KnE Social Sciences

Published date: Mar 27 2025

Journal Title: KnE Social Sciences

Issue title: The 3rd International Conference of Applied Psychology on Humanity (ICAP-H)

Pages: 62 - 71

DOI: 10.18502/kss.v10i7.18303

Achmad Sholehzholeh.wei@gmail.comGrowth Development Unit & Psychology Clinic, Rumah Sakit Dr. Oen Solo Baru, Indonesia

This study examined the diagnostic accuracy of the Indonesian Childhood Autism Rating Scale, Second Edition, Standard Version (ID-CARS2-ST) in identifying autism spectrum disorder (ASD) and differentiating it from other neurodevelopmental disorders. The ID-CARS2-ST can be used to develop diagnostic hypotheses and design intervention plans for children with ASD, complementing clinical judgment based on the DSM criteria. This study involved a total of 50 subjects in our clinic, consisting of 25 children diagnosed with ASD and 25 children with other neurodevelopmental disorders. We conducted reliability tests and receiver operating characteristic (ROC) curve analysis to assess the sensitivity and specificity of the ID-CARS2-ST to determine the optimal standard cutoff point for diagnosing ASD in children. Cronbach’s alpha reliability yielded a result of Ω = 0.937. The optimal ID-CARS2-ST cutoff score was 30, with a sensitivity of 96% and specificity of 88% (AUC = 0.927, P<0.001; Youden’s J = 0.84). Our findings are exciting, and a score of 30 is the same as the original cut-off of the CARS2-ST in identifying ASD.

Keywords: CARS2-ST, ID-CARS2-ST, autism spectrum disorder, diagnose, cut-off score

[1] American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5-TR) (Fifth Edit). 2022.

[2] World Health Organization. Autism. 2023.

[3] Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ. 2023 Mar;72(2):1–14.

[4] Zablotsky B, Black LI, Maenner MJ, Schieve LA, Danielson ML, Bitsko RH, et al. Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017. Pediatrics. 2019 Oct;144(4):e20190811.

[5] Shaw KA, Maenner MJ, Bakian AV, Bilder DA, Durkin MS, Furnier SM, et al. Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ. 2021 Dec;70(10):1–14.

[6] Stefanni DM. detikHealth. [ Juta Anak di Indonesia Idap Autisme.]. Wamenkes Ungkap. 2024;2:4.

[7] Zero to Three. DC:0–5TM: Diagnostic classification of mental health and developmental disorders of infancy and early childhood. Washington DC; 2016.

[8] Schopler E, Reichler R, Renner B. Childhood Autism Rating Scale (CARS) [Manual]Western Psychological Services; 1988.

[9] Schopler E. Bourgondien ME, Van, Wellman GJ, Love SR. Childhood Autism Rating Scale, Second Edition (CARS2) [Manual]. Torrance: Western Psychological Services.; 2010.

[10] Kaufman NK. Rethinking “gold standards” and “best practices” in the assessment of autism. Appl Neuropsychol Child. 2022;11(3):529–40.

[11] Kaufman N, Bush S. Validity Assessment in Military Psychology. In 2020. p. 211.

[12] Kaufman NK, Bush SS. Concussion in Pediatric Neuropsychology. J Pediatr Neuropsychol. 2020 Mar;6(1):14–26.

[13] Wolff M, Bridges B, Denczek T. The complexity of autism spectrum disorders. Routledge. Routledge; 2018. https://doi.org/10.4324/9780429454646.

[14] Kasiram M. Metode Penelitian Kuantitatif. UINPress; 2008.

[15] Dawkins T, Meyer AT, Van Bourgondien ME. The Relationship Between the Childhood Autism Rating Scale: Second Edition and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5. J Autism Dev Disord. 2016 Oct;46(10):3361–8.

[16] Lee S, Yoon SA, Shin MS. Validation of the Korean Childhood Autism Rating Scale-2. Res Autism Spectr Disord. 2023 May;103:102128.

[17] Ji SI, Park H, Yoon SA, Hong SB. A Validation Study of the CARS-2 Compared With the ADOS-2 in the Diagnosis of Autism Spectrum Disorder: A Suggestion for Cutoff Scores. J Korean Acad Child Adolesc Psychiatry. 2023 Jan;34(1):45–50.

[18] Akoury-Dirani L, Alameddine M, Salamoun M. Validation of the lebanese childhood autism rating scale-second edition-standard version. Res Autism Spectr Disord. 2013;7(9):1097–103.

[19] Alotaibi B, Alotaibi A. Exploratory and confirmatory factor analyses of the Arabic version of the Childhood Autism Rating Scale. Res Autism Spectr Disord. 2021 Aug;86:86.

[20] Nelson DE, Holtzman D, Bolen J, Stanwyck CA, Mack KA. Reliability and validity of measures from the behavioral risk factor surveillance system (BRFSS). Soz Praventivmed. 2001;46(1 Suppl 1):S3–42.

[21] Metz CE. Basic principles of ROC analysis. Semin Nucl Med. 1978 Oct;8(4):283–98.

[22] Biggersta BJ. Comparing diagnostic tests: a simple graphic using likelihood ratios. Volume 19. STATISTICS IN MEDICINE Statist. Med; 2000.

[23] Youden WJ. Index for rating diagnostic tests. Cancer. 1950 Jan;3(1):32–5.