{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:53:20Z","timestamp":1791820400686,"version":"4.3.4"},"reference-count":73,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T00:00:00Z","timestamp":1628035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    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\u2010cultural validity are lacking. This study evaluated the cross\u2010cultural measurement invariance of the CARS among children with ASD from six countries, for whom data were aggregated from previous studies in India (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0101), Jamaica (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0139), Mexico (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a072), Spain (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a099), Turkey (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0150), and the United States of America (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0186). 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\u2010invariant 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\u2010country non\u2010invariance 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\u2010culturally valid ASD assessments. Thus, cross\u2010cultural comparisons with the CARS should consider first which items operate differently across samples of interest, since its cross\u2010cultural measurement non\u2010invariance could be a source of cross\u2010cultural variability in ASD presentations. Additional studies are needed before drawing valid recommendations in relation to the cultural sensitivity of particular items.\n                  <\/jats:p>","DOI":"10.1002\/aur.2586","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T04:44:46Z","timestamp":1628052286000},"page":"2544-2554","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Measurement invariance of the Childhood Autism Rating Scale (\n                    <scp>CARS<\/scp>\n                    ) across six countries"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8236-5246","authenticated-orcid":false,"given":"Dejan","family":"Stevanovic","sequence":"first","affiliation":[{"name":"Department of Psychiatry Clinic for Neurology and Psychiatry for Children and Youth  Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floriana","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Child and Adolescent Neuropsychiatry Unit Bambino Ges\u00f9 Children's Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Fuc\u00e0","sequence":"additional","affiliation":[{"name":"Child and Adolescent Neuropsychiatry Unit Bambino Ges\u00f9 Children's Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Valeri","sequence":"additional","affiliation":[{"name":"Child and Adolescent Neuropsychiatry Unit Bambino Ges\u00f9 Children's Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Vicari","sequence":"additional","affiliation":[{"name":"Child and Adolescent Neuropsychiatry Unit Bambino Ges\u00f9 Children's Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L.","family":"Robins","sequence":"additional","affiliation":[{"name":"A.J. Drexel Autism Institute Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Samms\u2010Vaughan","sequence":"additional","affiliation":[{"name":"University of the West Indies  Kingston Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Handan","family":"Ozek Erkuran","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry Unit Dr Behcet Uz Children's Research and Training Hospital  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferhat","family":"Yaylaci","sequence":"additional","affiliation":[{"name":"Child Psychiatry Unit Bursa Dortcelik Children's Hospital  Bursa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita N.","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Centre of Excellence in Mental health, Atal Bihari Vajpayee Institute of Medical Sciences; Dr. Ram Manohar Lohia Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"INCLEN Trust  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narendra K.","family":"Arora","sequence":"additional","affiliation":[{"name":"INCLEN Trust  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5862-4404","authenticated-orcid":false,"given":"Lilia","family":"Albores\u2010Gallo","sequence":"additional","affiliation":[{"name":"Research Division Hospital Psiqui\u00e1trico Infantil \u201cDr. Juan N. 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