Accuracy of the Indonesian Childhood Autism Rating Scale Second Edition (CARS-2) as a Diagnosis Tool for Autism Spectrum Disorder

This study examined the diagnostic accuracy of the Indonesian Childhood Autism Rating Scale, Second Edition, Standard Version (ID-CARS2-ST) in identifying autism spectrum disorder (ASD) and differentiating it from other neurodevelopmental disorders. The ID-CARS2-ST can be used to develop diagnostic hypotheses and design intervention plans for children with ASD, complementing clinical judgment based on the DSM criteria. This study involved a total of 50 subjects in our clinic, consisting of 25 children diagnosed with ASD and 25 children with other neurodevelopmental disorders. We conducted reliability tests and receiver operating characteristic (ROC) curve analysis to assess the sensitivity and specificity of the ID-CARS2-ST to determine the optimal standard cutoff point for diagnosing ASD in children. Cronbach’s alpha reliability yielded a result of Ω = 0.937. The optimal ID-CARS2-ST cutoff score was 30, with a sensitivity of 96% and specificity of 88% (AUC = 0.927, P<0.001; Youden’s J = 0.84). Our findings are exciting, and a score of 30 is the same as the original cut-off of the CARS2-ST in identifying ASD.