Premium
Re‐adjusting the cut‐off score of the K orean version of the C hildhood A utism R ating S cale for high‐functioning individuals with autism spectrum disorder
Author(s) -
Kwon HyukJin,
Yoo HeeJeong,
Kim JooHyun,
Noh DongHyun,
Sunwoo HyunJung,
Jeon Ye Seul,
Lee Sangyoun,
Jo Yeul,
Bong GuiYoung
Publication year - 2017
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/pcn.12540
Subject(s) - autism diagnostic observation schedule , autism , autism spectrum disorder , high functioning autism , childhood autism rating scale , psychology , rating scale , clinical psychology , intelligence quotient , spectrum disorder , audiology , psychiatry , medicine , developmental psychology , cognition
Aim The current cut‐off score of the Korean version of the Childhood Autism Rating Scale (K‐CARS) does not seem to be sensitive enough to precisely diagnose high‐functioning autism. The aim of this study was to identify the optimal cut‐off score of K‐CARS for diagnosing high‐functioning individuals with autism spectrum disorders (ASD). Methods A total of 329 participants were assessed by the Korean versions of the Autism Diagnostic Interview – Revised (K‐ADI‐R), Autism Diagnostic Observation Schedule (K‐ADOS), and K‐CARS. IQ and Social Maturity Scale scores were also obtained. Results The true positive and false negative rates of K‐CARS were 77.2% and 22.8%, respectively. Verbal IQ (VIQ) and Social Quotient (SQ) were significant predictors of misclassification. The false negative rate increased to 36.0% from 19.8% when VIQ was >69.5, and the rate increased to 44.1% for participants with VIQ > 69.5 and SQ > 75.5. In addition, if SQ was >83.5, the false negative rate increased to 46.7%, even if the participant’s VIQ was ≤69.5. Optimal cut‐off scores were 28.5 (for VIQ ≤ 69.5 and SQ ≤ 75.5), 24.25 (for VIQ > 69.5 and SQ > 75.5), and 24.5 (for SQ > 83.5), respectively. Conclusion The likelihood of a false negative error increases when K‐CARS is used to diagnose high‐functioning autism and Asperger's syndrome. For subjects with ASD and substantial verbal ability, the cut‐off score for K‐CARS should be re‐adjusted and/or supplementary diagnostic tools might be needed to enhance diagnostic accuracy for ASD.