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| Reliability and validity analysis of parental version of childhood autism rating scale |
| LI Yicheng1,2, HUO Yanyan1, ZHANG Yuanyuan1, QIU Xiaoyan1, MA Chenhuan1, YIN Anxin3 , LIU Qiaoyun4, WANG Jian5, LUO Jieming6, LI Tianshu6, XU Jing7, ZHOU Jie8, WANG Yan9 , TAO Bingtong10, MENG Fanping11, WANG Yu1, JIANG Hong3, CHEN Jinjin1 |
| 1. Department of Child Health Care, Shanghai Children’s Hospital, Shanghai Jiao Tong University School of medicine, Shanghai 200062, China; 2. Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; 3. School of Public Health, Fudan University, Shanghai 200436, China; 4. Department of Rehabilitation Science, East China Normal University, Shanghai 200062, China; 5. Jing’an District Maternal and Child Health Care Center, Shanghai 200072, China; 6. Huangpu District Maternal and Child Health Care Center, Shanghai 200010, China; 7. Yangpu District Maternal and Child Health Care Center, Shanghai 200082, China; 8. Putuo District Maternity and Infant Health Hospital, Shanghai 200062, China; 9. Jiaozhou Branch of Shanghai East Hospital, Tongji University, Jiaozhou 266318, Shandong Province, China; 10. Nanyang Second People’s Hospital, Nanyang 473009, Henan Province, China; 11. Chengdu Southwest Children’s Hospital, Chengdu 610047, Sichuan Province, China |
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Abstract Objective To examine the reliability and validity of the parent version of the childhood autism ratingscale (CARS). Methods In 3 districts of Shanghai, 319 children and their parents were recruited and randomly selected to participate in the study. Based on group discussion and Delphi expert inquiry method, the original version of CARS was annotated to make it easy to understand and suitable to fill out for parents, forming the parent version of CARS. After attending two online classes, parents filled out the scale according to their children’s daily performance and completed an online assessment. The discriminant validity, structural validity, criterion-related validity, homogeneity reliability, test-retest reliability, and inter-rater reliability of the scale were statistically tested. Results The item range of discriminant validity for the 15 items of the parent version of CARS was 0.588-0.801. Exploratory factor analysis showed a KMO value of 0.788 and a Bartlett’s sphere test with P<0.001. After extracting 4 common factors, the cumulative variance contribution rate was 61.74%, and the factor loading of each item was 0.443-0.801. Confirmatory factor analysis supported the 4-factor model (χ2/df=2.834, RMSEA=0.107, GFI=0.842, CFI=0.814, AGFI=0.774, IFI=0.818, TLI=0.767). The criterion-related validity of the scale was 0.41, 0.69, and 0.43 (P<0.01) when compared to the modified checklist for autism in toddlers (M-CHAT), autism behavior checklist (ABC), and autism diagnostic observation schedule (ADOS). The Cronbach’s α coefficient, split-half reliability, test-retest reliability, and inter-rater reliability of the scale were 0.91, 0.90, 0.81, and 0.71, respectively. Conclusion The parent version of CARS meets the measurement standards and demonstrates good reliability and validity, making it suitable for early home screening of children with autism spectrum disorder.
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