sam5886 Report post Posted February 20, 2007 Can anyone let me know where I can find a copy of the GARs ASD questionnaire?? Many thanks Sam x Quote Share this post Link to post Share on other sites
baddad Report post Posted February 20, 2007 Can anyone let me know where I can find a copy of the GARs ASD questionnaire?? Many thanks Sam x Hi sam - I found a couple of links here: http://www.udel.edu/bkirby/asperger/ but both links seemed to be 'cold' ... one indicated that the tests were up for a limited time for data gathering, so it may be that you missed the boat(?) there was an e-mail link, though, so you could try that and see what response you get. There are other tests/diagnostic tools there, so you may find something else that's suitable(?) L&P BD Quote Share this post Link to post Share on other sites
sam5886 Report post Posted February 21, 2007 Thanks Baddad My Pead is using this Gars questionnaire as their dx tool. Basically it is a load of nonsensicle qestions and she kinda waved it under my nose at the meeting BUT didn't actually let me see a copy. She then sent me a 'crock' of a report to which I sent back a four page reply telling her 'politely' that the fact that my son had eye contact and did not tiptoe didn't actually mean he wasn't on the spectrum!!! Anyhoo, she has asked me back for a meeting and I wanted to go prearemed with some actual responses to this questionnaire that I didn't have to come up with suddenly in a meeting whilst trying to stop my son from smashing up her office or trying to bite lumps out of other members of staff Sam x Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 (edited) The validty of this test has been queried ... http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract The Gilliam Autism Rating Scale (GARS) was developed as a relatively easy, inexpensive aid in the surveillance and diagnosis of autism. This study examined the validity of the GARS when used with a sample of 119 children with strict DSM-IV diagnoses of autism, ascertained from both clinical and research settings. The GARS consistently underestimated the likelihood that autistic children in this sample would be classified as having autism. The sample mean for the Autism Quotient, a hypothesized index of the likelihood of having autism, was 90.10, significantly below the reference mean of 100. Diagnostic classification according to criteria specified by the GARS resulted in a sensitivity of only .48. Limitations of rating scales in general and of the GARS specifically are discussed. It is recommended that clinicians and researchers using or considering using the GARS for autism diagnosis or ratings of autism severity recognize the need for further research regarding its use. 2002 http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=16283084 The Gilliam Autism Rating Scale was developed to identify individuals with autism in research and clinical settings. It has benefited from wide use and acceptance but has received little empirical attention. The purpose of this study was to evaluate the construct and diagnostic validity, interrater reliability, and effects of participant characteristics of the GARS in a large and heterogeneous sample of children and adolescents with autism spectrum disorders. 360 parent and teacher ratings were submitted to factor analysis. A three-factor solution explaining 38% of the variance was obtained. Almost half of all items loaded on a Repetitive and Stereotyped Behavior factor. The Developmental Disturbance subscale did not contribute to the Autism Quotient (AQ) and was poorly related to other subscales. Internal consistency for the three behavioral subscales was good but low for the Developmental Disturbance subscale. The average AQ was significantly lower than what was reported in the test manual, suggesting low sensitivity with the current cutoff criteria. Interrater reliability was also much lower than originally reported by the instrument's developer. No significant age or gender effects were found. Level of impairment, as measured by adaptive behavior, was negatively related to total and subscale scores. The implications of these findings were discussed, as was the use of diagnostic instruments in the field in general.2005 http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=17088271 Recent years have seen a surge of interest in assessment instruments for diagnosing autism in children. Instruments have generally been developed and evaluated from a research perspective. The Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and Gilliam Autism Rating Scale (GARS) have received considerable attention and are widely used. The objective of this study was to explore the diagnostic utility and discriminative ability of these tools using a clinical population of children referred to a specialty diagnostic clinic over a 3 year time span. The results indicated that the ADOS-G and ADI-R led to approximately 75 percent agreement with team diagnoses, with most inconsistencies being false positive diagnoses based on the measures. The GARS was generally ineffective at discriminating between children with various team diagnoses and consistently underestimated the likelihood of autism. The findings have important implications for the use of these measures in both research and clinical practice. 2006 I haven't got access to the full articles but you may be able to track down a copy via your local autistic society ... Edited February 21, 2007 by UltraMum Quote Share this post Link to post Share on other sites
sam5886 Report post Posted February 21, 2007 Errrm thanks Ultramum (I think... ) Am I being really thick or are these study quotes basically suggesting that the GARS, although widely used as a diagnosis tool, actually doesn't work!!!!! So I can go back to the Pead and say I dont' agree with your dx (or non-dx)?? Sam x Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 (edited) Yep - that's what they seem to say ... and i didn't even look for critical stuff - they just came up There's a glowing report of it here from the people who publish and sell it Edited February 21, 2007 by UltraMum Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 (edited) Yep - that's what they seem to say ... and i didn't even look for critical stuff - they just came up The last one was published last year in Autism - you may be able to get a copy of the full article from the NAS ... The discriminative ability and diagnostic utility of the ADOS-G, ADI-R, and GARS for children in a clinical setting Carla A. Mazefsky University of Pittsburgh, USA Donald P. Oswald Virginia Commonwealth University, USA, Autism, Vol. 10, No. 6, 533-549 (2006) DOI: 10.1177/1362361306068505 � 2006 The National Autistic Society, SAGE Publications The abstract is available on this page and also includes the email addy of one of the authors - you could email and ask politely for an electronic copy of the article as you are a parent who does not have access to the full text. No harm done by asking and I often find that the article is sent ... Edited February 21, 2007 by UltraMum Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 OK - the abstract for the first one is available here - and would you know it - there's an email addy for one of the authors again!!! Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 OK - here's an interesting quote: Autism Assessment Instruments Although several instruments have been designed to assess autism in young children, experts recommend that no single autism assessment instrument be used as the sole basis for diagnosing autism. from p 29 of Kabot,S., Masi,W., and Segal M. (2003) Advances in the Diagnosis and Treatment of Autism Spectrum Disorders. Professional Psychology: Research and Practice. Copyright 2003 by the American Psychological Association, Inc. 2003, Vol. 34, No. 1, 26?33 FULL TEXT AVAILABLE HERE caps lock Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 (edited) OK - study 2 from my original post has an abstract here and the authors email addy This was a review of the article: bottom of last page Edited February 21, 2007 by UltraMum Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 (edited) OK - just came across a Word doc - p23-24 - see below The Identification of Autism Spectrum Disorders: A Primer for the School Psychologist Indirect Assessment Indirect assessment involves obtaining data from caregivers (e.g., parents and teachers) about the student being assessed. It has the advantage of taping into the significant amount of experiences working with and observing the student typically possessed by caregivers. However, it is important to acknowledge the subjective nature indirect assessment. On some occasions caregivers have biased and/or inaccurate views of a student's behavior. Thus, direct assessment (to be discussed next) is also an important element of any diagnostic assessment. Form the author's applied school psychology experiences; the following rating scales and interview are offered as potentially valuable tools for use by the school psychologist who is attempting to diagnose an ASD. Rating scales. The Gilliam Autism Rating Scale (GARS; Gilliam, 1995) is a behavioral checklist designed to assist in the diagnosis of autism among individuals 3 through 22 years of age. It includes three core subtests (i.e., Stereotyped Behaviors, Communication, and Social Interaction) and a fourth optional subtest (i.e., Developmental) that collects developmental history data for the first three years of life. Each subtest is comprised of 14-items. GARS items are scored on a 4-point scale (with '0' corresponding to 'Never Observed' and '3' corresponding to 'Frequently Observed'). Designed to be completed by a parent, teacher, or other caregiver who knows the individual well [i.e., someone who has "... had regular, sustained contact with the subject for at least 2 weeks" (Gilliam, 1995, p. 9)]. No special training is required to administer or score the GARS, and it is suggested most raters will be able to complete it in 5 to 10 minutes. GARS subtest raw scores are converted into standard scores, which are then summed and in turn converted to an Autism Quotient (AQ). Subtest standard scores of 8 and above, and AQs of 90 and above, are associated with 'Average' and above probabilities of the subject being a person with an ASD. Conversely, subtest standard scores below 8, and AQs below 90 are associated with 'Below Average' probabilities of an ASD. However, when considering GARS scores, it is important to keep in mind recent research suggesting that the GARS underestimates the likelihood of autism. In a study by South et al. (2002) the mean GARS AQ of a sample comprised of children already diagnosed by expert clinicians with autism, was significantly lower than the reference mean. While the GARS mean is100, the mean in this sample of 119 children with strict DSM IV (APA, 1994) diagnoses of autism was 90.10. Given its high false negative rate (52% in the South et al. study), the GARS would not appear to be appropriate for use as a screening tool. Diagnosticians using this tool should take into account that its scores may underestimate the likelihood of autism and the results of this (or any rating scale) should never be used to make a diagnosis. Psychometrically, reliability among GARS subtests is good. However, as was mention above convergence "with similar scales from gold-standard research diagnostic measures was quite poor" (South et al., p. 596). In addition, it is important to note that the Developmental Disturbances scale is generally unrelated to the other scales" (South et al., p. 596). I'll stop bombarding you now and get on with my letter to the LEA - hope you find some ammo here to help you ask the paed to consider using some other form of assessment as well Edited February 21, 2007 by UltraMum Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 I'll stop bombarding you now and get on with my letter to the LEA - hope you find some ammo here to help you ask the paed to consider using some other form of assessment as well Sorry - just came across this as well ... Two other well-known scales are the Gilliam Autism Rating Scale (GARS)[10,11] and the Childhood Autism Rating Scale (CARS).[12] Both of these tools are primarily intended for level 2 screening but they are sometimes mistakenly used as diagnostic instruments. Both instruments are not commonly used with young children. Quote Share this post Link to post Share on other sites
sam5886 Report post Posted February 21, 2007 Thanks Ultramum - I can feel yet another 'essay' coming on. Problem is, I still need to find an Autism Diagnostic checklist that I can also throw at the Pead. Sam x Quote Share this post Link to post Share on other sites
UltraMum Report post Posted February 21, 2007 (edited) Thanks Ultramum - I can feel yet another 'essay' coming on. Problem is, I still need to find an Autism Diagnostic checklist that I can also throw at the Pead. Sam x ADOS or ADI? http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=17088271 1: Autism.2006 Nov;10(6):533-49. The discriminative ability and diagnostic utility of the ADOS-G, ADI-R, and GARS for children in a clinical setting. Mazefsky CA, Oswald DP. University of Pittsburgh, USA. Recent years have seen a surge of interest in assessment instruments for diagnosing autism in children. Instruments have generally been developed and evaluated from a research perspective. The Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and Gilliam Autism Rating Scale (GARS) have received considerable attention and are widely used. The objective of this study was to explore the diagnostic utility and discriminative ability of these tools using a clinical population of children referred to a specialty diagnostic clinic over a 3 year time span. The results indicated that the ADOS-G and ADI-R led to approximately 75 percent agreement with team diagnoses, with most inconsistencies being false positive diagnoses based on the measures. The GARS was generally ineffective at discriminating between children with various team diagnoses and consistently underestimated the likelihood of autism. The findings have important implications for the use of these measures in both research and clinical practice. There's quite a bit of stuff on here but not all the links are working Edited February 21, 2007 by UltraMum Quote Share this post Link to post Share on other sites
sam5886 Report post Posted March 2, 2007 Ultramum - just wanted to let you know that I emaild Mr Oswald and he sent me the fully transcript of his document. Not sure exactly how much it will help my cause as I can't see the hospital changing their diagnostic tool on the word of an Americal Prof. - but at least I can prove to the pead that I have done my research and am prepared to fight my corner. Sam x Quote Share this post Link to post Share on other sites
UltraMum Report post Posted March 3, 2007 Can't wait to hear what she says .... Quote Share this post Link to post Share on other sites
butterfingersbimbo Report post Posted March 3, 2007 see, i told you you rock! Quote Share this post Link to post Share on other sites
UltraMum Report post Posted March 4, 2007 see, i told you you rock! Quote Share this post Link to post Share on other sites
sam5886 Report post Posted March 4, 2007 Ultramum - you interested in a copy of the complete article?? Sam x Quote Share this post Link to post Share on other sites
UltraMum Report post Posted March 9, 2007 Ultramum - you interested in a copy of the complete article?? Sam x Sorry about the late reply - had a busy week - yes please - I'll pm you my email addy Quote Share this post Link to post Share on other sites
