• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.4
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• pp.172-177
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• 2018

Objectives: We examined the agreement between the Autism Diagnostic Observation Schedule (ADOS) and the Childhood Autism Rating Scale (CARS) in the diagnosis of autism spectrum disorder. Methods: The ADOS and CARS scores of 78 children were retrospectively collected from a chart review. A correlation analysis was performed to examine the concurrent validity between the two measures. Using the receiver operating characteristic (ROC) curve, we determined the optimal cut-off score of the CARS for identifying autism spectrum disorder. Results: The CARS score was significantly correlated with the ADOS score (r=0.808, p<0.001). Taking ADOS as the ideal standard, the optimal cut-off scores of CARS for identifying autism and autism spectrum were 30 and 24.5, respectively. Conclusion: We determined the optimal cut-off scores of CARS for screening and diagnosing autism spectrum disorder.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.4
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• pp.49-60
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• 2017

Objectives The purpose of this study is to report the effectiveness of Korean medicine on treating autism spectrum disorder (ASD) in childhood. Methods We treated an 8-years-old patient who was diagnosed with autism (grade II) with herbal medicine, acupuncture and electric moxibustion. Every 11 months, Korean-Childhood Autism Rating Scale (K-CARS) was used to assess the patient's symptom progression. Results After 21 months of Korean medicine treatment, the child's overall health was improved. Moreover, language ability, emotional control, memory and cognitive abilities got better, as well as anxiety, agitation, and aggressive behavior related to ASD were also decreased. K-CARS score at the initial stage of the treatment was 39.5 points, which can be considered as severe autism. After 11 months of the treatment, the K-CARS score was 34.5 points which is mild-moderate autism. Conclusions Korean medicine treatment can be effective in improving symptoms of ASD. However, further studies are needed to demonstrate the treatment benefits to ASD.

• 재활복지
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• v.20 no.4
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• pp.135-156
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• 2016

The purpose of this study was to investigate item goodness-of-fit of Childhood Autism Rating Scale(CARS), Rasch rating scale model was applied to 15 items of the CARS in a sample of pervasive development disorder(n=238). An assumption to test Rasch Model, which is satisfaction of unidimensionality, is regarded through PCAR analysis, and jMetrik 4.03 program is used to test the goodness-of-fit of items. The results of this study were: First, 5-point rating scale was appropriate for the CARS rather than 7-point original rating scale. Second, the result of examining the CARS questions goodness-of-fit, there was a overfitting or misfitting items according to the classified groups. Only in particular Q11 item in diagnosis subject of integration population of autism has become inappropriate. Therefore, it is necessary to provide education for the CARS more systematically. Thirdly, the result of comparing the personal attributes score and difficulty of a CARS question, Q2, Q3, Q10, Q11 items are necessary to distinguish conceptually defined in more detail. Fourth, the results of investigating the difficulty of CARS question, it was found to exhibit a verbal communication is most serious problem for the population of autism.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.2
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• pp.114-123
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• 2006

Objectives : The special class has been made, bringing rapid increase quantitatively. The authors carried out the child psychiatric interview and evaluation for 9 special-classed children in Asan city to find out clinical diagnosis and emotional/behavioral characteristics. Methods : The child psychiatrists evaluated special class children by DSM-IV and K-SADS-PL. Tools for the evaluation were Child Behavior Checklist- Korean version, Korean Personality Inventory for Children, Children's Depression Inventory, Abbreviated Conners Parent-Teacher Rating Scale-Revised, State-Trait Anxiety Inventory for Children, Vineland Social Maturity Scale, Wechsler Intelligence Scale for Children-III, and Childhood Autism Rating Scale. Results : Ultimately 53 children, consisting of 35 boys(67.9%) and 18 girls(32.1%), participated, and the average age was $10.5{\pm}1.3$ years old. Their measure of Vineland Social Maturity Scale was $78.7{\pm}20.0$, Childhood Autism Rating Scales was $25.4{\pm}9.0$, Child Depression Inventory was $22.2{\pm}5.2$, State-Trait Anxiety Inventory for Children was $35.2{\pm}8.2/36.5{\pm}6.2$, and Abbreviated Conners Parent-Teacher Rating Scale was $11.0{\pm}4.6$. In the clinical diagnosis evaluation, the prevalence rate of learning disorder was decreased compared to early research, ADHD had been newly appeared and depression disorder and anxiety disorder had been increased. Conclusion : This result suggests that a lot of children in a special class have complex emotional and behavioral problems in addition to educational problems.

• 대한상한금궤의학회지
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• v.12 no.1
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• pp.183-198
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• 2020

Objective: The purpose of this study was to report improvement in patients with autism spectrum disorder (ASD) treated with herbal medication described in Shanghanlun. Methods: The patient was diagnosed with Lesser Yin disease based on the 315^th provision of Shanghanlun, and Baektonggajeodamjup-tang was used for treatment. The result was evaluated using the Korean-Childhood Autism Rating Scale (K-CARS). Results: The K-CARS score decreased from 32 to 15 after 7 months of treatment. Conclusions: Lesser Yin disease 315^th provision of Shanghanlun may be a provision describing ASD; in addition, Baektonggajeodamjup-tang may be an effective treatment for ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.1
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• pp.40-50
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• 2023

Objectives: This study examined the validity of the Childhood Autism Rating Scale, Second Edition (CARS-2) compared with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in identifying autism spectrum disorder (ASD). Methods: A total of 237 children were tested using both the CARS-2 and ADOS-2. We examined the correlation using Pearson's correlation analysis. In addition, we used a receiver operating characteristic graph to determine the optimal standard version of the CARS-2 (CARS2-ST) cutoff score for ASD diagnosis using the ADOS-2. Results: The concurrent validity of the CARS2-ST was demonstrated by a significant correlation with the ADOS-2 (r=0.864, p<0.001). The optimal CARS2-ST cutoff scores were 30 and 28.5 for identifying autism and autism spectrum, respectively, based on the ADOS-2. Conclusion: We suggest a newly derived CARS2-ST cutoff score of 28.5 for screening ASD and providing early intervention.

• Clinical and Experimental Pediatrics
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• v.60 no.10
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• pp.312-319
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• 2017

Purpose: To evaluate the usefulness of the Korean Developmental Screening Test (K-DST) for infants and children for developmental delay assessment. Methods: This study was based on retrospective studies of the results of the K-DST, Preschool Receptive-Expressive Language Scale (PRES), Sequenced Language Scale for Infants (SELSI), Childhood Autism Rating Scale (CARS), Modified Checklist for Autism in Toddlers (M-CHAT), electroencephalography, magnetic resonance imaging, and extensive tests conducted in 209 of 1,403 patients, of whom 758 underwent the K-DST at the Korea University Guro Hospital between January 2015 and December 2016 and 645 were referred from local clinics between January 2015 and June 2016. Results: Based on the K-DST results, the male children significantly more frequently required further or follow-up examination than the female children in most test sections, except for gross motor. The male children had notably lower mean scores than the female children. The PRES/SELSI results showed that when more further or follow-up evaluations were required in the K-DST communication section, significantly more problems in language delay or disorder emerged. When further or follow-up evaluation was required in the cognitive section in the CARS/M-CHAT, the possibility of autism increased significantly. A child tended to score low in the CARS test and show autism when further or follow-up evaluation was recommended in the K-DST. Conclusion: This study demonstrated the usefulness of the K-DST as a screening test early in the development of infants and children in Korea. Data of normal control groups should be examined to determine the accuracy of this investigation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.2
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• pp.80-85
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• 2018

Objectives: We aimed to assess the test-retest reliability, internal consistency, and validity of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT). Methods: The Korean version of the Q-CHAT and the Korean version of the Child Behavior Checklist (CBCL) 1.5-5 were completed by parents of 24 toddlers and preschoolers with autism spectrum disorder (ASD) and 80 unselected toddlers and preschoolers. Parents of the ASD group also completed the Social Communication Questionnaire (SCQ), and Childhood Autism Rating Scale (CARS) scores were obtained from medical records. Results: The ASD group scored higher on the Q-CHAT than the unselected group. The Cronbach's alpha coefficient of the Q-CHAT was 0.658, and test-retest reliability was calculated to be 0.836. The estimated area under the curve was 0.793. The total scores of the Q-CHAT in the ASD group demonstrated significant positive correlations with findings regarding pervasive development problems in the CBCL, SCQ, and CARS. A total score of 33.5 may be a useful cutoff point to use when identifying toddlers at risk of ASD. Conclusion: The Korean version of the Q-CHAT has good reliability and validity and can be used as a screening tool in order to identify toddlers and preschool children at risk of ASD.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.383-390
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• 2018

Objective: Autism spectrum disorder (ASD) is a complex neurodevelopmental syndrome with an increasingly prevalent etiology, yet not fully understood. It has been thought that vitamin D, complex B vitamin levels and homocysteine are associated with environmental factors and are important in ASD. The aim of this study was to examine serum vitamin D, vitamin D receptor (VDR), homocysteine, vitamin B6, vitamin B12 and folate levels in ASD. Methods: In this study, serum vitamin D and VDR, homocysteine, vitamins B6, B12 and folate levels were determined in 60 patients with ASD (aged 3 to 12 years) and in 45 age-gender matched healthy controls. In addition, calcium, phosphorus and alkaline phosphatase, which are associated with vitamin D metabolism, were measured from serum in both groups. ASD severity was evaluted by the Childhood Autism Rating Scale (CARS). Results: Serum vitamin D and VDR were substantially reduced in patients with ASD in comparision to control group. However, homocysteine level was significantly higher and vitamin B6, vitamin B12 and folate were also reduced in patients with ASD. Total CARS score showed a positive association with homocysteine and a negative correlation with vitamins D,B6, B12, folate and VDR. Conclusion: This comprehensive study, which examines many parameters has shown that low serum levels of vitamins D, B6, B12, folate and VDR as well as high homocysteine are important in the etiopathogenesis of ASD. However, further studies are required to define the precise mechanism(s) of these parameters and their contributions to the etiology and treatment of ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.4
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• pp.188-195
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• 2012

Objectives:This study was conducted in order to evaluate the effectiveness of a day-center treatment program to promote development of children with pervasive development disorder (PDD) and pervasive development disorder/mental retardation (PDD/MR). Methods:Twenty five children (14 in the PDD group and 11 in the PDD/MR group) participated in a day-center treatment program. They had been enrolled in the whole program for 2-3 years. Their performance was evaluated according to the Preschool Language Scale (PRES), Social Maturity Scale (SMS), and Korean version of the Childhood Autism Rating Scale (CARS). They were grouped by diagnosis at the beginning of the program and the treatment effect was compared. Results:Children who participated in the day-center treatment program showed a significant increase in their PRES and SMS scores and a decrease in their CARS scores. Conclusions:A day-center treatment program is effective for development of children with PDD and PDD/MR.