Brief report: concurrent validity of autism symptom severity measures.
Expect ADOS, CARS, and SRS to give different severity answers for the same preschooler — plan for it.
01Research in Context
What this study did
The team gave the preschoolers with autism three common severity tools on the same day.
They used ADOS, CARS, and both parent and teacher SRS forms.
Then they counted how often the tools placed the same child in the same severity bracket.
What they found
Only about half of the kids got matching severity labels across the tools.
ADOS and parent SRS disagreed the most — they lined up for just one in three children.
Teacher SRS agreed slightly better, but still missed many matches.
How this fits with other research
de Bildt et al. (2011) show ADOS calibrated scores stay stable across age and language level, so the mismatch here is not just bad ADOS math.
Rogers et al. (2017) prove the newer SRS-Preschool is solid with toddlers; that makes the poor ADOS-parent SRS fit in this study even more noteworthy.
Bennett et al. (2008) found the revised ADOS can over-identify autism in Hispanic preschoolers with mild social issues — a different problem, but both papers warn us to double-check ADOS scores before making big decisions.
Why it matters
When numbers conflict, teams waste time in meetings and parents get mixed messages.
Use ADOS for observation data, but always add a second tool and explain why scores may differ.
Document each measure’s result in plain language so everyone sees the full picture, not just the lowest or highest number.
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02At a glance
03Original 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.
Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-013-1879-7