Childhood Autism Rating Scale, Second Edition

Covering the entire Autism Spectrum including Asperger’s Syndrome, the Childhood Autism Rating Scale, Second Edition (CARS-2) helps you to identify children with autism and determine symptom severity through quantifiable ratings based on direct observation.

Widely used and empirically validated, the CARS-2 has proven to be especially effective in:

• Discriminating between children with autism and those with severe cognitive deficits
• Distinguishing mild-to-moderate from severe autism

The CARS 2 addresses the following functional areas, among others:

• Relating to People
• Body Use
• Visual Response
• Listening Response
• Taste, Smell, and Touch Response and Use
• Verbal Communication
• Nonverbal Communication
• Level and Consistency of Intellectual Response

Description

Since its original publication, the CARS has become one of the most widely used and empirically validated autism assessments. It has proven especially effective in discriminating between children with autism and those with severe cognitive deficits, and in distinguishing mild-to-moderate from severe autism.

Now a revised Second Edition expands the test’s clinical value, making it more responsive to individuals on the “high functioning” end of the autism spectrum—those with average or higher IQ scores, better verbal skills, and more subtle social and behavioural deficits. While retaining the simplicity, brevity, and clarity of the original test, the CARS 2 adds forms and features that help you integrate diagnostic information, determine functional capabilities, provide feedback to parents, and design targeted intervention.

The CARS 2 includes three forms:

• Standard Version CARS 2 ST Rating Booklet — Equivalent to the original CARS; for use with individuals younger than 6 years of age and those with communication difficulties or below-average estimated IQs.
• High Functioning Individuals CARS 2 HF Rating Booklet — An alternative for assessing verbally fluent individuals, 6 years of age and older, with IQ scores above 80.
• Questionnaire for Parents or Caregivers CARS 2 QPC — An unscored scale that gathers information for use in making CARS 2-ST and CARS 2-HF Ratings.

The Standard and High Functioning Forms

The CARS 2-ST and CARS 2-HF each include 15 items addressing the following functional areas:

• Relating to People
• Imitation (ST); Social-Emotional Understanding (HF)
• Emotional Response (ST); Emotional Expression and Regulation of Emotions (HF)
• Body Use
• Object Use (ST); Object Use in Play (HF)
• Adaptation to Change (ST); Adaptation to Change/Restricted Interests (HF)
• Visual Response
• Listening Response
• Taste, Smell, and Touch Response and Use
• Fear or Nervousness (ST); Fear or Anxiety (HF)
• Verbal Communication
• Nonverbal Communication
• Activity Level (ST); Thinking/Cognitive Integration Skills (HF)
• Level and Consistency of Intellectual Response
• General Impressions

The clinician rates the individual on each item, using a 4-point response scale. Ratings are based not only on frequency of the behaviour in question, but also on its intensity, peculiarity, and duration. While this more nuanced approach gives you greater flexibility in integrating diagnostic information, it still yields quantitative results.

Rating values for all items are summed to produce a Total Raw Score. Each form includes a graph that allows you to quickly convert the Total Raw Score to a standard score or percentile rank (based on a clinical sample of 1,034 individuals with autism spectrum disorders). The Manual provides guidelines for score interpretation, suggestions for intervention, and case examples.

The Questionnaire for Parents or Caregivers

The areas covered by the CARS 2-QPC include the individual’s early development; social, emotional, and communication skills; repetitive behaviours; play and routines; and unusual sensory interests.