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The Childhood Autism Rating Scale (CARS) is a simple and inexpensive tool for Autism spectrum disorder (ASD) assessments, with evidenced psychometric data from different countries. However, it is still unclear whether ASD symptoms are measured the same way across different societies and world regions with this tool, since data on its cross-cultural validity are lacking. This study evaluated the crosscultural measurement invariance of the CARS among children with ASD from six countries, for whom data were aggregated from previous studies in India (n = 101), Jamaica (n = 139), Mexico (n = 72), Spain (n = 99), Turkey (n = 150), and the United States of America (n = 186). We analyzed the approximate measurement invariance based on Bayesian structural equation modeling. The model did not fit the data and its measurement invariance did not hold, with all items found non-invariant across the countries. Items related to social communication and interaction (i.e., relating to people, imitation, emotional response, and verbal and nonverbal communication) displayed lower levels of cross-country noninvariance compared to items about stereotyped behaviors/sensory sensitivity (i.e., body and object use, adaptation to change, or taste, smell, and touch response). This study found that the CARS may not provide cross-culturally valid ASD assessments. Thus, cross-cultural comparisons with the CARS should consider first which items operate differently across samples of interest, since its cross-cultural measurement non-invariance could be a source of cross-cultural variability in ASD presentations. Additional studies are needed before drawing valid recommendations in relation to the cultural sensitivity of particular items.

The aim of this study was to examine the psychometric properties of an adapted version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT), an early screening tool that quantifies autistic traits dimensionally, in a community sample of Chilean children aged 18-24 months. An intentional non-probabilistic sampling was used. All primary caregivers of children aged 18-24 months who attended health check-up at four primary care clinics in Chile's Araucanía region during the study period were invited to participate. One hundred and eighty-eight toddlers were screened. Evidence of construct validity was determined through Exploratory Factor Analysis (EFA), evidence of convergent validity with the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F), and evidence of reliability through internal consistency and test-retest. The EFA showed a two-factor structure, which explained 42.2 % of the variance: “Restrictive and Repetitive Patterns” (factor 1), and “Communication and Social Interaction” (factor 2). The total Q-CHAT scores correlated positively and significantly with the total M-CHAT-R/F scores (r=0.59, p<0.01) with a large effect size. Internal consistency was acceptable for the scale in general (α=0.74), acceptable for factor 1 (α = 0.76) and good (α=0.85) for factor 2. Regarding test-retest stability, the intraclass correlation coefficient was good (ICC=0.86, p<0.001). In terms of the factor structure evidenced by the EFA, the two factors are theoretically consistent with the current diagnostic criteria of the DSM-5. The evidence of validity and reliability of Q-CHAT is encouraging when considering its use as an early detection tool in Chile.

The aim of this study was to examine the psychometric properties of an adapted version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT), an early screening tool that quantifies autistic traits dimensionally, in a community sample of Chilean children aged 18-24 months. An intentional non-probabilistic sampling was used. All primary caregivers of children aged 18-24 months who attended health check-up at four primary care clinics in Chile's Araucanía region during the study period were invited to participate. One hundred and eighty-eight toddlers were screened. Evidence of construct validity was determined through Exploratory Factor Analysis (EFA), evidence of convergent validity with the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F), and evidence of reliability through internal consistency and test-retest. The EFA showed a two-factor structure, which explained 42.2 % of the variance: “Restrictive and Repetitive Patterns” (factor 1), and “Communication and Social Interaction” (factor 2). The total Q-CHAT scores correlated positively and significantly with the total M-CHAT-R/F scores (r=0.59, p<0.01) with a large effect size. Internal consistency was acceptable for the scale in general (α=0.74), acceptable for factor 1 (α = 0.76) and good (α=0.85) for factor 2. Regarding test-retest stability, the intraclass correlation coefficient was good (ICC=0.86, p<0.001). In terms of the factor structure evidenced by the EFA, the two factors are theoretically consistent with the current diagnostic criteria of the DSM-5. The evidence of validity and reliability of Q-CHAT is encouraging when considering its use as an early detection tool in Chile.