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GilligamAutism Rating Scale-2

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Tiffany Zilka

on 8 December 2014

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Transcript of GilligamAutism Rating Scale-2

The Gilliam Autism Rating Scales-Second Edition is a standardized instrument designed for assessment of persons with autism and other severe behavioral disorders. The GARS-2 provides norm-referenced information that can assist in the diagnosis of Autism.

The test is norm-referenced with persons with autism/autistic characteristics.
Rating Scale
Components
Description
Subscales
Stereotyped Behaviors: Motility Disorders and other unique and a typical behaviors
Communication: Verbal and nonverbal behaviors that are symptomatic of autism.
Social Interaction: The individual's ability to relate appropriately to people, objects and events.

The scores in these areas are standard scores ranging from 1-20.
Autism Index (AI)
Another kind of Standard Score composed of the sum of the scaled scores.
It has a mean of 100 and Standard Deviation of 15.
It is the most reliable score and predictor of Autism.

AI Interpretation Guide
85-100: Very Likely
70-84: Possible
69- Below: Unlikely
Standard Scores
The Standard Scores (SS) are composed of the raw scores in the three subscales
The score is used to determine the deviation from the average performance; the larger the SS the more severe the autistic behavior.
A SS of 7 or higher means the probability is very likely
Reported Reliability and Validity
Reliability:
Internal consistency was found using Cronbach's Alpha Technique. Since the coefficients are large,(.84 for Stereotyped Behaviors,.86 for Communication,.88 for Social Interaction, .94 for Autism Index) they indicate the measures are consistent in measuring autistic behavior
Validity:
Several studies found the items very consistent and discriminative. Concurrent validity was established with the GARS-2 and Autism Behavior Checklist. A positive correlation was also found between the instruments. Studies found the GARS-2 discriminates between autism and children with mental retardation, multiple disabilities, and children with disability.
Using GARS-2 to Diagnose ASD
Be aware that raters have their own bias or have a mistaken impression of the child's behavior.
Ratings inconsistent with other results should be viewed with caution
Multiple tools and a multidisciplinary team should evaluate and determine ASD.
-Use test data
- A file review
-Other tools
Characteristics of the Gilliam Autism Rating Scales-Second Edition
Scores Obtained
Practical Considerations
Autism Screening and Assessment
Examiner's Manual
Response Booklet
Rating Scales
Parent Interview
Key Questions
Instructional Objectives for Children who have Autism
The Rating Scale contains three scales of 14 items.
The items are based on the Autism Society of American and the diagnostic criteria of the Autistic Disorder in the DSM-IV-TR.
The scores are rated based on frequency of occurrence as observed by the rater, such as parent or teacher.
0- Never Observed
1- Seldom Observed
2- Sometimes Observed
3- Frequently Observed
Criticisms
May not adequately assess individuals with autism who are higher functioning or display less severe autism symptoms.
Several items assess characteristics that do not seem autism-specific.
Three subscales are not adequate in evaluating ASD.

More research is needed to evaluate the overall sensitivity and specificity need to be optimize diagnostic accuracy must be identified, especially in the absence of normative data for these scales.
Overall
A multidisciplinary team should evaluate the results of the GARS-2 with its limitations in mind and use multiple sources when diagnosing ASD. The GARS-2 has been cited
To under diagnose autism (Norris and Lecavalier, 2010)
Can be useful screening tool for autism when used as part of a comprehensive assessment.

Other ASD Screening and Assessment methods
AUTISM DIAGNOSTIC
OBSERVATION SCHEDULE
SECOND EDITION (ADOS-2)

Semi- Structured, standardized observation assessment tool.
Assesses
Communication
Social interaction
Play
Restrictive and Repetitive Behaviors
Ages: Toddlers to Adults
Practical Considerations:
Does NOT assess nonverbal children and adults with the ADOS.
The examiner must observe a wide variety of behaviors related to the diagnosis of autism or PDD.  




Autism Spectrum Screening Questionnaire (ASSQ)
Consists of twenty-seven items rated yes, sometimes, or no.
Assesses the areas of impaired social interaction, communication, restricted or repetitive behavior, and associated symptoms.
Practical Considerations:
High sensitivity (.91) and specificity (.77) when parents were raters (Norris and Lecavalier 2010)
Can differentiate between AS and high functioning ASD from ADHD, behavioral disorders, and learning disorders.



Social Communication Questionnaire (SCQ)
Consists of 40 yes/no items
Four subscales:
Social interaction
Communication
Abnormal Language
Stereotyped Behaviors.
Practical Considerations:
Not optimal with younger populations (Best with over 7).
SCQ was more likely to miss higher-functioning than lower-functioning children



Asperger Syndrome
Diagnostic Scale (ASDS)
Consists of 50 yes/no items
Children with a score greater than 90 are likely or very likely to have AS.
Five Subscales
Language
Social
Maladaptive
Cognitive
Sensorimotor
Practical Considerations:
Children with AS scored higher than children with ASD.
Only partially supported diagnostic validity.
Sources
Autism Diagnostic Observation Schedule, WPS Publishing, 2014

Gilliam, J. (2006) GARS-2: Gilliam Autism Rating Scale- Second Edition, Austin, TX: PRO-ED.

Gilliam Autism Rating Scale, Second Edition, WPS Publishing, 2014

Klinger, L.G, O’Kelley, S.E, Mussey, J.L.. (Ed.), Assessment of Autism Spectrum Disorders (pp.209-252). New York, NY. The Guifold Press.

Norris M., Lecavalier L. (2010) Screening accuracy of level 2 autism spectrum disorder rating scales: A review of selected instruments. Autism, 14 (4) , pp. 263-284.
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