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Childhood Autism rating scale

(C.A.R.S)
Author and year
The Childhood Autism Rating Scale (CARS) was developed by Eric Schopler, Robert J.
Reichler, and Barbara Rochen Renner in 1980.
Introduction
The Childhood Autism Rating Scale (CARS) is a tool used to assess the severity of
autism spectrum disorder (ASD) in children. It helps healthcare professionals and researchers
evaluate various aspects of a child’s behavior, communication, and social interaction. The CARS
consists of 15 items that are scored based on observations and information gathered from parents
or caregivers. It provides a standardized way to measure the presence and severity of ASD
symptoms, aiding in diagnosis and treatment planning for children on the autism spectrum.
Objectives
The Childhood Autism Rating Scale (CARS) is a widely used tool in the field of autism
assessment. Its objective is to aid in the diagnosis and evaluation of autism spectrum disorder
(ASD) in children. The CARS helps healthcare professionals assess the severity of autism-
related symptoms and provides a standardized way to measure and compare these symptoms
across individuals.
1. Assessing Communication:
The CARS evaluates communication skills in children with autism. It looks at the child’s ability
to use language for social interaction, engage in reciprocal conversation, and understand
nonverbal cues such as gestures and facial expressions.
2. Assessing Social Interactions:
Another objective of the CARS is to assess social interactions. It examines how the child
interacts with others, including their ability to initiate and respond to social interactions, make
and maintain eye contact, and demonstrate appropriate social behaviors.
3. Assessing Stereotyped Behaviors and Restricted Interests:
The CARS also aims to assess the presence of stereotyped behaviors and restricted interests,
which are common characteristics of autism. It evaluates repetitive behaviors, adherence to
routines, and intense focus on specific topics or objects.
4. Evaluating Overall Severity:
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In addition to specific symptom domains, the CARS provides an overall severity score that
reflects the overall impact of autism-related symptoms on the child’s functioning. This score
helps healthcare professionals gauge the level of impairment and guide treatment planning.
By utilizing the CARS, healthcare professionals can obtain a standardized assessment of autism-
related symptoms in children. This information assists in making an accurate diagnosis,
determining the severity of symptoms, and tracking progress over time. The CARS helps
healthcare professionals gain a comprehensive understanding of the child’s autism profile,
leading to more targeted interventions and support.

Response Recording
Response recording in the Childhood Autism Rating Scale (CARS) test involves trained
clinicians observing and rating a child's behaviors across various domains relevant to autism
spectrum disorder (ASD). Using a scale of 1 to 4 for each of the 15 items, observers document
the frequency, intensity, and quality of behaviors observed. These ratings are then totaled to
calculate an overall score, which aids in diagnosing ASD, assessing symptom severity, and
guiding treatment planning.

Administration
Test materials
The test materials required for conducting the Childhood Autism Rating Scale (CARS)
assessment include the CARS manual for guidance on administering the test, observation forms
for recording behaviors across the 15 items, standardized rating scales to quantify symptom
severity, consent forms for parental authorization, a suitable observation setting free from
distractions, and training materials for assessors to ensure consistency. Additionally, familiarity
with diagnostic criteria for autism spectrum disorder (ASD) is crucial for accurate interpretation
of assessment results, enabling clinicians to gather comprehensive information and make
informed diagnostic and treatment decisions.
Demographic information of the client
Name L.G
Gender Male
Age 21
Education BS
No of Siblings 5
Scoring and interpretation
Scoring the Childhood Autism Rating Scale (CARS) involves evaluating the child's
behavior across 15 items, each rated on a 4-point scale from 1 (indicating typical behavior) to 4
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(indicating severe impairment). Trained evaluators observe the child's social interactions,
communication skills, and repetitive behaviors, assigning scores based on their observations.
After rating each item, the scores are totaled to yield an overall score reflecting the severity of
the child's autistic symptoms. Higher total scores indicate more pronounced impairment, while
lower scores suggest milder symptoms or typical development. It's essential for evaluators to
consider the child's behavior across various settings and gather information from multiple
sources, such as parents, teachers, and caregivers, to ensure a comprehensive assessment.
Quantitative Scoring
Table 1.
Sub-scales Score range Scores Severity level
Relating to people 1-4 2 Mildly relating to
people
Imitation 1-4 2 Mildly imitation
Emotional response 1-4 2 Mildly emotional
response
Body use 1-4 3 Moderate body use
Object use 1-4 2 Mildly object use
Adaptation to change 1-4 1 Normal adaptation
to change
Visual response 1-4 1 Normal visual
Response
Listening response 1-4 1 Normal listening
Response
Taste, smell, and 3
touch response and use 1-4 Moderate
taste,smell,and
touch response and
use
Fear or nervousness 1-4 3 Moderate fear or
nervousness
Verbal communication 1-4 2 Mildly verbal
communication
Non verbal 1
communication 1-4 Normal non verbal
communication
Activity level 1-4 1 Normal activity
level
Level and consistency 1
of intellectual response 1-4 Normal level and
consistency of
intellectual response
General impressions 1-4 2 Mildly general
impression
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Total score 15-60 27 Non autistic

Qualitative Interpretation
The table indicates varied scores across different sub-scales of functioning. While many
aspects such as adaptation to change, visual response, listening response, verbal communication,
and general impressions fall within the normal range, there are mild to moderate impairments in
body use, object use, taste, smell, and touch response, emotional response as well as in non-
verbal communication and activity level. Overall, the total score falls within the normal range,
suggesting a generally functional level of behavior, but with some areas of mild to moderate
concern warranting attention and potential intervention.

Reference
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