{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:35:36Z","timestamp":1791005736655,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T00:00:00Z","timestamp":1585785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["HD042541"],"award-info":[{"award-number":["HD042541"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["HD087011"],"award-info":[{"award-number":["HD087011"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["HD39663"],"award-info":[{"award-number":["HD39663"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate a novel observational rating protocol designed to expedite clinical diagnosis of autism spectrum disorder (ASD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Two hundred and forty patients referred to a tertiary autism center (median age 8y 9mo, range 2y 6mo\u201334y 8mo; 188 males, 52 females) were rated using an adaptation of the Childhood Autism Rating Scale, Second Edition (CARS\u20102) based exclusively on patient observation (CARS\u20102<jats:sup>obs<\/jats:sup>). Scores were compared to expert diagnosis of ASD, parent\u2010reported Social Responsiveness Scale, Second Edition (SRS\u20102) and, in a selected subset of patients, the Autism Diagnostic Observation Schedule, Second Edition (ADOS\u20102).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CARS\u20102<jats:sup>obs<\/jats:sup> distinguished patients with a clinical diagnosis of ASD from those with non\u2010ASD neuropsychiatric disorders (mean score=18 vs 11.7, <jats:italic>p<\/jats:italic>&lt;0.001). Severity ratings on the CARS\u20102<jats:sup>obs<\/jats:sup> correlated with the ADOS\u20102 (<jats:italic>r<\/jats:italic>=0.68, <jats:italic>\u03c1<\/jats:italic>=0.64) and SRS\u20102 (<jats:italic>r<\/jats:italic>=0.31, <jats:italic>\u03c1<\/jats:italic>=0.32). A CARS\u20102<jats:sup>obs<\/jats:sup> cutoff point equal to or greater than 16 demonstrated 95.8% specificity and 62.3% sensitivity in discriminating individuals with ASD from individuals without ASD in a specialty referral setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The CARS\u20102<jats:sup>obs<\/jats:sup> allows the rapid acquisition of quantitative ratings of autistic severity by direct observation. Coupled with parent\/teacher\u2010reported symptoms and developmental history, the measure may contribute to a low\u2010cost diagnostic paradigm in clinical and public health settings, where positive results might help reduce delays in diagnosis, and negative results could prompt further specialty assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>The Childhood Autism Rating Scale, Second Edition based on patient observation distinguished individuals with versus without autism spectrum disorder (ASD).<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>A score equal to or greater than 16 on this assessment showed high specificity for a diagnosis of ASD.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14530","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T07:18:12Z","timestamp":1585811892000},"page":"806-812","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Expediting clinician assessment in the diagnosis of autism spectrum disorder"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-9027","authenticated-orcid":false,"given":"Matthew J","family":"Sanchez","sequence":"first","affiliation":[{"name":"Department of Psychiatry School of Medicine Case Western Reserve University Cleveland OH USA"},{"name":"University Hospitals Cleveland Medical Center Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8888-4186","authenticated-orcid":false,"given":"John N","family":"Constantino","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Pediatrics Washington University in St Louis St Louis MO USA"},{"name":"St Louis Children\u2019s Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6706a1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2010.10020223"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00151-9"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02172145"},{"key":"e_1_2_7_6_1","volume-title":"Autism Diagnostic Observation Schedule\u2010WPS (WPS edition)","author":"Lord C","year":"1999"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2011.02458.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1362361306066601"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1362361315573636"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-4300C"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2011.10.006"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106552"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e318212ec6e"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e318157cb23"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2217\/npy.12.28"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.b.31103"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.040196"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-009-0926-x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-005-0006-9"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-016-2860-z"},{"key":"e_1_2_7_21_1","volume-title":"The Childhood Autism Rating Scale","author":"Schopler E","year":"2010"},{"key":"e_1_2_7_22_1","volume-title":"Social Responsiveness Scale","author":"Constantino JN","year":"2012"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdev.13170"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"}],"container-title":["Developmental Medicine &amp; 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