Year: 2021
Type: Article
Title: Measurement invariance of the Childhood Autism Rating Scale (
CARS ) across six countries
Author: Stevanovic, Dejan
Author: Costanzo, Floriana
Author: Fucà, Elisa
Author: Valeri, Giovanni
Author: Vicari, Stefano
Author: Robins, Diana L.
Author: Samms‐Vaughan, Maureen
Author: Ozek Erkuran, Handan
Author: Yaylaci, Ferhat
Author: Deshpande, Smita N.
Author: Deshmukh, Vaishali
Author: Arora, Narendra K.
Author: Albores‐Gallo, Lilia
Author: García‐López, Cristina
Author: Gatica‐Bahamonde, Gabriel
Author: Gabunia, Maia
Author: Zirakashvili, Medea
Author: Machado, Fernanda Prada
Author: Radan, Miruna
Author: Samadi, Sayyed Ali
Author: TOH, Teck‐Hock
Author: Gayle, Windham
Author: Brennan, Laura
Author: Zorcec, Tatjana
Author: Auza, Alejandra
Author: Jonge, Maretha
Author: Shoqirat, Noordeen
Author: Marini, Anita
Author: Knez, Rajna
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.
Publisher: Wiley
Relation: Autism Research
Identifier: oai:repository.ukim.mk:20.500.12188/22031
Identifier: http://hdl.handle.net/20.500.12188/22031Identifier: 10.1002/aur.2586
Identifier: https://onlinelibrary.wiley.com/doi/pdf/10.1002/aur.2586Identifier: https://onlinelibrary.wiley.com/doi/full-xml/10.1002/aur.2586Identifier: https://onlinelibrary.wiley.com/doi/pdf/10.1002/aur.2586Identifier: 14
Identifier: 12
