Psychometric Properties of an Arabic Modified Childhood Autism Rating Scale 2 Standard Form

In middle- and lower-income countries, the scarcity of psychiatric expertise and IQ testing should be considered when developing and testing assessment tools. This study aims to assess the psychometric properties of a modified Arabic version of the Childhood Autism Rating Scale 2 Standard Form.

A diagnostic accuracy study, including 286 children, was conducted from December 1, 2023, to August 1, 2024, at Baghdad's National Centre and Al-Subtain Academy for Autism. Confirmatory factor analysis was utilized for structural validity, standardized alpha and the average inter-item correlation for reliability, and ROC curve analysis for diagnostic accuracy.

Good fit was demonstrated for the 1-, 2-, and 3-factor solutions. In all models, 'activity levels' had the lowest loadings and higher scores in children with ADHD (p-value = 0.0002). Excellent internal consistency was shown with a standardised alpha of 0.90 (> 0.7) and an average inter-item correlation of 0.394 (> 0.15). At the optimal cut-off (≥ 28.5), the scale had a sensitivity of 82.6%, a specificity of 93.4%, and would increase the child's odds of having ASD by 12.5.

The modified scale has good psychometric properties and might be utilised to adjust the psychiatric evaluation of children suspected of having a neurodevelopmental disorder.