CDC Kerala 10: Diagnostic Accuracy of the Severity Scores for Childhood Autism Rating Scale in India

• Published in: Indian journal of pediatrics 2014-12, Vol.81 (Suppl 2), p.120-124
• Main Authors: Nair, M. K. C., Russell, Paul Swamidhas Sudhakar, George, Babu, Prasanna, G. L., Bhaskaran, Deepa, Shankar, Satya Raj, Singh, Yogendra
• Format: Article
• Language: English
• Subjects: Autistic Disorder - diagnosis; Behavior Rating Scale; Child, Preschool; Female; Gynecology; Humans; India; Male; Medicine; Medicine & Public Health; Original Article; Pediatrics
• ISSN: 0019-5456; 0973-7693
• DOI: 10.1007/s12098-014-1623-0

Objective To document the diagnostic accuracy of the Childhood Autism Scale (CARS) thresholds to identify mild, moderate and severe autism in India. Methods The CARS scores of 623 children, with and without autism were compared against the Diagnostic and Statistical Manual for Mental Disorders 4th edition (DSM-IV-TR) for ASD diagnosis and clinical consensus between two developmental paediatricians as the reference standard for autism severity using the Receiver operating characteristics (ROC) curve analyses and contingency tables. Results The CARS total score for mild, moderate and severe autism ranged from 30.5 to 35, 35.5–40 and ≥40.5 respectively in this study. The overall diagnostic accuracy of CARS total score in the mild range was moderate [AUC = 0.68 (95%CI = 0.62–0.88), z = 1.34; P  = 0.18], moderate range was high [AUC = 0.90 (95%CI = 0.77–0.97), z = 8.62; P  = 0.0001] and severe range was also high [AUC = 0.85 (95%CI = 0.77–0.90), z = 7.09; P  = 0.0001]. Conclusions There are validated severity scores for Childhood Autism Rating Scale for clinical and research use in India.