A Validation Study of the CARS-2 Compared With the ADOS-2 in the Diagnosis of Autism Spectrum Disorder: A Suggestion for Cutoff Scores

• Published in: Journal of the Korean Academy of Child and Adolescent Psychiatry Vol. 34; no. 1; pp. 45 - 50
• Main Authors: Ji, Seong-In, Park, Hyungseo, Yoon, Sun Ah, Hong, Soon-Beom
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한소아청소년정신의학회 2023; Korean Academy of Child and Adolescent Psychiatry; 대한소아청소년 정신의학회
• Subjects: Age; Algorithms; Autism; Child & adolescent psychiatry; Childhood; Original; Review boards; Teenagers; Validation studies; 정신과학; United States > US; Screening; ADOS-2; CARS-2; Diagnosis; Autism spectrum disorder
• ISSN: 1225-729X; 2233-9183; 2233-9183
• DOI: 10.5765/jkacap.220027

This study examined the validity of the Childhood Autism Rating Scale, Second Edition (CARS-2) compared with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in identifying autism spectrum disorder (ASD). A total of 237 children were tested using both the CARS-2 and ADOS-2. We examined the correlation using Pearson's correlation analysis. In addition, we used a receiver operating characteristic graph to determine the optimal standard version of the CARS-2 (CARS2-ST) cutoff score for ASD diagnosis using the ADOS-2. The concurrent validity of the CARS2-ST was demonstrated by a significant correlation with the ADOS-2 (r=0.864, p<0.001). The optimal CARS2-ST cutoff scores were 30 and 28.5 for identifying autism and autism spectrum, respectively, based on the ADOS-2. We suggest a newly derived CARS2-ST cutoff score of 28.5 for screening ASD and providing early intervention.