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Journal article
Measurement invariance of the Childhood Autism Rating Scale (CARS) across six countries
Autism research, Vol.14(12), pp.2544-2554
Dec 2021
PMID: 34346193
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The Childhood Autism Rating Scale (CARS) is a simple and inexpensive tool for Autism spectrum disorder (ASD) assessments, with evidenced psychometric data from different countries. However, it is still unclear whether ASD symptoms are measured the same way across different societies and world regions with this tool, since data on its cross-cultural validity are lacking. This study evaluated the cross-cultural measurement invariance of the CARS among children with ASD from six countries, for whom data were aggregated from previous studies in India (n = 101), Jamaica (n = 139), Mexico (n = 72), Spain (n = 99), Turkey (n = 150), and the United States of America (n = 186). We analyzed the approximate measurement invariance based on Bayesian structural equation modeling. The model did not fit the data and its measurement invariance did not hold, with all items found non-invariant across the countries. Items related to social communication and interaction (i.e., relating to people, imitation, emotional response, and verbal and nonverbal communication) displayed lower levels of cross-country non-invariance compared to items about stereotyped behaviors/sensory sensitivity (i.e., body and object use, adaptation to change, or taste, smell, and touch response). This study found that the CARS may not provide cross-culturally valid ASD assessments. Thus, cross-cultural comparisons with the CARS should consider first which items operate differently across samples of interest, since its cross-cultural measurement non-invariance could be a source of cross-cultural variability in ASD presentations. Additional studies are needed before drawing valid recommendations in relation to the cultural sensitivity of particular items.
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- Title
- Measurement invariance of the Childhood Autism Rating Scale (CARS) across six countries
- Creators
- Dejan Stevanovic - Department of Psychiatry Clinic for Neurology and Psychiatry for Children and Youth Belgrade SerbiaFloriana Costanzo - Bambino Gesù Children's HospitalElisa Fucà - Bambino Gesù Children's HospitalGiovanni Valeri - Bambino Gesù Children's HospitalStefano Vicari - Bambino Gesù Children's HospitalDiana L Robins - Drexel UniversityMaureen Samms-Vaughan - University of the West Indies SystemHandan Ozek Erkuran - Child and Adolescent Psychiatry Unit, Dr Behcet Uz Children's Research and Training Hospital, Izmir, TurkeyFerhat Yaylaci - Child Psychiatry Unit, Bursa Dortcelik Children's Hospital, Bursa, TurkeySmita N Deshpande - Dr. Ram Manohar Lohia HospitalVaishali Deshmukh - INCLEN Trust InternationalNarendra K Arora - INCLEN Trust InternationalLilia Albores-Gallo - Hospital Psiquiatrico Infantil Juan N NavarroCristina García-López - Hospital Sant Joan de Déu BarcelonaGabriel Gatica-Bahamonde - University of La FronteraMaia Gabunia - Mental Health Center Tbilisi GeorgiaMedea Zirakashvili - Ilia State UniversityFernanda Prada Machado - Pontifícia Universidade Católica de São PauloMiruna Radan - National Institute for Maternal and Child Health Bucharest RomaniaSayyed Ali Samadi - University of UlsterTeck-Hock Toh - Sibu HospitalWindham Gayle - Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USALaura Brennan - University of ConnecticutTatjana Zorcec - Boston Children's HospitalAlejandra Auza - Hospital General Dr. Manuel Gea GonzalezMaretha de Jonge - Leiden UniversityNoordeen Shoqirat - Mutah UniversityAnita Marini - World Health OrganizationRajna Knez - University of GothenburgInstitute of Neuroscience and Physiology
- Publication Details
- Autism research, Vol.14(12), pp.2544-2554
- Publisher
- Wiley
- Grant note
- 001 / World Health Organization
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Identifiers
- 991019168119904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Behavioral Sciences
- Psychology, Developmental