AUTISM SPECTRUM RATING SCALE S (ASRS
AUTISM SPECTRUMRATING SCALES(ASRS ) Sam Goldstein, Ph.D. & Jack A. Naglieri, Ph.D.Goldstein & NaglieriPRODUCT OVERVIEWExcnceI n A s seelslsements
Autism SpectrumRating Scales (ASRS ) Product OverviewSam Goldstein, Ph.D. & Jack A. Naglieri, Ph.D.Please Note: All data presented in this overview are subject to change.Copyright 2009, 2010 Multi-Health Systems Inc. All rights reserved.No part of this document may be reproduced by any means without permission from the publisher.USA: P.O. Box 950, North Tonawanda, NY, 14120-0950Tel: 1.800.456.3003, Fax: 1.888.540.4484CAN: 3770 Victoria Park Avenue, Toronto, Ontario, M2H 3M6Tel: 1.800.268.6001, Fax: 1.888.540.4484Website: www.mhs.com Email: customerservice@mhs.comGoldstein & NaglieriExcnceI n A s seelslsements
OverviewThe Autism Spectrum Rating Scales (ASRS ) aredesigned to measure behaviors associated with theAutism Spectrum Disorders (ASD) for children andyouth aged 2 through 18 years, as reported by parentsand/or teachers or childcare providers.1 As recognitionand prevalence of the ASDs increase, risk of over- andunder-diagnosis increase in parallel. The need for a valid,reliable, and carefully crafted tool for assessment becomesparamount; the ASRS was developed to meet this need.The ASRS can help guide diagnostic decisions and can beused during treatment planning, ongoing monitoring ofresponse to intervention, and program evaluation.ASRS Components and Scale StructureAs illustrated in Figure 1, the ASRS has full-length andshort forms for young children aged 2 to 5 years, and forolder children and adolescents aged 6 to 18 years.The Full-Length ASRS Form: The full-length ASRS(2 5 Years) comprises 70 items, and the full-length ASRS(6 18 Years) consists of 71 items. There are separateparent (ASRS Parent Ratings) and teacher (ASRS TeacherRatings) rating forms for each age group. This form isthe most comprehensive and offers the most completeassessment information, including the Total Score, theASRS Scales, the DSM-IV-TR Scale, and the TreatmentScales. The full-length form is recommended for use ininitial evaluations and full re-evaluations.The ASRS Short Form: The ASRS Short Form wasdeveloped by selecting items that best differentiatednonclinical youth from youth diagnosed with an ASD.The ASRS Short Form (2–5 Years) and ASRS Short Form(6–18 Years) both contain 15 items, and parents andteachers complete the same form. This form providesone Short Form total score, and can be used as a screenerto determine which youth are most likely to requireadditional evaluation or services for an ASD andrelated issues. The Short Form may be most suitable formonitoring treatment/intervention.Figure 1. Overview of the ASRS FormsAutism Spectrum Rating Scales FormsFULL-LENGTH FORMSASRS (2–5 Years)Parent RatingsASRS (2–5 Years)Teacher/ChildcareProvider RatingsASRS (6–18 Years)Parent RatingsSHORT FORMSASRS (6–18 Years)Teacher RatingsASRS Short Form(2–5 Years)ASRS Short Form(6–18 Years)Age Range: 2–5 YearsNumber of Items: 70Reading Level: 6.0Admin. Time: 15 mins.Age Range: 6–18 YearsNumber of Items: 71Reading Level: 6.2Admin. Time: 15 mins.Age Range: 2–5 YearsNumber of Items: 15Reading Level: 6.2Admin. Time: 5 mins.Age Range: 6–18 YearsNumber of Items: 15Reading Level: 6.0Admin. Time: 5 mins.Total ScoreTotal ScoreShort Form ScoreShort Form ScoreASRS Scales Social/Communication Unusual BehaviorsASRS Scales Social/Communication Unusual Behaviors Self-RegulationDSM-IV-TR ScaleDSM-IV-TR ScaleTreatment Scales Peer Socialization Adult Socialization Social/Emotional Reciprocity Atypical Language Stereotypy Behavioral Rigidity Sensory Sensitivity Attention/Self-RegulationTreatment Scales Peer Socialization Adult Socialization Social/Emotional Reciprocity Atypical Language Stereotypy Behavioral Rigidity Sensory Sensitivity AttentionNote. Reading Level determined by the Flesch-Kincaid Grade Level.For the ASRS (2–5 Years) both teachers and/or childcare providers cancomplete the form. For ease of presentation, this group of raters is referredto as “teacher” herein.1Autism Spectrum Rating Scales (ASRS )2
Administration andScoring OptionsReport OptionsAll of the forms can be administered via paper-and-pencilor using the ASRS Online Asssessment Center. TheASRS can be scored via paper-and-pencil, the ASRSScoring Software, or the ASRS Online AsssessmentCenter. Figure 2 outlines the various combinations ofadministration and scoring options.ASRS reports can be obtained by using the ASRS ScoringSoftware or the ASRS Online Assessment Center. Thereare three report types:(1) the Interpretive Report provides detailed results fromone administration,(2) the Comparative Report provides a multi-raterperspective by combining results from up to fivedifferent raters, and(3) the Progress Monitoring Report provides an overviewof change over time by combining resultsof up to four administrations from the same rater.Figure 2. Overview of Administration and Scoring OptionsADMINISTRATION AND SCORING OPTIONSPaper-and-Pencil AdministrationRater completes the assessment ina Response Booklet or ASRSQuikScore Form.Paper-and-Pencil ScoringAssessor separates pagesof the QuikScore form andcalculates scores directlyon the form.Software ScoringAssessor enters responsesinto ASRS Scoring Softwarefor automatic scoring andreport generating.Online AdministrationRater completes theassessment online.Online ScoringAssessor enters responsesinto ASRS OnlineAssessment Center forautomatic scoring andreport generating.Online ScoringAssessment is automaticallyscored and reports aregenerated online.Normative andClinical SamplesData collection took place between October, 2006 andOctober, 2008. Over 7,000 assessments were collectedwhich included normative data, clinical data, as wellas reliability and validity research data. Of theseassessments, 2,560 were included in the normativesample (320 ASRS [2 5 Years] Parent Ratings, 320ASRS [2 5 Years] Teacher/Childcare Provider Ratings,960 ASRS [6 18 Years] Parent Ratings, and 960 ASRS[6 18 Years] Teacher Ratings). The ASRS normativesamples are proportioned evenly in terms of age andgender (see Table 1) and are highly similar to the mostrecent U.S. Census in terms of race/ethnicity (see Table 2).While the normative samples primarily include ratingsof nonclinical children, 7.6% of the normative sampleincludes ratings of children with an educationalclassification or clinical diagnosis. These cases wereincluded in the normative sample in order to reflect theactual U.S. general population, which includes bothchildren with and without clinical conditions.Autism Spectrum Rating Scales (ASRS )In addition to the clinical data that were collected forinclusion in the normative sample, ratings from over1,600 youth with a clinical diagnosis were collectedin order to create clinical samples; see Table 3 for thediagnostic makeup of these samples.3
Table 1. Age x Gender Distribution: ASRS Normative SamplesParent RatingsAgeMale (N)Teacher RatingsFemale (N)Total (N)Male (N)Female (N)Total 08040408016404080404080ASRS (2 5 Years) Total17/18404080404080ASRS (6 18 Years) Table 2. Race/Ethnicity Distribution: ASRS Normative SamplesParent RatingsASRS(2 5 Years)ASRS(6 18 ispanicWhiteOtherTotalTeacher RatingsCensusASRS(2 5 Years)ASRS(6 18 63209601,280Total1752693209601,280CensusTable 3. Primary Diagnosis: ASRS Clinical SamplesParent RatingsASRS(2 5Years)DiagnosisASRS(6 18Years)Teacher RatingsTotalASRS(2 5Years)ASRS(6 18Years)TotalTotalASRS(2 5Years)ASRS(6 18Years)TotalAutism Spectrum A147147N/A270270Anxiety/Mood DisordersN/A3131N/A2929N/A6060Communication Disorders3539743840787379152Delayed Cognitive e. N/A Not Applicable.Autism Spectrum Rating Scales (ASRS )4
ReliabilityTest-Retest Reliability refers to the stability of test scoreswhen an assessment is administered on two or moreoccasions. Test-retest reliability scores were computed forthe ASRS scores over a 2- to 4-week interval (see Table 5).Overall, the test-retest values indicate excellent test-retestreliability.Internal Consistency refers to the extent to which all itemson the same scale consistently or reliably measure the samecontent, and is commonly assessed by an examination ofCronbach’s alpha statistic, which ranges from 0.0 to 1.0(Cronbach, 1951). The internal consistency of the ASRS wasassessed, and the scales were found to demonstrate highlevels of internal consistency (see Table 4).Table 4. Internal Consistency Coefficients (Cronbach’s Alpha)Parent RatingsASRS(2 5 Years)ScaleTotal ScoreASRSScalesASRS (6 18 Years)ASRS6 11 Years 12 18 Years (2 5 Years)ASRS (6 18 Years)6 11 Years 12 18 94.97.95.94Unusual 3N/A.94.92.95.96.95.95.95.95DSM-IV-TR ScaleTreatmentScalesTeacher RatingsPeer Socialization.89.88.88.91.87.87Adult Socialization.77.77.78.82.81.77Social/Emotional Reciprocity.91.90.90.93.91.91Atypical 3.77Behavioral Rigidity.90.91.91.90.92.92Sensory 2.92.92.93.91.92Short FormNote. N/A Not Applicable.Table 5. Test-Retest Reliability Coefficients (Pearson’s r)Parent RatingsScaleTotal ScoreASRSScalesASRS(2 5 Years)ASRS(6 18 Years)ASRS(2 5 Years)ASRS(6 18 Unusual 1.91.87.78DSM-IV-TR ScaleTreatmentScalesTeacher RatingsPeer Socialization.79.87.92.78Adult Socialization.88.90.83.79Social/Emotional Reciprocity.86.88.90.70Atypical al Rigidity.85.90.87.81Sensory 0N/A.87N/AAttentionN/A.91N/A.835610962218NNote. All rs significant, p .001. N/A Not Applicable.Autism Spectrum Rating Scales (ASRS )5
Validitythat assesses Autism Spectrum Disorders. These othermeasures included the Gilliam Autism Rating ScaleSecond Edition (GARS-2 ; Gilliam, 2006), the GilliamAsperger’s Disorder Scale (GADS ; Gilliam, 2001), andthe Childhood Autism Rating Scale (CARS ; Schopler,Reichler, & Rochen Renner, 1986).Discriminative Validity pertains to an instrument’sability to distinguish between relevant participant groups(i.e., the ability of the ASRS to differentiate betweenAutism Spectrum Disorder group membership andGeneral Population or Other Clinical group membership).A series of discriminant function analyses wereconducted in order to determine the ability of the scoresto predict group membership into the Autism SpectrumDisorder or General Population group. Table 6 displaysthe classification accuracy of both the ASRS full-lengthand ASRS Short Form Total Scores. On average, the scaleswere able to very accurately predict group membership,with a mean overall correct classification rate of 92.10%.The correlations (both obtained and corrected for rangeinstability), as well as means and standard deviations,are provided in Table 7. Examination of these values mustbe made with recognition of the different metrics usedfor the different rating scales, and the fact that the CARSonly provides a raw score. The mean scores obtainedon the GARS and GADS are based on a comparison toatypical samples so that a score of 100 indicates averageperformance in relation to individuals on the AutismSpectrum. For children rated on both the ASRS and theGARS, the ASRS means by rater and age varied from 69.3to 75.3 and the GARS values ranged from 88.6 to 100.9.The results for the 6–18 year olds rated by parents andteachers were particularly important because the GARSmeans were less than 100, yet the ASRS means were about70 (two standard deviations above the normative mean forthe general population). Similar findings were obtainedfor the GADS, illustrating the importance of having ageneral population reference group.Furthermore, Figures 3 to 6 reveal that for virtuallyevery scale, the Autism Spectrum Disorder group wasrated higher than both the General Population and theOther Clinical groups. Results from a series of Analysesof Covariance revealed that these differences werestatistically significant for every scale (with mostlylarge effect sizes; 2 mean Cohen’s d 1.60), with theexception of the Attention scale on the ASRS (6 18Years) Teacher form, where scores between the AutismSpectrum Disorder and Other Clinical groups did notdiffer significantly from each other (this result is notunexpected due to the fact that the Other Clinical groupin the ASRS [6 18 Years] sample includes a large ADHDsample).The ASRS Total Score was moderately correlated with theGARS Autism Index and the GADS Asperger’s DisorderQuotient. The correlations between the ASRS Total Scoreand the CARS Total Score were somewhat lower. Thelow ASRS–CARS correlations could be due to the factthat different raters completed the forms (i.e., scoresfrom parent- and teacher-completed ASRS forms werecompared to clinician-completed CARS scores) and/or theCARS only yields a raw score.Convergent Validity is established if results from themeasure of interest are correlated with results fromtheoretically-related measures (Anastasi & Urbina,1997). In an attempt to provide evidence for theconvergent validity of the ASRS, a sample of parentsand teachers completed the ASRS forms along with atleast one other measure of childhood psychopathologyTable 6. Classification Accuracy of the ASRS Total ScoresFull-Length Total ScoreParent RatingsClassification StatisticASRS(2 5Years)ASRS(6 18Years)Short Form Total ScoreTeacher RatingsASRS(2 5Years)Parent RatingsASRS(6 18Years)ASRS(2 5Years)Teacher RatingsASRS(6 18Years)ASRS(2 5Years)ASRS(6 18Years)94.9Overall Correct Classification (%)90.091.389.491.494.293.488.4Sensitivity (%)89.890.390.292.193.992.792.695.4Specificity (%)90.392.288.690.794.594.184.394.3Positive Predictive Power (%)91.391.888.690.394.694.185.594.1Negative Predictive Power (%)88.790.890.292.593.892.791.995.6False Positive Rate (%)9.77.811.49.35.55.915.75.7False Negative Rate 90.90.9Autism Spectrum Disorder (N)126183114206129202131219General Population (N)115196112212128207111228Rough rules of thumb for interpreting effect size in clinical/educationalpsychology have been provided by Cohen (1988): small effect size .2;medium effect size .5; large effect size .8.2Autism Spectrum Rating Scales (ASRS )6
Figure 3. Mean T-Scores by Group: ASRS (2 5 Years) Parent SASASAutism Spectrum DisorderAutism Spectrum DisorderSERSERALALSTSTOther ClinicalOther neral PopulationGeneral PopulationFigure 4. Mean T-Scores by Group: ASRS (2 5 Years) Teacher SASASAutism Spectrum DisorderAutism Spectrum DisorderSERSERALALOther ClinicalOther ClinicalSTSTBRBRSSSSGeneral PopulationGeneral PopulationTOT Total ScoreAS Adult SocializationBR Behavioral RigiditySC Social/CommunicationSER Social/Emotional ReciprocitySS Sensory SensitivityUB Unusual BehaviorsAL Atypical LanguageASR Attention/Self-RegulationDSM DSM-IV-TR ScaleST StereotypyShort Short FormPS Peer SocializationAutism Spectrum Rating Scales (ASRS )7
Figure 5. Mean T-Scores by Group: ASRS (6 18 Years) Parent TSCUBSRDSMPSASSERALAutism Spectrum DisorderOther ClinicalAutism Spectrum DisorderOther ClinicalSTBRSSATShortSTBRSSATShortGeneral PopulationGeneral PopulationFigure 6. Mean T-Scores by Group: ASRS (6 18 Years) Teacher TSCUBSRDSMPSASSERALAutism Spectrum DisorderAutism Spectrum DisorderOther ClinicalOther ClinicalSTBRSSATShortSTBRSSATShortGeneral PopulationGeneral PopulationTOT Total ScorePS Peer SocializationBR Behavioral RigiditySC Social/CommunicationAS Adult SocializationSS Sensory SensitivityUB Unusual BehaviorsSER Social/Emotional ReciprocityAT AttentionSR Self-RegulationAL Atypical LanguageShort Short FormDSM DSM-IV-TR ScaleST StereotypyAutism Spectrum Rating Scales (ASRS )8
Table 7. Correlations Between the ASRS Total Score and Other MeasuresGARS, GADS, or CARSOther MeasuresGARSAutism IndexGADS Asperger’sDisorder QuotientCARSTotal Raw ScoreRaterAgesParent2–5 YearsASRSObtained rCorrected rNMSDMSD.83.6178100.925.774.511.4Teacher2–5 Years.76.4153100.130.575.312.7Parent6–18 Years.80.6310493.924.469.310.0Teacher6–18 Years.82.6811688.623.369.810.0Parent2–5 Years.63.497896.919.374.511.4Teacher2–5 Years.76.565298.320.875.612.6Parent6–18 Years.70.548392.321.668.110.7Teacher6–18 Years.74.618291.521.667.710.0Teacher2–5 Years.50.663436.89.776.76.6Parent2–5 Years.06.063636.910.378.410.1Teacher6–18 Years.35.4010935.310.569.58.7Parent6–18 Years.50.5112235.710.871.39.9Note. ASRS T-scores (normative sample M 50, SD 10) were correlated with: GARS-2 and GADS Standard Scores (reference sample M 100, SD 15), andCARS raw scores. All correlations significant, p .01, except for the ASRS (2–5 Years) Teacher correlation with the CARS (ns). Pair-wise deletion of missingcases was used.ReferencesAnastasi, A., & Urbina S. (1997). Psychological testing(7th ed.). Upper Saddle River, NJ: Prentice Hall.Cohen, J. (1988). Statistical power analysis for behaviouralsciences (2nd ed.). Hillsdale, NJ: Erlbaum Associates.Cronbach, L. J. (1951). Coefficient alpha and the internalstructure of tests. Psychometrika, 16, 297–335.Gilliam, J. E. (2001). Gilliam Asperger’s Disorder Scaleexaminer’s manual. Austin, TX: PRO-ED.Gilliam, J. E. (2006). Gilliam Autism Rating Scale SecondEdition examiner’s manual. Austin, TX: PRO-ED, Inc.Schopler, E., Reichler, R. J., & Rochen Renner, B. (1986).Childhood Autism Rating Scale. Los Angeles: WesternPsychological Services.Autism Spectrum Rating Scales (ASRS )9
The Autism Spectrum Rating Scales . (ASRS Parent Ratings) and teacher (ASRS Teacher Ratings) rating forms for each age group. This form is the most comprehensive and offers the most complete assessment information, including the Total Score, the . the Progress Monitoring Report provides an overview
Autism spectrum disorder encompasses disorders previously referred to as early infantile autism, childhood autism, Kanner’s autism, high-functioning autism, atypical autism, pervasive developmental disorder not otherwise specified, childhood disintegrative disorder, and Asperger’s disorder
At least three of the following, one of which must be an ASD specific diagnostic tool*: Autism Diagnostic Observation Schedule (ADOS)* Autism Diagnostic Interview (ADI)* Childhood Autism Rating Scale (CARS)* Gilliam Autism Rating Scale (GARS) Vineland Assessment of Basic Language and Le
Next Steps: A Guide for Families New to Autism Autism Society Affiliates Autism Society affiliates are your best source for information about autism in Wisconsin. Autism Society affiliates provide support, education, information & referral, and advocacy. Below is a map of the local Autism Society affiliates in Wisconsin, color coded by service .
Autism Speaks www.autismspeaks.org. Leading autism science and advocacy organization, dedicated to funding research into the causes, prevention, treatments and a cure for autism, increasing awareness of autism spectrum disorders, and ad-vocating for the needs of individuals with autism and their families.
The Official Autism 101 E-Book: Autism Today Experts Discover the awesome in Autism! DISCOVER THE AWESOME IN AUTISM! The Official Autism 101 E-Book: Autism Today
Fall/Winter 2011 AUTISM ADVOCATE 7 A s the nation’s oldest grassroots autism organization, the Autism Society has been working to improve the lives of all affected by autism for 46 years. When the organization was founded in 1965, the autism community was very different than it is today: the term “autism” was not widely known, and doctors often blamed the condition on “refrigerator .
Autism Eye media l Autism Eye Magazine (quarterly) l Autism Eye Newsletter (monthly, 10 times a year) lAutism Eye website managed to recruit a member of staff in this way." Content lIn-depth information "Being autism-specific, for parents and professionals who care for or work with children with autism. Topics covered include education .
Diagnostic Tools Autism Diagnostic Observation Schedule (ADOS) Considered the Gold Standard Childhood Autism Rating Scale (CARS) Autism Diagnosis Interview-Revised (ADI-R) Gilliam Autism Rating Scare-Third Edition (GARS-3) In addition to the tools above, the American Psychiatric
