Expediting clinician assessment in the diagnosis of autism spectrum disorder.
Matthew J Sanchez, John N Constantino
PMID 32239502WHAT IT FOUND
A brief, standardized 15-minute observation using the CARS-2 effectively distinguished children with autism from those without in a clinic setting.
Scores of 16 or higher were highly specific for autism, offering a tool to expedite diagnosis and reduce wait times for specialists.
Key findings
01The CARS-2 observation score was significantly higher in patients with autism compared to those without, showing a clear separation between the groups.
02A CARS-2 observation score of 16 or higher provided high specificity for diagnosing autism, though sensitivity was lower.
03The observation scores correlated strongly with the ADOS-2, a standard diagnostic assessment, but only moderately with parent-reported social responsiveness scores.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used a referral population with high suspicion of autism, so the results may not apply to general screening in low-risk populations. The sample had relatively few females and children with intellectual disability, limiting generalizability to these groups. Only a minority of patients (19) completed the ADOS-2, so correlations with this gold-standard measure are based on a small subset.
Declared interests
Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. No other conflicts of interest are explicitly detailed in the provided text, though the study was conducted within a clinical center.
The easy way to misread this
Do not use the CARS-2 obs score as a standalone diagnostic tool for general population screening. The high specificity (93.2%) means a high score is strong evidence for autism, but the moderate sensitivity (65.9%) means many individuals with autism will score below the cutoff. It is designed to expedite diagnosis in suspected cases, not to rule out autism in unselected children.