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Childhood autism rating scale--Tokyo version for screening pervasive developmental disorders
Hisateru Tachimori1, Hirokazu Osada, Hiroshi Kurita
1Department of Mental Health Administration, National Institute of Mental Health, National Center for Neurology and Psychiatry, Chiba, Japan. tachi@ncnp-k.go.jp
Psychiatry and Clinical Neurosciences
|January 10, 2003
Summary
The Childhood Autism Rating Scale - Tokyo Version (CARS-TV) effectively differentiates Pervasive Developmental Disorders (PDD) from non-PDD intellectual disability and distinguishes Autistic Disorder (AD) from PDD-Not Otherwise Specified (PDDNOS) in children.
Area of Science:
- Child and Adolescent Psychiatry
- Neurodevelopmental Disorders
- Psychometric Assessment
Background:
- Accurate diagnosis of Autism Spectrum Disorder (ASD) and related conditions is crucial for timely intervention.
- Differentiating between various Pervasive Developmental Disorders (PDD) and intellectual disability (ID) presents diagnostic challenges.
- The Childhood Autism Rating Scale - Tokyo Version (CARS-TV) is a tool used for assessing ASD symptoms.
Purpose of the Study:
- To evaluate the diagnostic utility of the CARS-TV in differentiating between subgroups of children diagnosed with DSM-IV PDD.
- To compare CARS-TV total scores across distinct diagnostic groups: Autistic Disorder (AD), Childhood Disintegrative Disorder (CDD), Asperger's Disorder, and PDD-Not Otherwise Specified (PDDNOS).
- To establish cut-off scores for distinguishing PDD from non-PDD intellectual disability (MR) and for differentiating AD from PDDNOS.
Main Methods:
- A cross-sectional study involving 430 children with DSM-IV PDD diagnoses.
- Comparison of CARS-TV total scores among the four diagnostic subgroups (AD, CDD, Asperger's, PDDNOS).
- Calculation of reliability (Cronbach's alpha) and diagnostic accuracy (sensitivity, specificity, predictive values) for established cut-off scores.
Main Results:
- CARS-TV demonstrated high internal consistency (Cronbach's alpha = 0.91-0.93).
- Total scores were significantly higher in the PDD group compared to the non-PDD MR group (mean difference = 7.2, P < 0.0001), with a cut-off of 25.5/26 yielding good diagnostic accuracy (sensitivity=0.86, specificity=0.83).
- Significant differences in CARS-TV scores were observed among the four PDD subgroups, with CDD and AD scoring higher than PDDNOS and Asperger's disorder. A cut-off of 30/30.5 distinguished AD from PDDNOS (sensitivity=0.71, specificity=0.75).
Conclusions:
- The CARS-TV is a valuable instrument for differentiating between PDD and non-PDD intellectual disability.
- The CARS-TV can also effectively distinguish between Autistic Disorder and PDD-Not Otherwise Specified.
- Further research is recommended to replicate these findings and confirm the clinical utility of CARS-TV across diverse populations.