Diagnostic Tools

Diagnostic Tools

students will be responsible for reading three research articles and completing written responses to the

readings for that day. These responses are meant to facilitate class discussion of the assigned material. For each

response, students will be required to write a one-page paper synthesizing the three articles and include at least 1

discussion question per article that they are prepared to bring up in class that day.


Brief Report: Concurrent Validity of Autism Symptom
Severity Measures
Stephanie S. Reszka • Brian A. Boyd •
Matthew McBee • Kara A. Hume • Samuel L. Odom
Published online: 27 June 2013
Springer Science+Business Media New York 2013
Abstract The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a
severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation
schedule (ADOS), Childhood Autism Rating Scale (CARS)
and social responsiveness scale (SRS) (teacher and parent
versions), include an assessment of symptom severity. The
purpose of this study was to examine whether symptom
severity and/or diagnostic status of preschool-aged children
with ASD (N = 201) were similarly categorized on these
measures. For half of the sample, children were similarly
classified across the four measures, and scores on most
measures were correlated, with the exception of the ADOS
and SRS-P. While the ADOS, CARS, and SRS are reliable
and valid measures, there is some disagreement between
measures with regard to child classification and the categorization of autism symptom severity.
Keywords Concurrent validity Autism Severity
Diagnostic classification
The proposed changes to the forthcoming diagnostic and
statistical manual of mental disorders, DSM-5 (http://
www.dsm5.org) would include severity criteria for the
autism spectrum disorders (ASD) category. This new criteria would combine autism disorder, Asperger syndrome,
and pervasive developmental disorder—not otherwise
specified (PDD-NOS) into one larger ASD category. As a
result of this collapse, reliable and valid measurement of
autism severity will be even more important in the determination of services for children with a diagnosis of ASD
(Matson et al. 2012).
Currently, the Childhood Autism Rating Scale (CARS;
Schopler et al. 1986) and Social Responsiveness Scale
(SRS; Constantino 2002) are two commonly used measures
that include a symptom severity estimate. Previously,
higher raw scores on the autism diagnostic and observation
schedule (ADOS; Lord et al. 1999) indicated the presence
of more deficits that are characteristic of individuals with
ASD, suggesting a greater level of impairment, but the raw
scores were not normalized to indicate severity (Gotham
et al. 2009). A recent calibrated severity metric provides
estimations of ASD symptom severity using ADOS scores
(see Gotham et al. 2009). Generally, severity is measured
in several areas for children with ASD: language delay,
cognitive functioning, and behavioral issues (Gotham et al.
2009), however these are not necessarily considered the
core features of ASD. Each of these measures, the CARS,
SRS, and ADOS utilizes slightly different methods of
evaluating the severity of ASD symptoms and have varied
diagnostic cut-offs along the ASD spectrum.
The primary purpose of this study was to examine
whether children’s symptom severity and/or diagnostic
status were similarly categorized across the four measures.
S. S. Reszka (&) B. A. Boyd
Department of Allied Health, Division of Occupational Science
and Occupational Therapy, University of North Carolina, 321 S.
Columbia Street, Bondurant Hall CB #7122, Chapel Hill,
NC 27599-7122, USA
e-mail: stephanie.reszka@unc.edu
Present Address:
M. McBee
East Tennessee State University, Johnson City, TN, USA
M. McBee K. A. Hume S. L. Odom
Frank Porter Graham Child Development Institute, University
of North Carolina, Chapel Hill, NC, USA
J Autism Dev Disord (2014) 44:466–470
DOI 10.1007/s10803-013-1879-7

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