Assessing autism with DSM-IV and DSM-5 criteria using the Childhood Autism Rating Scale (CARS)
##plugins.themes.bootstrap3.article.main##
Abstract
Objective. To study the psychometric properties in the Mexican population using DSM-IV and DSM-5 criteria.
Method. This is an observational, cross-sectional study. Participants (N = 137) were 78.8% male, with an age range between 2 and 18 years, mean 8.5. Parents completed the M-CHAT, the ABC, the ADI-R, and semi-structured clinical interviews with DSM-IV. We inferred DSM-5 criteria by selecting atypical sensory items from the ABC.
Results. The internal consistency for the total CARS items was α = .88. The concurrent validity of the CARS and the DSM-IV criteria showed a Spearman coefficient of correlation of rs = .62. The convergent validity with the ADI-R showed moderate correlations, rs = .32 to .61, with the DSM-IV k = .33 and DSM-5 k = .36. The concordance with the DSM-IV and DSM-5 was 71% and 84.5%, sensitivity was 58.1% and 46-7%, and specificity 76.6% and 90.5%, respectively. The discriminant analysis showed that the CARS correctly classified 97% of children with autism, 70% with pervasive developmental disorders not otherwise specified (PDD-NOS), and 12.5% with Asperger’s syndrome.
Discussion and conclusion. The Mexican version of the CARS is a valid and reliable instrument for diagnosing autism in Mexican children and adolescents.
Downloads
References
Akoury-Dirani, L., Alameddine, M., & Salamoun, M. (2013). Validation of the Lebanese Childhood Autism Rating Scale-Second Edition-Standard Version. Research in Autism Spectrum Disorders, 7(9), 1097-1103. doi: 10.1016/j.rasd.2013.05.004
Albores-Gallo, L., Roldán-Ceballos, O., Villarreal-Valdes, G., Betanzos-Cruz, B. X., Santos-Sánchez, C., Martínez-Jaime, M. M., … Hilton, C. L. (2012). M-CHAT Mexican Version Validity and Reliability and Some Cultural Considerations. ISRN Neurology, 2012, 408694. doi: 10.5402/2012/408694
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders DSM-5 (5th Edition). Washington, DC: American Psychiatric Publishing.
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: The Journal of Mental Science, 161, 839-843. doi: 10.1192/bjp.161.6.839
Breidbord, J., & Croudace, T. J. (2013). Reliability generalization for Childhood Autism Rating Scale. Journal of Autism and Developmental Disorders, 43(12), 2855-2865. doi: 10.1007/s10803-013-1832-9
Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the Childhood Autism Rating Scale to Diagnose Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 40(7), 787-799. doi: 10.1007/s10803-009-0926-x
Constantino, J. N., & Gruber, C. (2005). Social Responsiveness Scale (SRS) Manual. Western Psychological Services.
Dawkins, T., Meyer, A. T., & Van Bourgondien, M. E. (2016). The Relationship Between the Childhood Autism Rating Scale: Second Edition and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5. Journal of Autism and Developmental Disorders, 46, 3361-3368. doi: 10.1007/s10803-016-2860-z
Finch, H. (2009). Identification of Variables Associated With Group Separation in Descriptive Discriminant Analysis: Comparison of Methods for Interpreting Structure Coefficients. The Journal of Experimental Education, 78(1), 26-52. doi: 10.1080/00220970903224602
Fombonne, E., Marcin, C., Bruno, R., Tinoco, C. M., & Marquez, C. D. (2012). Screening for Autism in Mexico. Autism Research, 5(3), 180-189. doi: 10.1002/aur.1235
Fombonne, E., Marcin, C., Manero, A. C., Bruno, R., Diaz, C., Villalobos, M., … Nealy, B. (2016). Prevalence of Autism Spectrum Disorders in Guanajuato, Mexico: The Leon survey. Journal of Autism and Developmental Disorders, 46(5), 1669-1685. doi: 10.1007/s10803-016-2696-6
García-López, C., & Narbona, J. (2014). Inventario del espectro autista y childhood autism rating scale: Correspondencia con criterios DSM-IV-TR en pacientes con trastornos generalizados del desarrollo. Anales de Pediatría, 80(2), 71-76. doi: 10.1016/j.anpedi.2013.05.012
García-Villamisar, D., & Muela, C. (2000). Propiedades Psicométricas de la Childhood Autism Rating Scale (CARS) como instrumento diagnóstico de los adultos autistas en el ámbito laboral. Revista de Psicología General y Aplicada, 53(3), 515-521.
Garfin, D. G., McCallon, D., & Cox, R. (1988). Validity and reliability of the Childhood Autism Rating Scale with autistic adolescents. Journal of Autism and Developmental Disorders, 18(3), 367-378. doi: 10.1007/BF02212193
Harris, B., & Barton, E. E. (2016). Autism services in Mexico: A qualitative survey of education professionals. International Journal of School & Educational Psychology, 5(1), 1-13. doi: 10.1080/21683603.2016.1155514
Krug, D., Arick, J., & Almond, P. (1980). Behavior checklist for identifiying severely handicapped individuals with high levels of autistic behavior. Journal of Child Psychology and Psychiatry, 21(3), 221-229. doi: 10.1111/j.1469-7610.1980.tb01797.x
Krug, D., Arick, J., & Almond, P. (1993). Autism Screening Instrument for Educational Planning-ASIEP-2. PRO-ED.
Kurita, H., Miyake, Y., & Katsuno, K. (1989). Reliability and validity of the Childhood Autism Rating Scale-Tokyo version (CARS-TV). Journal of Autism and Developmental Disorders, 19(3), 389-396. doi: 10.1007/BF02212937
Le Couteur, A., Haden, G., Hammal, D., & McConachie, H. (2008). Diagnosing Autism Spectrum Disorders in Pre-school Children Using Two Standardised Assessment Instruments: The ADI-R and the ADOS. Journal of Autism and Developmental Disorders, 38(2), 362-372. doi: 10.1007/s10803-007-0403-3
Living-Varela, K., & Albores-Gallo, L. (2012). Confiabilidad y Validez del Inventario de comportamiento autista (ABC) en niños con trastornos del espectro autista. UNAM.
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659-685. doi: 10.1007/BF02172145
Lord, C., Rutter, M., Dilavore, P., & Risi, S. (1999). Autism Diagnostic Observation Schedule. Western Psychological Services.
Mayes, S. D., Calhoun, S. L., Murray, M. J., Morrow, J. D., Yurich, K. K. L., Mahr, F., … Petersen, C. (2009). Comparison of Scores on the Checklist for Autism Spectrum Disorder, Childhood Autism Rating Scale, and Gilliam Asperger’s Disorder Scale for Children with Low Functioning Autism, High Functioning Autism, Asperger’s Disorder, ADHD, and Typical Development. Journal of Autism and Developmental Disorders, 39(12), 1682-1693. doi: 10.1007/s10803-009-0812-6
Mayes, S. D., Calhoun, S. L., Murray, M. J., Pearl, A., Black, A., & Tierney, C. D. (2014). Final DSM-5 under-identifies mild Autism Spectrum Disorder: Agreement between the DSM-5, CARS, CASD, and clinical diagnoses. Research in Autism Spectrum Disorders, 8(2), 68-73. doi: 10.1016/j.rasd.2013.11.002
Montiel-Nava, C., Chacín, J. A., & González-Ávila, Z. (2017). Age of diagnosis of autism spectrum disorder in Latino children: The case of Venezuelan children. Autism, 21(5), 573-580. doi: 10.1177/1362361317701267
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(1), 69-75. doi: 10.1023/a:1026067104198
Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., … Cunniff, C. (2012). Prevalence of Autism Spectrum Disorders in Hispanic and Non-Hispanic White Children. Pediatrics, 129(3), e629-e635. doi: 10.1542/peds.2011-1145
Pereira, A., Riesgo, R. S., & Wagner, M. B. (2008). Childhood autism: Translation and validation of the Childhood Autism Rating Scale for use in Brazil. Jornal de Pediatria, 84(6), 487-494. doi: 10.2223/JPED.1828
Perry, A., Condillac, R. A., Freeman, N. L., 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(5), 625-634. doi: 10.1007/s10803-005-0006-9
Pilowsky, T., Yirmiya, N., Shulman, C., & Dover, R. (1998). The Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: Differences Between Diagnostic Systems and Comparison Between Genders. Journal of Autism and Developmental Disorders, 28(2), 143-151. doi: 10.1023/A:1026092632466
Polaino-Lorente, A., García-Villamisar, D., & Muela, C. (1991). The internal consistency and concurrent validity of Spanish traslation of CARS and AAPEP. He Journal of Child Psychology and Psychiatry Abstracts Booklet, 121.
Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F. (2004). Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) Correspondence and Conflicts with DSM-IV Criteria in Diagnosis of Autism. Journal of Autism and Developmental Disorders, 34(6), 703-708. doi: 10.1007/s10803-004-5290-2
Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (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(2), 131-144. doi: 10.1023/a:1010738829569
Russell, P. S., Daniel, A., Russell, S., Mammen, P., Abel, J. S., Raj, L. E., … Thomas, N. (2010). Diagnostic accuracy, reliability and validity of Childhood Autism Rating Scale in India. World Journal of Pediatrics, 6(2), 141-147. doi: 10.1007/s12519-010-0029-y
Saemundsen, E., Magnússon, P., Smári, J., & Sigurdardóttir, 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(3), 319-328. doi: 10.1023/A:1024410702242
Sanchez, M. J., & Constantino, J. N. (2020). Expediting clinician assessment in the diagnosis of autism spectrum disorder. Developmental Medicine & Child Neurology, 62(7), 806-812. doi: 10.1111/dmcn.14530
Schopler, E., Reichler, R. J., & Renner, B. R. (1988). The Childhood Autism Rating Scale (CARS). Western Psychological Services.
Schopler, E., Reichler, R. J., DeVellis, R. F., & Daly, K. (1980). Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS). Journal of Autism and Developmental Disorders, 10(1), 91-103. doi: 10.1007/BF02408436
Schopler, E., Van Bourgondien, M. E., Wellman, J., & Love, S. (2010). Childhood autism rating scale-second edition (CARS2): Manual. Los Angeles: Western Psychological Services.
Shin, M. S., & Kim, Y.-H. (1998). Standardization study for the Korean version of the Childhood Autism Rating Scale: Reliability, validity and cut-off score. Korean Journal of Clinical Psychology, 17(1), 1-15.
Sturmey, P., Matson, J. L., & Sevin, J. A. (1992). Brief report: Analysis of the internal consistency of three autism scales. Journal of Autism and Developmental Disorders, 22(2), 321-328. doi: 10.1007/BF01058159
Tachimori, H., Osada, H., & Kurita, H. (2003). Childhood Autism Rating Scale- Tokyo Version for screening pervasive developmental disorders. Psychiatry and Clinical Neurosciences, 57(1), 113-118. doi: 10.1046/j.1440-1819.2003.01087.x
Tapia Guillen, L. G., Solis Bravo, M. A., Albores-Gallo, L., Flores-Rodriguez, Y., Roldán-Ceballos, O., Aguerre-Estevez, R., & Martin-Salas, J. (2019). Autism Spectrum Disorders in an Upper-Middle Income Country. Global Journal of Intellectual & Developmental Disabilities, 6(2), 1-7. doi: 10.19080/GJIDD.2019.06.555684
Ventola, P. E., Kleinman, J., Pandey, J., Barton, M., Allen, S., Green, J., … Fein, D. (2006). Agreement Among Four Diagnostic Instruments for Autism Spectrum Disorders in Toddlers. Journal of Autism and Developmental Disorders, 36(7), 839-847. doi: 10.1007/s10803-006-0128-8
Zavaleta-Ramírez, P., Rosetti, M. F., Albores-Gallo, L., Vargas-Soberanis, M. A., López, O. N., & Medina-Mora, M. E. (2020). Pathways to a Diagnosis of Autism Spectrum Disorder. Psychiatric Services, 71(11), 1120-1126. doi: 10.1176/appi.ps.201900518
