Réajustement du score seuil de la version coréenne du CARS pour les personnes avec un diagnostic de "trouble du spectre de l'autisme" et un "haut niveau de fonctionnement cognitif"

Aperçu: G.M.

Le score de coupure actuel de la version coréenne de l'échelle d'évaluation de l'autisme de l'enfance (K-CARS) ne semble pas suffisamment sensible pour diagnostiquer précisément l'autisme à "haut niveau de fonctionnement cognitif". L'objectif de cette étude était d'identifier le score seuil optimal du K-CARS pour le diagnostic de personnes à haut rendement cognitif avec des troubles du spectre de l'autisme (TSA).

La probabilité d'une fausse erreur négative augmente lorsque K-CARS est utilisé pour diagnostiquer l'autisme à haut fonctionnement cognitif et le syndrome d'Asperger. 

Pour les sujets "avec TSA" et une capacité verbale substantielle, le score seuil pour le K-CARS devrait être réajusté et / ou des outils de diagnostic supplémentaires pourraient être nécessaires pour améliorer la précision diagnostique pour les TSA

Psychiatry Clin Neurosci. 2017 May 26. doi: 10.1111/pcn.12540. 

Re-adjusting the cut-off score of the Korean version of the Childhood Autism Rating Scale for high-functioning individuals with autism spectrum disorder

Kwon HJ¹, Yoo HJ¹, Kim JH¹, Noh DH¹, Sunwoo HJ¹, Jeon YS¹, Lee SY¹, Jo YU¹, Bong GY¹.

Author information

1

Department of Psychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Abstract

AIM:

The current cut-off score of the Korean version of the Childhood Autism Rating Scale(K-CARS) does not seem 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. Intelligence quotient (IQ) and Social Maturity Scale (SMS; SQ) scores were also obtained.

RESULTS:

True positive and false negative rates of K-CARS were 77.2% and 22.8%, respectively. Verbal Intelligent Quotient and Social Quotient were significant predictors of misclassification. The false negative rate increased to 36.0% from 19.8% when VIQ > 69.5, and the rate increased to 44.1% for participants with VIQ > 69.5 and SQ > 75.5. In addition, if SQ > 83.5, the false negative rate increased to 46.7%, even if the participant's VIQ ≦ 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.

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PMID: 28547882

DOI: 10.1111/pcn.12540