The Relationship Between the Childhood Autism Rating Scale: Second Edition and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5

Dawkins, Tamara; Meyer, Allison; Bourgondien, Mary E. Van

doi:10.1007/s10803-016-2860-z

Cited by 43 publications

(39 citation statements)

References 12 publications

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“…In addition, many of the studies that have evaluated CARS have not been blinded to the CARS result when assigning the clinical best estimate diagnosis. Reported sensitivities (in English speaking countries) range from 0.89 to 0.94,176178 and reported specificities range from 0.61 to 1,161178 depending on the algorithm and CARS version used.…”

Section: Diagnostic Assessment Toolsmentioning

confidence: 99%

Autism spectrum disorder: advances in diagnosis and evaluation

Zwaigenbaum

Penner

2018

BMJ

182

137

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Autism spectrum disorder (ASD) has a variety of causes, and its clinical expression is generally associated with substantial disability throughout the lifespan. Recent advances have led to earlier diagnosis, and deep phenotyping efforts focused on high risk infants have helped advance the characterization of early behavioral trajectories. Moreover, biomarkers that measure early structural and functional connectivity, visual orienting, and other biological processes have shown promise in detecting the risk of autism spectrum disorder even before the emergence of overt behavioral symptoms. Despite these advances, the mean age of diagnosis is still 4-5 years. Because of the broad consistency in published guidelines, parameters for high quality comprehensive assessments are available; however, such models are resource intensive and high demand can result in greatly increased waiting times. This review describes advances in detecting early behavioral and biological markers, current options and controversies in screening for the disorder, and best practice in its diagnostic evaluation including emerging data on innovative service models.

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Section: Diagnostic Assessment Toolsmentioning

confidence: 99%

Autism spectrum disorder: advances in diagnosis and evaluation

Zwaigenbaum

Penner

2018

BMJ

182

137

View full text Add to dashboard Cite

show abstract

“…Therefore, it is unclear to what extent the findings of the current study apply to children diagnosed with ASD using DSM-5. Importantly, however, diagnostic agreement between the CARS and DSM-5 has been found to be similar to the diagnostic agreement with DSM-IV-TR (Mayes et al 2014; Dawkins et al 2016). Additionally, the factors identified in the current study appear to overlap with the two core symptom domains emphasized in DSM-5 (social communication, stereotyped behaviors and sensory sensitivities), with an additional factor reflective of emotional reactivity.…”

Section: Discussionmentioning

confidence: 63%

“…This finding is similar to findings of diagnostic agreement between the CARS and DSM-IV(-TR) diagnostic criteria (86%; Chlebowski et al 2010). Additional work has shown that diagnostic sensitivity of the CARS2-ST based on the DSM-5 was .84, compared with .81 for the DSM-IV-TR (Dawkins et al 2016). …”

Section: Introductionmentioning

confidence: 99%

Factor Analysis of the Childhood Autism Rating Scale in a Sample of Two Year Olds with an Autism Spectrum Disorder

Moulton

Bradbury

Barton

et al. 2016

J Autism Dev Disord

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The Childhood Autism Rating Scale (CARS, Schopler 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 two-year-old children with DSM-IV-TR (APA 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 two-year-old children.

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“…The third‐generation studies (2013–present) have been required to involve very complicated methodologies for assessing the accuracy, as significant changes were made to diagnostic criteria and disorder entity classifications for autism during the transition from DSM‐IV to DSM‐5 (2013–current). More specifically, these studies have considered all four possible combinations (CARS/DSM‐IV, CARS/DSM‐5, CARS‐HF/DSM‐IV, and CARS‐HF/DSM‐5) with the latest published in 2016 . Unlike how many tools either fade out or only need to adjust the cut‐off scores without having to update their version over changes in definition or diagnostic criteria for their target disorder, CARS has shown very dynamic updates over the years.…”

Section: Discussionmentioning

confidence: 99%

“…During transitions from DSM‐III to DSM‐IV, DSM‐IV‐TR, and DSM‐5, CARS has been updated in its versions, studied for its accuracy, and widely used across research and clinical settings . However, to our knowledge, there is currently no systematic review for its accuracy that encompasses its entire history.…”

mentioning

confidence: 99%

Accuracy of the Childhood Autism Rating Scale: a systematic review and meta‐analysis

Moon¹,

Hwang

Shin

et al. 2019

Develop Med Child Neuro

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Aim To assess the accuracy of the Childhood Autism Rating Scale (CARS) through systematic review and meta‐analysis. Method Studies that provided quantitative values for the reliability and validity for all versions of CARS were searched through MEDLINE, CINAHL, PsycINFO, Embase, and OpenDissertations. Results A total of 24 studies with 4433 participants were included in our analysis. Meta‐analysis showed that the summary Cronbach's alpha regarding a team of physicians and psychologists or others subgroup, derived from six studies (952 participants), was considered to be acceptable at 0.90 (95% confidence interval, 0.87–0.92) with moderate heterogeneity. Analysis of two ‘low risk of bias’ studies on the criterion validity for CARS with a cut‐off of 30 and DSM‐IV resulted in sensitivity of 0.86 and 0.71 and specificity of 0.79 and 0.75. Interpretation Through the results of the current systematic review and meta‐analysis, the internal consistency can be considered to be acceptable for a team of physicians and psychologists or others subgroup. In terms of the criterion validity, the sensitivity was thought to be acceptable although the specificity was not, suggesting that CARS should be used along with other confirmatory tools. What this paper adds The Childhood Autism Rating Scale can be considered as a supplementary diagnostic tool for autism spectrum disorder.

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The Relationship Between the Childhood Autism Rating Scale: Second Edition and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5

Cited by 43 publications

References 12 publications

Autism spectrum disorder: advances in diagnosis and evaluation

Autism spectrum disorder: advances in diagnosis and evaluation

Factor Analysis of the Childhood Autism Rating Scale in a Sample of Two Year Olds with an Autism Spectrum Disorder

Accuracy of the Childhood Autism Rating Scale: a systematic review and meta‐analysis

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