Samadi Sayyed Ali, Biçak Cemal A, Noori Hana, Abdalla Barez, Abdullah Amir, Ahmed Lizan
Institute of Nursing and Health Research, Ulster University, Newtownabbey BT37 0QB, Northern Ireland, UK.
Bahoz Centre for Children with Developmental Disabilities, Erbil 44002, The Kurdistan Region of Iraq, Iraq.
Brain Sci. 2022 Apr 23;12(5):537. doi: 10.3390/brainsci12050537.
There is joint agreement among professionals internationally on the importance of diagnosing autism spectrum disorders (ASD) in the early stages of the emergence of symptoms. Criteria changes for the diagnosis of ASD need updated versions of the scale to make the diagnosis feasible. This study aimed to evaluate the level of overlap between two different versions of the Gilliam Autism Rating Scale (GARS-2 and GARS-3), which have been updated based on changes in DSM-IV and DSM-5 on a Kurdish sample of individuals at risk of having ASD and Intellectual Disability, referred to the Bahoz center in the Kurdistan Region of Iraq. A group of 148 cases with ASD and developmental disabilities (DD) was evaluated using the 2nd and 3rd versions of the GARS scale to understand the level of cases that confirm an ASD diagnosis in both scales. Ninety-six individuals (65%) scored about the cut-off score for being diagnosed with ASD based on the GARS-2, and 137 individuals (93%) scored above the cut-off score based on the GARS-3. Moreover, keeping updated and meeting the changing demand of standardization and cultural suitability of the updating scales is a challenge. This challenge is due to the shortage of infrastructure sources and lack of established professionals in low- and middle-income countries (LMICs). Findings indicated that GARS-3, updated based on the DSM-5, tends to diagnose children with accompanying diagnoses and different levels of symptoms severity of ASD at different age levels. Further studies are needed to help professionals and policymakers in low- and middle-income countries understand the updated versions of the available scales and depend on the older version, which must be considered cautiously.
国际上的专业人士就症状出现早期诊断自闭症谱系障碍（ASD）的重要性达成了共同共识。ASD诊断标准的变化需要量表的更新版本以使诊断可行。本研究旨在评估基于《精神疾病诊断与统计手册》第四版（DSM-IV）和第五版（DSM-5）的变化而更新的两个不同版本的《 Gilliam自闭症评定量表》（GARS-2和GARS-3）之间的重叠程度，该研究针对伊拉克库尔德地区Bahoz中心转诊的有患ASD和智力残疾风险的库尔德样本个体。使用GARS量表的第二版和第三版对148例患有ASD和发育障碍（DD）的病例进行了评估，以了解两个量表中确诊ASD诊断的病例水平。96名个体（65％）根据GARS-2的得分高于被诊断为ASD的临界分数，137名个体（93％）根据GARS-3的得分高于临界分数。此外，保持更新并满足更新量表的标准化和文化适应性的不断变化的需求是一项挑战。这一挑战是由于低收入和中等收入国家（LMIC）基础设施资源短缺以及专业人员不足所致。研究结果表明，基于DSM-5更新的GARS-3倾向于诊断不同年龄水平伴有不同诊断和不同症状严重程度的ASD儿童。需要进一步的研究来帮助低收入和中等收入国家的专业人员和政策制定者了解可用量表的更新版本，并谨慎考虑依赖旧版本。
