Article

Test Review: GARS-2: Gilliam Autism Rating Scale-Second Edition

01/2008; DOI: 10.1177/0734282908317116

ABSTRACT The Gilliam Autism Rating Scale–Second Edition (GARS-2) is a screening tool for autism spectrum disorders for individuals between the ages of 3 and 22. It was designed to help differentiate those with autism from those with severe behavioral disorders as well as from those who are typically developing. It is a norm-referenced instrument that reflects the conceptualizations of autism per the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision; American Psychiatric Association, 2000) and the Autism Society of America (1994).[AUTHOR:PLEASE INCLUDE IN LIST. ASA 1994 CITED TWICE IN ARTICLE.] The GARS-2 was designed to be a supplementary tool for the diagnosis of autism, and it is intended to be used with a variety of diagnostic tools and relevant information in comprehensive assessment protocols for autism. Furthermore, it is intended to facilitate data-driven approaches to assessment and intervention by incorporating a resource that links instructional objectives to assessment findings. General Description Administration Screens and diagnostic instruments for autism spectrum disorders are increasingly required by professionals in various fields to enable timely and appropriate interventions (National Resource Council, 2001). There is a need for easy-to-use instruments that pos-sess good psychometric properties. Moreover, clinicians benefit from using tools that pro-vide an obvious and explicit link to intervention. However, few existing instruments incorporate this much-needed feature. The GARS-2 is a measure that has potential to link assessment to intervention. It can be completed by parents and professionals in a variety of settings, including the home and school. The examiner is responsible for selecting the most appropriate person to complete the rating. The rater should be someone who knows the individual well and has had sus-tained contact with him or her for at least 2 weeks. Furthermore, it is helpful if the rater is privy to early development information; as such, a parent is often the most appropriate rater for this measure. In cases where a professional regularly works with the individual for a significant part of each day, he or she may be the most appropriate rater to summa-rize current behaviors and functioning. In this type of scenario, one may want to include ratings from professionals and parents to enable the most comprehensive and accurate descriptions. However, Gilliam suggests that if this approach is adopted, the examiner may need to average the ratings to resolve discrepant reports. In addition, raters should be instructed to reserve ratings on items on which they believe they may not have enough information to complete.

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    ABSTRACT: The current assessment of movements in the inventories to diagnose autism spectrum disorders (ASD) focus on observation and discrete categorizations. However, measurements of physical movements, which would provide an objective characterization of behavior, have not been developed, or included as part of the assessments. These measurements are necessary to unveil interactions between the peripheral and the central nervous systems critical for the development and maintenance of spontaneous autonomy, self-regulation and voluntary control. The current approaches cannot deal with the heterogeneous, dynamic and stochastic nature of development. They leave no avenues for real-time or longitudinal assessments of change in a coping system continuously adapting and developing compensatory mechanisms. We offer a new unifying statistical framework to reveal features of kinesthetic re-afference in the individual with ASD. The new methodology is based on the non-stationary stochastic patterns of minute fluctuations (micro-movements) inherent to our natural actions. Such patterns of behavioral variability provide re-entrant sensory feedback contributing to the autonomous regulation and coordination of the motor output. From an early age, they enable centrally driven volitional control of actions and fluid, flexible transitions between intentional and spontaneous behaviors. We show that in ASD there is a disruption in the maturation of this form of proprioceptive information. Despite this disturbance, each individual has unique adaptive compensatory capabilities that we can unveil and exploit to evoke faster and more accurate decisions. Using the kinesthetic re-afference in tandem with external stimuli we can detect changes in their micro-movements indicative of a more predictive and reliable kinesthetic percept. Our methods address the heterogeneity of ASD by using a personalized approach grounded in the inherent sensory-motor abilities that the individual has already developed.

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