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

Seong-In Ji; Hyungseo Park; Sun Ah Yoon; Soon-Beom Hong

doi:10.5765/jkacap.220027

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

Soa Chongsonyon Chongsin Uihak. 2023 Jan 1;34(1):45-50. doi: 10.5765/jkacap.220027.

Authors

Seong-In Ji¹, Hyungseo Park¹, Sun Ah Yoon¹, Soon-Beom Hong^{2

3}

Affiliations

¹ Department of Psychiatry, Seoul National University Hospital, Seoul, Korea.
² Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
³ Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea.

Abstract

Objectives: 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).

Methods: 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.

Results: 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.

Conclusion: We suggest a newly derived CARS2-ST cutoff score of 28.5 for screening ASD and providing early intervention.

Keywords: ADOS-2; Autism spectrum disorder; CARS-2; Diagnosis; Screening.