Transcript Clinical and Personality Disorder Differences between
Slide 1
Psychometric Development of a New
Inventory to Assess Symptoms
Across the Spectrum of Autism
Presented By
Presented
by
Peter D. Marle, B.A.
Peter D. Marle, B.A.
Coolidge Autistic Symptoms Survey
Slide 2
• History and Popular Conceptions of Autism
•
Possible accounts written as early as the 16th century (Martin Luther)
•
First psychiatric evaluations – early 20th century (De Sanctis, Earl, & Potter)
•
First scientific research – 1943 (Leo Kanner) and 1944 (Hans Asperger)
•
Comparing Kanner’s and Asperger’s narratives
•
Both differentiated autistic behaviors in the children from schizophrenia
•
Children studied had milder forms of autism
•
Asperger emphasized the malicious behaviors of the children
•
Kanner suspected the origin of autism to come from cold parents
Coolidge Autistic Symptoms Survey
Slide 3
• Controversies
•
Bettelheim and “refrigerator mothers”
•
Rimland
•
Jenny McCarthy
•
Vaccinations causal to autism?
Coolidge Autistic Symptoms Survey
Slide 4
• History of the Diagnosis of Autism
•
•
Diagnostic and Statistical Manual of Mental Disorders (DSM; 1952)
•
No diagnosable autistic condition
•
Most synonymous diagnosis: Schizophrenic reaction, childhood type
DSM-II (1968)
•
•
DSM-III (1980)
•
•
Largely unchanged regarding the diagnosis of autism
Infantile autism
DSM-III-R (1987)
•
Autistic disorder
•
Pervasive developmental disorder – not otherwise specified
Coolidge Autistic Symptoms Survey
Slide 5
• History of the Diagnosis of Autism
•
•
DSM-IV (1994)
•
Autistic Disorder
•
Childhood disintegrative disorder
•
Asperger’s Disorder
•
Pervasive developmental disorder – not otherwise specified
DSM-IV-TR (2000)
•
•
Largely unchanged regarding the diagnosis of autism
DSM-5 (2013)
•
Autism Spectrum Disorder
•
Continuum, with three degrees of severity
Coolidge Autistic Symptoms Survey
Slide 6
• Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
A. Persistent deficits in social communication and social interaction across contexts,
not accounted for by general developmental delays
B. Restricted, repetitive patterns of behavior, interests, or activities
C. Symptoms must be present in early childhood
D. Symptoms together limit and impair everyday functioning
Coolidge Autistic Symptoms Survey
Slide 7
• Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
A. Persistent deficits in social communication and social interaction across contexts,
not accounted for by general developmental delays, manifested by
all three of the following:
1. Social Interactions:
abnormal social approach, conversation, reduced sharing of interests and emotions
2. Nonverbal Communication (includes verbal):
abnormal eye contact, body language, facial expressions, and gestures
3. Peer Relationships:
adjustment of behavior to suit social contexts, imaginative play, seems not interested
in people
Coolidge Autistic Symptoms Survey
Slide 8
• Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by
at least two of the following:
1. Stereotypies:
repetitive speech, motor movements, use of objects
2. Routine:
need for routine, patterns of behavior, resists change
3. Fixations:
fixated interests
4. Sensory Integration:
hyper and/or hypo-reactive to environmental stimuli
Coolidge Autistic Symptoms Survey
Slide 9
• Current Methods for Diagnosing Autism
•
Prevalence rate between 1:88 and 1:2000 (males 4 x more likely)
•
Combination of clinical observation, use of diagnostic tools, and parental reports
•
Current diagnostic tools
•
Autism Diagnostic Interview-Revised
•
Autism Diagnostic Observation Schedule
•
Childhood Autism Rating Scale
Coolidge Autistic Symptoms Survey
Slide 10
• Need for an Updated Diagnostic Tool
•
Current tools may soon be outdated
• Development of the Coolidge Autistic Spectrum Survey
•
Created to examine similarities between Asperger’s disorder and high functioning
autism (2007)
•
Another study later investigated the differentiation of milder forms of ASD and
schizoid personality disorder traits (in press)
Coolidge Autistic Symptoms Survey
Slide 11
• Purpose
To redesign the CASS in order to provide coverage for the new criteria in DSM-5 and to
extend the lower age range of the CASS to approximately 2 to 3 years
• Hypotheses
1. A 1-component solution (as determined by principal components analysis) would best fit
the structures of the new 83-item CASS and 39-item CASS-T (based on a previous study);
although, DSM-5 diagnostic criteria for ASD may suggest multiple components.
2. The new CASS and CASS-T would show good internal reliability (Cronbach’s α ≥ .80).
3. The surveys would have an adequate split-half reliability (r ≥ .80).
4. The surveys would significantly differentiate among children with
a) milder forms of autism (e.g., Asperger’s disorder and high-functioning autism)
b) moderate-to-severe forms of autistic spectrum disorders
c) no diagnoses (i.e., a group-matched control group)
5. There would be a strong, positive correlation between the CASS-T and the CASS means.
Coolidge Autistic Symptoms Survey
Slide 12
•
•
•
Table 1
Participant Data for Mild ASD, Moderate-to-Severe ASD, Group-Matched Control
Participants
Group, and Full Dataset
Materials
n
* Age
* Age
% in Therapy Length * Age Dx
(% male) Range (M, SD) Therapy (Months; M, SD) (M, SD)
• Informed Consent FormMild ASD
22 (77%) 6 – 16 (9.6, 2.5)
52%
(30.5, 21.8)
(6.4, 3.1)
M-S ASD
23 (83%) 5 – 16 (9.2, 3.3)
81%
(60.1, 37.6)
(3.0, 1.6)
• Demographic Sheet
Control
22 (59%) 5 – 17 (9.6, 3.9)
0%
----Full DS (CASS-T) 88 (63%) 5 – 17 (9.9, 3.5)
38%
(45.4, 32.6)
(4.7, 3.1)
• 39-item CASS-T (Retrospective)
Full DS (CASS)
86 (63%) 5 – 17 (9.9, 3.6)
34%
(48.2, 33.7)
(4.6, 3.0)
• 83-item CASS
Note. M-S = Moderate-to-Severe. DS = Dataset. Dx = Diagnosed. * in years.
Procedure
•
All data were collected with approval from the University’s institutional review board
•
Packets were either
•
hand-delivered to parents via a CITI-trained researcher (i.e., Peter D. Marle) or
•
given in an electronic format (via a secure online survey host; i.e., PsychData.com)
•
Packets took approximately 30 min to complete
•
Participants were given the option of returning the materials via a SASE or returning
the materials to the CITI-trained researcher
Coolidge Autistic Symptoms Survey
Slide 13
Hypothesis 1
A 1-component solution would provide the best fit for the CASS and the CASS-T
(accounting for at least 50% of the variance)
•
83-item CASS
•
•
A 1-component solution accounted for about 52% of the variance
39-item CASS-T
•
Either aTable
4-component
(total variance explained = 65.5%) or
2
Cronbach’s α Computations for the CASS-T 4- and 5-Component Solutions
5-component
solution (total variance explained = 69.5%) best fit the data
4-Component Solution
5-Component Solution
# Items
α
# Item
Overlap
1: DSM Dx Criteria
20
.96
14
19
.97
2: Physical Contact
9
.91
6
7
.90
3: Development
6
.83
4
4
.79
4: Sensory Issues
4
.91
4
4
.91
5: Stereotypy/Humor
--
--
0
5
.84
Component
# Items
α
Note. For all analyses, n = 88. # Item Overlap refers to the number of items in the 5-component
solution that also appear in the respective 4-component solution component.
Coolidge Autistic Symptoms Survey
* Supplemental Information
on Component Solutions
Slide 14
Hypothesis 2
The new CASS and CASS-T would show good internal reliability (Cronbach’s α ≥ .80)
•
83-item CASS
•
•
Cronbach’s α = .99 (n = 86)
39-item CASS-T
•
Cronbach’s α = .97 (n = 88)
Table 2
Cronbach’s α Computations for the CASS-T 4- and 5-Component Solutions
4-Component Solution
5-Component Solution
# Items
α
# Item
Overlap
1: DSM Dx Criteria
20
.96
14
19
.97
2: Physical Contact
9
.91
6
7
.90
3: Development
6
.83
4
4
.79
4: Sensory Issues
4
.91
4
4
.91
5: Stereotypy/Humor
--
--
0
5
.84
Component
# Items
α
Note. For all analyses, n = 88. # Item Overlap refers to the number of items in the 5-component
solution that also appear in the respective 4-component solution component.
Coolidge Autistic Symptoms Survey
Slide 15
Hypothesis 3
The CASS and CASS-T would have adequate split-half reliabilities (r ≥ .80)
•
83-item CASS
•
•
r(87) = .98, p < .001
39-item CASS-T
•
r(90) = .95, p < .001
Coolidge Autistic Symptoms Survey
Slide 16
Hypothesis 4
There would be significant differences among the group means for the CASS and CASS-T
a) the moderate-to-severe autism group would have the significantly highest mean,
b) the mild autism group would have the second highest mean, and
•
83-item CASS
F(2, 64) = 199.93,
p < .0005; η2 = .86
•
39-item CASS-T
F(2, 64) = 165.56,
p < .0005; η2 = .84
Possible Means ranged from
1 (Strongly False) to 4 (Strongly True)
c) the group-matched control group would have the significantly lowest mean
4
3
2
CASS Mean
1
CASS-T Mean
Figure 1. Comparison of CASS and CASS-T group means. 95% CIs are given.
Coolidge Autistic Symptoms Survey
Slide 17
Hypothesis 4
There would be significant differences among the group means for the CASS and CASS-T
a) the moderate-to-severe autism group would have the significantly highest mean,
b) the mild autism group would have the second highest mean, and
•
83-item CASS
F(2, 64) = 199.93,
p < .0005; η2 = .86
•
39-item CASS-T
F(2, 64) = 165.56,
p < .0005; η2 = .84
Possible Means ranged from
1 (Strongly False) to 4 (Strongly True)
c) the group-matched control group would have the significantly lowest mean
4
3
2
CASS Mean
1
CASS-T Mean
Figure 1. Comparison of CASS and CASS-T group means. 95% CIs are given.
Coolidge Autistic Symptoms Survey
Slide 18
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
4
r(92) = .89, p < .0005
3
CASS-T Mean
•
Control
2
Mild ASD
Moderate-to-Severe
ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Coolidge Autistic Symptoms Survey
Slide 19
Hypothesis 1
A 1-component solution would provide the best fit for the CASS and the CASS-T
(accounting for at least 50% of the variance)
•
•
83-item CASS
•
A 1-component solution accounted for about 52% of the variance
•
Hypothesis supported
39-item CASS-T
•
Either a 4-component (total variance explained = 65.5%) or
5-component solution (total variance explained = 69.5%) best fit the data
•
Hypothesis not supported
1. DSM-5 diagnostic criteria for ASD, sans sensory issues
2. Physical contact
3. Developmental milestones
4. Sensory issues
5. The 5-component solution added a stereotypies and humor component
Coolidge Autistic Symptoms Survey
Slide 20
Hypothesis 1
•
•
39-item CASS-T
•
DSM-5 diagnostic criteria for ASD, sans sensory issues
•
Physical contact
•
Developmental milestones
•
Sensory issues
•
The 5-component solution added a stereotypies and humor component
DSM-5 Criteria
• Social Interactions
• Nonverbal Communication
• Peer Relationships
•
•
•
•
Stereotypies
Routine
Fixations
Sensory Integration
}
manifested by all three
}
manifested by at least two
Coolidge Autistic Symptoms Survey
Slide 21
Hypothesis 2
The new CASS and CASS-T would show good internal reliability (Cronbach’s α ≥ .80)
•
•
•
83-item CASS
•
Cronbach’s α = .99 (n = 86)
•
Hypothesis supported
39-item CASS-T
•
Cronbach’s α = .97 (n = 88)
•
Hypothesis supported
Alphas too high?
Coolidge Autistic Symptoms Survey
Slide 22
Hypothesis 3
The CASS and CASS-T would have adequate split-half reliabilities (r ≥ .80)
•
•
•
83-item CASS
•
r(87) = .98
•
Hypothesis supported
39-item CASS-T
•
r(90) = .95
•
Hypothesis supported
Comparing split-half reliability and Cronbach’s α
Coolidge Autistic Symptoms Survey
Slide 23
Hypothesis 4
There would be significant differences among the group means for the CASS and CASS-T
a) the moderate-to-severe autism group would have the significantly highest mean,
b) the mild autism group would have the second highest mean, and
•
83-item CASS
•
F(2, 64) = 199.93,
p < .0005; η2 = .86
•
•
Hypothesis supported
39-item CASS-T
•
F(2, 64) = 165.56,
Possible Means ranged from
1 (Strongly False) to 4 (Strongly True)
c) the group-matched control group would have the significantly lowest mean
4
3
2
CASS Mean
1
CASS-T Mean
p < .0005; η2 = .84
•
Hypothesis supported
Figure 1. Comparison of CASS and CASS-T group means. 95% CIs are given.
Coolidge Autistic Symptoms Survey
Slide 24
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
•
r(92) = .89, p < .0005
•
Hypothesis supported
4
3
CASS-T Mean
•
Control
2
Mild ASD
Moderate-toSevere ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Coolidge Autistic Symptoms Survey
Slide 25
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
•
r(92) = .89, p < .0005
•
Hypothesis supported
4
3
CASS-T Mean
•
Control
2
Mild ASD
Moderate-toSevere ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Only midpoints given.
Coolidge Autistic Symptoms Survey
Slide 26
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
•
r(92) = .89, p < .0005
•
Hypothesis supported
4
3
CASS-T Mean
•
Control
Mild ASD
2
Moderate-toSevere ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Midpoints with 1 standard deviation projection given.
Coolidge Autistic Symptoms Survey
Slide 27
•
This study did not investigate the differentiation of moderate ASD
•
•
This study used parent-as-respondent data
•
•
•
Future research into the CASS and the CASS-T should explore this.
Cost vs. accuracy/error
Small sample size for the PCA
•
This study served as a preliminary component structure assessment of the surveys.
•
Future PCA with a larger pool of participants is recommended.
Test-retest reliability was not assessed
•
This study assessed split-half reliability.
•
Future studies should investigate time-based reliability.
Coolidge Autistic Symptoms Survey
Slide 28
•
Sensitivity and specificity of surveys not assessed
•
Future research investigating the accuracy of the surveys to accurately categorize ASD
into groups, as well as to accurately assess any non-ASD diagnosis.
•
Gender and age differences regarding the surveys should be analyzed
•
•
Future research should explore differences in item responses by age and gender.
Sensory integration disorder and the CASS
•
Because of the possible current trend of misdiagnosing children with an ASD who may
only have sensory integration problems, future research with the CASS should assess
the differentiation of these children.
Coolidge Autistic Symptoms Survey
Slide 29
Thank you!
Questions?
Coolidge Autistic Symptoms Survey
Psychometric Development of a New
Inventory to Assess Symptoms
Across the Spectrum of Autism
Presented By
Presented
by
Peter D. Marle, B.A.
Peter D. Marle, B.A.
Coolidge Autistic Symptoms Survey
Slide 2
• History and Popular Conceptions of Autism
•
Possible accounts written as early as the 16th century (Martin Luther)
•
First psychiatric evaluations – early 20th century (De Sanctis, Earl, & Potter)
•
First scientific research – 1943 (Leo Kanner) and 1944 (Hans Asperger)
•
Comparing Kanner’s and Asperger’s narratives
•
Both differentiated autistic behaviors in the children from schizophrenia
•
Children studied had milder forms of autism
•
Asperger emphasized the malicious behaviors of the children
•
Kanner suspected the origin of autism to come from cold parents
Coolidge Autistic Symptoms Survey
Slide 3
• Controversies
•
Bettelheim and “refrigerator mothers”
•
Rimland
•
Jenny McCarthy
•
Vaccinations causal to autism?
Coolidge Autistic Symptoms Survey
Slide 4
• History of the Diagnosis of Autism
•
•
Diagnostic and Statistical Manual of Mental Disorders (DSM; 1952)
•
No diagnosable autistic condition
•
Most synonymous diagnosis: Schizophrenic reaction, childhood type
DSM-II (1968)
•
•
DSM-III (1980)
•
•
Largely unchanged regarding the diagnosis of autism
Infantile autism
DSM-III-R (1987)
•
Autistic disorder
•
Pervasive developmental disorder – not otherwise specified
Coolidge Autistic Symptoms Survey
Slide 5
• History of the Diagnosis of Autism
•
•
DSM-IV (1994)
•
Autistic Disorder
•
Childhood disintegrative disorder
•
Asperger’s Disorder
•
Pervasive developmental disorder – not otherwise specified
DSM-IV-TR (2000)
•
•
Largely unchanged regarding the diagnosis of autism
DSM-5 (2013)
•
Autism Spectrum Disorder
•
Continuum, with three degrees of severity
Coolidge Autistic Symptoms Survey
Slide 6
• Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
A. Persistent deficits in social communication and social interaction across contexts,
not accounted for by general developmental delays
B. Restricted, repetitive patterns of behavior, interests, or activities
C. Symptoms must be present in early childhood
D. Symptoms together limit and impair everyday functioning
Coolidge Autistic Symptoms Survey
Slide 7
• Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
A. Persistent deficits in social communication and social interaction across contexts,
not accounted for by general developmental delays, manifested by
all three of the following:
1. Social Interactions:
abnormal social approach, conversation, reduced sharing of interests and emotions
2. Nonverbal Communication (includes verbal):
abnormal eye contact, body language, facial expressions, and gestures
3. Peer Relationships:
adjustment of behavior to suit social contexts, imaginative play, seems not interested
in people
Coolidge Autistic Symptoms Survey
Slide 8
• Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by
at least two of the following:
1. Stereotypies:
repetitive speech, motor movements, use of objects
2. Routine:
need for routine, patterns of behavior, resists change
3. Fixations:
fixated interests
4. Sensory Integration:
hyper and/or hypo-reactive to environmental stimuli
Coolidge Autistic Symptoms Survey
Slide 9
• Current Methods for Diagnosing Autism
•
Prevalence rate between 1:88 and 1:2000 (males 4 x more likely)
•
Combination of clinical observation, use of diagnostic tools, and parental reports
•
Current diagnostic tools
•
Autism Diagnostic Interview-Revised
•
Autism Diagnostic Observation Schedule
•
Childhood Autism Rating Scale
Coolidge Autistic Symptoms Survey
Slide 10
• Need for an Updated Diagnostic Tool
•
Current tools may soon be outdated
• Development of the Coolidge Autistic Spectrum Survey
•
Created to examine similarities between Asperger’s disorder and high functioning
autism (2007)
•
Another study later investigated the differentiation of milder forms of ASD and
schizoid personality disorder traits (in press)
Coolidge Autistic Symptoms Survey
Slide 11
• Purpose
To redesign the CASS in order to provide coverage for the new criteria in DSM-5 and to
extend the lower age range of the CASS to approximately 2 to 3 years
• Hypotheses
1. A 1-component solution (as determined by principal components analysis) would best fit
the structures of the new 83-item CASS and 39-item CASS-T (based on a previous study);
although, DSM-5 diagnostic criteria for ASD may suggest multiple components.
2. The new CASS and CASS-T would show good internal reliability (Cronbach’s α ≥ .80).
3. The surveys would have an adequate split-half reliability (r ≥ .80).
4. The surveys would significantly differentiate among children with
a) milder forms of autism (e.g., Asperger’s disorder and high-functioning autism)
b) moderate-to-severe forms of autistic spectrum disorders
c) no diagnoses (i.e., a group-matched control group)
5. There would be a strong, positive correlation between the CASS-T and the CASS means.
Coolidge Autistic Symptoms Survey
Slide 12
•
•
•
Table 1
Participant Data for Mild ASD, Moderate-to-Severe ASD, Group-Matched Control
Participants
Group, and Full Dataset
Materials
n
* Age
* Age
% in Therapy Length * Age Dx
(% male) Range (M, SD) Therapy (Months; M, SD) (M, SD)
• Informed Consent FormMild ASD
22 (77%) 6 – 16 (9.6, 2.5)
52%
(30.5, 21.8)
(6.4, 3.1)
M-S ASD
23 (83%) 5 – 16 (9.2, 3.3)
81%
(60.1, 37.6)
(3.0, 1.6)
• Demographic Sheet
Control
22 (59%) 5 – 17 (9.6, 3.9)
0%
----Full DS (CASS-T) 88 (63%) 5 – 17 (9.9, 3.5)
38%
(45.4, 32.6)
(4.7, 3.1)
• 39-item CASS-T (Retrospective)
Full DS (CASS)
86 (63%) 5 – 17 (9.9, 3.6)
34%
(48.2, 33.7)
(4.6, 3.0)
• 83-item CASS
Note. M-S = Moderate-to-Severe. DS = Dataset. Dx = Diagnosed. * in years.
Procedure
•
All data were collected with approval from the University’s institutional review board
•
Packets were either
•
hand-delivered to parents via a CITI-trained researcher (i.e., Peter D. Marle) or
•
given in an electronic format (via a secure online survey host; i.e., PsychData.com)
•
Packets took approximately 30 min to complete
•
Participants were given the option of returning the materials via a SASE or returning
the materials to the CITI-trained researcher
Coolidge Autistic Symptoms Survey
Slide 13
Hypothesis 1
A 1-component solution would provide the best fit for the CASS and the CASS-T
(accounting for at least 50% of the variance)
•
83-item CASS
•
•
A 1-component solution accounted for about 52% of the variance
39-item CASS-T
•
Either aTable
4-component
(total variance explained = 65.5%) or
2
Cronbach’s α Computations for the CASS-T 4- and 5-Component Solutions
5-component
solution (total variance explained = 69.5%) best fit the data
4-Component Solution
5-Component Solution
# Items
α
# Item
Overlap
1: DSM Dx Criteria
20
.96
14
19
.97
2: Physical Contact
9
.91
6
7
.90
3: Development
6
.83
4
4
.79
4: Sensory Issues
4
.91
4
4
.91
5: Stereotypy/Humor
--
--
0
5
.84
Component
# Items
α
Note. For all analyses, n = 88. # Item Overlap refers to the number of items in the 5-component
solution that also appear in the respective 4-component solution component.
Coolidge Autistic Symptoms Survey
* Supplemental Information
on Component Solutions
Slide 14
Hypothesis 2
The new CASS and CASS-T would show good internal reliability (Cronbach’s α ≥ .80)
•
83-item CASS
•
•
Cronbach’s α = .99 (n = 86)
39-item CASS-T
•
Cronbach’s α = .97 (n = 88)
Table 2
Cronbach’s α Computations for the CASS-T 4- and 5-Component Solutions
4-Component Solution
5-Component Solution
# Items
α
# Item
Overlap
1: DSM Dx Criteria
20
.96
14
19
.97
2: Physical Contact
9
.91
6
7
.90
3: Development
6
.83
4
4
.79
4: Sensory Issues
4
.91
4
4
.91
5: Stereotypy/Humor
--
--
0
5
.84
Component
# Items
α
Note. For all analyses, n = 88. # Item Overlap refers to the number of items in the 5-component
solution that also appear in the respective 4-component solution component.
Coolidge Autistic Symptoms Survey
Slide 15
Hypothesis 3
The CASS and CASS-T would have adequate split-half reliabilities (r ≥ .80)
•
83-item CASS
•
•
r(87) = .98, p < .001
39-item CASS-T
•
r(90) = .95, p < .001
Coolidge Autistic Symptoms Survey
Slide 16
Hypothesis 4
There would be significant differences among the group means for the CASS and CASS-T
a) the moderate-to-severe autism group would have the significantly highest mean,
b) the mild autism group would have the second highest mean, and
•
83-item CASS
F(2, 64) = 199.93,
p < .0005; η2 = .86
•
39-item CASS-T
F(2, 64) = 165.56,
p < .0005; η2 = .84
Possible Means ranged from
1 (Strongly False) to 4 (Strongly True)
c) the group-matched control group would have the significantly lowest mean
4
3
2
CASS Mean
1
CASS-T Mean
Figure 1. Comparison of CASS and CASS-T group means. 95% CIs are given.
Coolidge Autistic Symptoms Survey
Slide 17
Hypothesis 4
There would be significant differences among the group means for the CASS and CASS-T
a) the moderate-to-severe autism group would have the significantly highest mean,
b) the mild autism group would have the second highest mean, and
•
83-item CASS
F(2, 64) = 199.93,
p < .0005; η2 = .86
•
39-item CASS-T
F(2, 64) = 165.56,
p < .0005; η2 = .84
Possible Means ranged from
1 (Strongly False) to 4 (Strongly True)
c) the group-matched control group would have the significantly lowest mean
4
3
2
CASS Mean
1
CASS-T Mean
Figure 1. Comparison of CASS and CASS-T group means. 95% CIs are given.
Coolidge Autistic Symptoms Survey
Slide 18
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
4
r(92) = .89, p < .0005
3
CASS-T Mean
•
Control
2
Mild ASD
Moderate-to-Severe
ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Coolidge Autistic Symptoms Survey
Slide 19
Hypothesis 1
A 1-component solution would provide the best fit for the CASS and the CASS-T
(accounting for at least 50% of the variance)
•
•
83-item CASS
•
A 1-component solution accounted for about 52% of the variance
•
Hypothesis supported
39-item CASS-T
•
Either a 4-component (total variance explained = 65.5%) or
5-component solution (total variance explained = 69.5%) best fit the data
•
Hypothesis not supported
1. DSM-5 diagnostic criteria for ASD, sans sensory issues
2. Physical contact
3. Developmental milestones
4. Sensory issues
5. The 5-component solution added a stereotypies and humor component
Coolidge Autistic Symptoms Survey
Slide 20
Hypothesis 1
•
•
39-item CASS-T
•
DSM-5 diagnostic criteria for ASD, sans sensory issues
•
Physical contact
•
Developmental milestones
•
Sensory issues
•
The 5-component solution added a stereotypies and humor component
DSM-5 Criteria
• Social Interactions
• Nonverbal Communication
• Peer Relationships
•
•
•
•
Stereotypies
Routine
Fixations
Sensory Integration
}
manifested by all three
}
manifested by at least two
Coolidge Autistic Symptoms Survey
Slide 21
Hypothesis 2
The new CASS and CASS-T would show good internal reliability (Cronbach’s α ≥ .80)
•
•
•
83-item CASS
•
Cronbach’s α = .99 (n = 86)
•
Hypothesis supported
39-item CASS-T
•
Cronbach’s α = .97 (n = 88)
•
Hypothesis supported
Alphas too high?
Coolidge Autistic Symptoms Survey
Slide 22
Hypothesis 3
The CASS and CASS-T would have adequate split-half reliabilities (r ≥ .80)
•
•
•
83-item CASS
•
r(87) = .98
•
Hypothesis supported
39-item CASS-T
•
r(90) = .95
•
Hypothesis supported
Comparing split-half reliability and Cronbach’s α
Coolidge Autistic Symptoms Survey
Slide 23
Hypothesis 4
There would be significant differences among the group means for the CASS and CASS-T
a) the moderate-to-severe autism group would have the significantly highest mean,
b) the mild autism group would have the second highest mean, and
•
83-item CASS
•
F(2, 64) = 199.93,
p < .0005; η2 = .86
•
•
Hypothesis supported
39-item CASS-T
•
F(2, 64) = 165.56,
Possible Means ranged from
1 (Strongly False) to 4 (Strongly True)
c) the group-matched control group would have the significantly lowest mean
4
3
2
CASS Mean
1
CASS-T Mean
p < .0005; η2 = .84
•
Hypothesis supported
Figure 1. Comparison of CASS and CASS-T group means. 95% CIs are given.
Coolidge Autistic Symptoms Survey
Slide 24
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
•
r(92) = .89, p < .0005
•
Hypothesis supported
4
3
CASS-T Mean
•
Control
2
Mild ASD
Moderate-toSevere ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Coolidge Autistic Symptoms Survey
Slide 25
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
•
r(92) = .89, p < .0005
•
Hypothesis supported
4
3
CASS-T Mean
•
Control
2
Mild ASD
Moderate-toSevere ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Only midpoints given.
Coolidge Autistic Symptoms Survey
Slide 26
Hypothesis 5
There would be a strong, positive correlation between the CASS-T and the CASS means
Correlation coefficient
•
r(92) = .89, p < .0005
•
Hypothesis supported
4
3
CASS-T Mean
•
Control
Mild ASD
2
Moderate-toSevere ASD
1
0
0
1
2
CASS Mean
3
4
Figure 2. Scatterplot of CASS and CASS-T means marked by group.
Midpoints with 1 standard deviation projection given.
Coolidge Autistic Symptoms Survey
Slide 27
•
This study did not investigate the differentiation of moderate ASD
•
•
This study used parent-as-respondent data
•
•
•
Future research into the CASS and the CASS-T should explore this.
Cost vs. accuracy/error
Small sample size for the PCA
•
This study served as a preliminary component structure assessment of the surveys.
•
Future PCA with a larger pool of participants is recommended.
Test-retest reliability was not assessed
•
This study assessed split-half reliability.
•
Future studies should investigate time-based reliability.
Coolidge Autistic Symptoms Survey
Slide 28
•
Sensitivity and specificity of surveys not assessed
•
Future research investigating the accuracy of the surveys to accurately categorize ASD
into groups, as well as to accurately assess any non-ASD diagnosis.
•
Gender and age differences regarding the surveys should be analyzed
•
•
Future research should explore differences in item responses by age and gender.
Sensory integration disorder and the CASS
•
Because of the possible current trend of misdiagnosing children with an ASD who may
only have sensory integration problems, future research with the CASS should assess
the differentiation of these children.
Coolidge Autistic Symptoms Survey
Slide 29
Thank you!
Questions?
Coolidge Autistic Symptoms Survey