
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The Childhood Autism Rating Scale (CARS), (Schopler et al. in J Autism Dev Disord 10(1):91–103, 1980) is a 15-item observation-based rating scale that yields a total score reflective of autism symptom severity. This study investigated the factor structure of the CARS in a sample of 2-year-old children with DSM-IV-TR (American Psychiatric Association in Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Publishing, Washington, 2000) diagnoses of AD or PDD-NOS. Following a preliminary internal cross-validation, principal axis factor analysis was completed (N = 282). The results indicate a three-factor solution: Social Communication, Stereotyped Behaviors and Sensory Sensitivities, and Emotional Reactivity. The factors are meaningful, with the first two reflective of DSM-5 symptom domains. This study supports the continued relevance of the CARS in ASD assessment, and extends its utility in 2-year-old children.
KeywordsCARS Factor analysis ASD assessment
The authors thank the families who participated in the current study, the physicians who assisted by offering the screening study to their patients, and the research teams at the University of Connecticut and the University of Washington, especially Wendy Stone and Geraldine Dawson. Geraldine Dawson is now Professor in the Departments of Psychiatry and Behavioral Sciences, Pediatrics, and Psychology and Neuroscience and the Director of the Duke Center for Autism and Brain Development at Duke University, North Carolina. Wendy Stone is Professor of Psychology at The University of Washington. The authors also acknowledge the following funding sources: Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant R01HD039961, U.S. Department of Education Student-Initiated Research Grant, Maternal and Child Health Bureau Grant R40MC00270, the University of Connecticut’s Research Foundation Faculty Grant, the National Alliance of Autism Research, and a National Institute of Mental Health Predoctoral Fellowship F31MH12550.
EM participated in conception of the study design, coordination and data collection, performed the statistical analyses and drafted sections of the manuscript; KB participated in conception of the study design, coordination and data collection, performed statistical analyses and drafted sections of the manuscript; MB participated in conception of the study design, data collection, interpretation of the data and the revising of the manuscript; DF participated in conception of the study design, data collection, interpretation of the data, and the revising of the manuscript. All authors read and approved the final manuscript.
This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant R01HD039961, U.S. Department of Education Student-Initiated Research Grant, Maternal and Child Health Bureau Grant R40MC00270, the University of Connecticut’s Research Foundation Faculty Grant, the National Alliance of Autism Research, and a National Institute of Mental Health Predoctoral Fellowship F31MH12550.
Compliance with Ethical standards
Conflict of Interest
Deborah Fein, and Marianne Barton are co-owners of M-CHAT, LLC, which receives royalties from companies that incorporate the M-CHAT into commercial products. Data reported in the current paper is from the freely available paper version of the M-CHAT. Authors Emily Moulton and Kathryn Bradbury declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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