Diagnostic accuracy, reliability and validity of Childhood Autism Rating Scale in India
- PDF / 244,445 Bytes
- 7 Pages / 595.22 x 842 pts (A4) Page_size
- 79 Downloads / 205 Views
Diagnostic accuracy, reliability and validity of Childhood Autism Rating Scale in India Paul SS Russell, Anna Daniel, Sushila Russell, Priya Mammen, Julie S Abel, Lydia E Raj, Satya Raj Shankar, Naveen Thomas Vellore, Southern India
Methods: Children and adolescents suspected of having autism were identified from the unit's database. Scale and item level scores of CARS were collected and analyzed. Sensitivity, specificity, likelihood ratios and predictive values for various CARS cut-off scores were calculated. Test-retest reliability and inter-rater reliability of CARS were examined. The dichotomized CARS score was correlated with the ICD-10 clinical diagnosis of autism to establish the criterion validity of CARS as a measure of autism. Convergent and divergent validity was calculated. The factor structure of CARS was demonstrated by principal components analysis. Results: A CARS score of ≥33 (sensitivity = 81.4%, specificity = 78.6%; area under the curve = 81%) was suggested for diagnostic use in Indian populations. The inter-rater reliability (ICC=0.74) and test-retest reliability (ICC=0.81) for CARS were good. Besides the adequate face and content validity, CARS demonstrated good internal consistency (Cronbach's α=0.79) and item-total correlation. There was moderate convergent validity with Binet-Kamat Test of Intelligence or Gessell's Developmental Schedule (r=0.42; P=0.01), divergent validity (r=-0.18; P=0.4) with ADD-H Comprehensive Teacher Rating Scale, and high concordance rate with the reference standard, ICD-10 diagnosis (82.52%; Cohen's κ=0.40, P=0.001) in classifying autism. A 5-factor structure explained 65.34% of variance.
Author Affiliations: Autism Clinic, Child & Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore 632 002, Southern India (Russell PS, Daniel A, Russell S, Mammen P, Abel JS, Raj LE, Shankar SR, Thomas N) Corresponding Author: Paul Russell, MD, Autism Clinic, Child & Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore 632 002, Southern India (Tel: +91(0416) 2284307; Fax: +91 (0416) 32788 or 32368; Email: [email protected]) doi:10.1007/s12519-010-0029-y ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2010. All rights reserved.
Conclusion: The CARS has strong psychometric properties and is now available for clinical and research work in India. World J Pediatr 2010;6(2):141-147 Key words: autism; diagnostic accuracy; India; reliability; validation
Original article
Background: Since there is no established measure for autism in India, we evaluated the diagnostic accuracy, reliability and validity of Childhood Autism Rating Scale (CARS).
Introduction
T
here has been a documented increase in the prevalence of autism worldwide.[1,2] The Indian Academy of Pediatrics, as stated in the aims of its Vision 2007, plans to conduct epidemiological studies and enhance early identification of autism.[3] To achieve these goals, establishing the psychometric
Data Loading...
