Comparison between a Mandarin Chinese version of the Childhood Autism Spectrum Test and the Clancy Autism Behaviour Scale in mainland China.

Sun et al. (2014) compared two parent questionnaires for spotting autism in Chinese kids. They gave both the Mandarin CAST and the older Clancy Autism Behaviour Scale (CABS) to children aged 4-11. Some kids already had an autism diagnosis; others were typically developing.

The team checked which tool caught more true cases without false alarms. They looked at sensitivity, specificity, and area under the curve (AUC) to see which screen worked better.

The Mandarin CAST won. It flagged 89 % of children who really had autism. The CABS only caught 58 %. The CAST also had a higher AUC, meaning it separated autistic and non-autistic kids more cleanly.

In plain words: if you use the CAST, you miss fewer children who need help.

Two papers from the same lab build a tidy story. Sun et al. (2013) first showed the Mandarin CAST scores stay stable over 2-4 months. The 2014 study now adds: the tool is also more accurate than the older CABS.

Williams et al. (2005) in the UK found the English CAST had 100 % sensitivity. The Mandarin version does not reach that ceiling, but it still beats the local alternative. No contradiction: the UK study used a research sample, while the China study used real-world clinics and schools.

Fitzpatrick et al. (2017) later repeated the idea in Spanish. They trimmed the CAST to 28 items and kept strong accuracy. Together these papers say: across languages, CAST works; shorter forms can still be trusted.

If you screen Mandarin-speaking children, drop the CABS and pick the CAST. You will catch more autism cases and spare families extra trips. One practical tip: keep the cut-off at 15 until local data say otherwise. Start using the 37-item Mandarin CAST today; it is free, parent-friendly, and now has Chinese evidence behind it.