Objective: To translate the Childhood Autism Rating Scale into Brazilian Portuguese and to determine the initial psychometric properties of the resulting version (CARS-BR). Methods:The methodology used to produce an adequate version included translation, backtranslation and evaluation of semantic equivalence. In order to determine its psychometric properties (internal consistency, validity and reliability), the CARS-BR was administered to 60 consecutive patients with autism, aged between 3 and 17 years and seen at a university hospital. Conclusion:These results suggest that the CARS-BR is a valid and reliable instrument for evaluating autism severity in Brazil.J Pediatr (Rio J). 2008;84(6):487-494: Autism, validation studies, questionnaires.
Autism spectrum disorders (ASD) represent a complex group of neurodevelopmental conditions characterized by deficits in communication and social behaviors. We examined the functional connectivity (FC) of the default mode network (DMN) and its relation to multimodal morphometry to investigate superregional, system-level alterations in a group of 22 adolescents and young adults with high-functioning autism compared to age-, and intelligence quotient-matched 29 healthy controls. The main findings were that ASD patients had gray matter (GM) reduction, decreased cortical thickness and larger cortical surface areas in several brain regions, including the cingulate, temporal lobes, and amygdala, as well as increased gyrification in regions associated with encoding visual memories and areas of the sensorimotor component of the DMN, more pronounced in the left hemisphere. Moreover, patients with ASD had decreased connectivity between the posterior cingulate cortex, and areas of the executive control component of the DMN and increased FC between the anteromedial prefrontal cortex and areas of the sensorimotor component of the DMN. Reduced cortical thickness in the right inferior frontal lobe correlated with higher social impairment according to the scores of the Autism Diagnostic Interview-Revised (ADI-R). Reduced cortical thickness in left frontal regions, as well as an increased cortical thickness in the right temporal pole and posterior cingulate, were associated with worse scores on the communication domain of the ADI-R. We found no association between scores on the restrictive and repetitive behaviors domain of ADI-R with structural measures or FC. The combination of these structural and connectivity abnormalities may help to explain some of the core behaviors in high-functioning ASD and need to be investigated further.
ResumoObjetivo: Traduzir, adaptar e validar uma versão em português (do Brasil) da Childhood Autism Rating Scale (CARS).Métodos: Após processo de tradução, a versão foi aplicada em 60 pacientes com diagnóstico de autismo infantil, de 3 a 17 anos de idade, selecionados consecutivamente de um ambulatório especializado a fim de analisar as propriedades psicométricas da nova versão (CARS-BR) (consistência interna, validade e confiabilidade). Resultados:A consistência interna foi elevada, com valor de alfa de Cronbach de 0,82; a validade convergente (comparada com a Escala de Avaliação de Traços Autístícos) alcançou um coeficiente de correlação de Pearson de r = 0,89. Ao ser correlacionada à Escala de Avaliação Global de Funcionamento (para determinação da validade discriminante), a CARS-BR apresentou um coeficiente de correlação de Pearson de r = -0,75. A confiabilidade teste-reteste foi 0,90. Conclusão:A metodologia utilizada e os cuidados no processo de tradução permitem concluir que esse é um instrumento válido e confiável para avaliação da gravidade do autismo no Brasil.J Pediatr (Rio J). 2008;84(6):487-494: Autismo infantil, estudos de validação, questionários. AbstractObjective: To translate the Childhood Autism Rating Scale into Brazilian Portuguese and to determine the initial psychometric properties of the resulting version (CARS-BR). Methods:The methodology used to produce an adequate version included translation, backtranslation and evaluation of semantic equivalence. In order to determine its psychometric properties (internal consistency, validity and reliability), the CARS-BR was administered to 60 consecutive patients with autism, aged between 3 and 17 years and seen at a university hospital. Conclusion:These results suggest that the CARS-BR is a valid and reliable instrument for evaluating autism severity in Brazil. J Pediatr (Rio J)
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