Cars Report

Gurman Kaur Chawla, 2337524

Department of Psychology CHRIST (Deemed to be University) Bangalore, India

MPS 352
Dr. Uma Krishnan

20 July, 2024
 Introduction

The Childhood Autism Rating Scale, 2nd Edition (CARS2) is designed as a clinical
rating scale for the trained clinician to rate items indicative of Autism Spectrum
Disorder (ASD) after direct observation of the child. The form is used with individuals of all
ages and in both clinical and research settings.

The CARS2-ST and CARS2-HF each include 15 items that ask respondents to rate an
individual on a scale from 1 to 4 in key areas related to autism diagnosis.

CARS2-ST: Children under age 6, or over age 6 but with an estimated IQ of 79 or

lower, or a notable communication impairment. CARS-HF: Age 6 or older, with an estimated
IQ of 80 or higher and fluent communication.

CARS2-ST: Clinician ratings based on information gathered from an observation of

the child or from the parent's completion of the CARS2-QPC. Items are rated on a 4 point
scale. CARS2-HF: Clinician ratings, based on at least 2 sources of information (both direct
observation and information gathered from someone who knows the individual's behavior in
different settings).

Professionals who have had exposure and training in ASD and brief training about the
CARS can make valid ratings. This is not a parent questionnaire, but parent observations can
be obtained through the CARS2-QPC, which would be incorporated into the CARS2-ST or
CARS2-HF by the professional.

History and Test development

 The CARS-2 is an update of the Childhood Autism Rating Scale (CARS), an older
and widely-used rating scale for autism. The original CARS was developed primarily with
individuals with comorbid intellectual functioning and was criticized for not accurately
identify higher functioning individuals on the autism spectrum. The CARS-2 retained the
original CARS form for use with younger or lower functioning individuals (now renamed the
CARS2-ST for "Standard Form"), and it developed a separate rating scale for use with higher
functioning individuals (named the CARS2-HF for "High Functioning"). Clinically, the
original CARS was often misused as a parent questionnaire; it was designed as a clinician
rating scale to be completed after a direct observation of the child by a professional familiar
with autism who had also obtained some brief training on how to rate the CARS items. The
CARS-2 retains this same format. Information from parents can be obtained with the CARS2-
QPC (Questionnaire of Parent Concerns), an unscored form for parents to record
observations.

Psychometric properties

Reliability of ratings on the original CARS made from different sources of clinical
information. To assess the internal consistency of the Total scores on the original CARS,
coefficient alpha was computed for these ratings. The Total raw score alpha estimate for the
original CARS in this sample was .94. Other authors have reported scale alphas for various
samples and translations of the CARS ranging from .73 to .94

Instructions

CARS 2- ST

For each category, use the space provided in the Observations section for taking notes
concerning the behaviors relevant to that item. After you have finished observing the child,
rate the behaviors relevant to each item by circling the number that corresponds to the
statement that best describes the child. You may indicate that the child’s behavior falls
between two descriptions by circling ratings of 1.5, 2.5, or 3.5. Abbreviated rating criteria are
presented for each item.

Scoring Pattern

CARS 2-ST
 Rating values for each of the 15 CARS2-ST items range from 1 to 4. Generally, a
rating value of 1 indicates that an individual’s behavior is within normal limits for an
individual of that age. A value of 2 means that the individual’s behavior is mildly abnormal
compared with a person of the same age. A value of 3 indicates that the individual’s behavior
is moderately abnormal for that age. A value of 4 indicates that the individual’s behavior is
severely abnormal for someone of that age.

In addition to these four ratings, the midpoints between them (1.5, 2.5, and 3.5)
should be used when the behavior appears to fall between two categories. For example, if a
behavior is mildly-to-moderately abnormal, it should be rated 2.5. Thus, the seven allowable
ratings for each item are as follows:

1: Within normal limits for that age

1.5: Very mildly abnormal for that age

2: Mildly abnormal for that age

2.5: Mildly-to-moderately abnormal for that age

3: Moderately abnormal for that age

3.5: Moderately-to-severely abnormal for that age

4: Severely abnormal for that age

While rating the individual’s behaviour, that of a typically developing individual of

the same age. When behaviors are observed that are not typical for an individual of the same
age, the peculiarity, frequency, intensity, and duration of these behaviors should be
considered.

1. Transfer the ratings for all 15 categories from the inside pages of the booklet to the
corresponding spaces provided in the Summary section on the front page of the
booklet
2. Sum the ratings to obtain the Total raw score
3. Indicate the Severity Group that corresponds with the Total raw score by making a
check mark in the appropriate box
4. To obtain a standard score in the form of a T-score, circle the value that corresponds
to the Total raw score in the Raw score table provided on the right side of the
Summary section
 5. The number printed to the left of the value you have circled is the T-score.
6. The number printed to the left of the T-score value is the percentile rank that
corresponds to the Total raw score. In the example, the percentile rank for the
obtained Total raw score is 69

Demographic details

Name: A.B.

Date: 15/07/2024

Age: 5 years, 4 months

Gender: Female

Ethnic Background: Indian

Rater’s Name: GKC

Purpose of Testing: The present test was administered for academic purposes

Test Findings

Item Description Score Remarks

Relating to How the child behaves 2 (Mildly Abnormal Child avoids eye
People in a variety of situations Relationships) contact, excessively
shy
Imitation How the child imitates 1 (Appropriate Child can imitate
verbal and nonverbal imitation) sounds and
acts movements but
sometimes there is a
minor delay
Emotional How the child reacts to 1 (Age-appropriate Child shows
Response both pleasant and and situation- appropriate type and
unpleasant situations appropriate degree of emotional
emotional response) response
Body Use Coordination and 2 (Mildly abnormal Some minor repetitive
appropriateness of body body use) movements and
movements clumsiness is present
Object Use Child’s interest in toys 2 (Mildly Less interest in toys
 or other objects inappropriate
interest in, or use of,
toys and other
objects)
Adaptation to Difficulties in changing 1 (Age-appropriate The child comments
Change established routines or response to change) on changes in routine
patterns but is easily able to
adapt
Visual Unusual visual attention 2 (Mildly abnormal The child stares off
Response patterns visual response) into space sometimes
and avoids eye contact
Listening Unusual listening 2 (Mildly abnormal There is some delay in
Response behaviour or unusual listening response) response to certain
responses to sounds sounds
Taste, Smell, Child’s response to 1 (Normal use of The child normally
and Touch stimulation of the taste, and response to explores new objects
Response and smell, and touch senses taste, smell and in an age-appropriate
Use touch) manner
Fear or Unusual or 1 (Normal fear or The child’s behaviour
Nervousness unexplainable fears nervousness) is appropriate both to
the situation and to
their age
Verbal Child’s use of speech 1 (Normal verbal Verbal communication
Communicatio and language communication) is age and situation
n appropriate
Nonverbal Child’s nonverbal 1 (Normal use of Nonverbal
Communicatio communication through nonverbal communication is age
n facial expression, body communication) and situation
movement and gestures appropriate
Activity Level How much the child 2 (Mildly abnormal The child is somewhat
moves about in both activity level) lazy and moves slowly
restricted and at times
unrestricted situations
Level and The child’s general level 1 (Intelligence is The child does not
 Consistency of of intellectual normal and have any unusual
Intellectual functioning and reasonable intellectual skills or
Response consistency of consistent across deficits
functioning in different various areas)
skills
General Overall rating of autism 1 (No autism The child shows none
Impressions based on impressions spectrum disorder) of the symptoms of
autism

Total Raw Severity T Score Percentile

Score
22 Minimal to No symptoms of Autism 30 2
Spectrum Disorder

Impressions

Autism was ruled out as the presenting behaviors were similar to but not of the same
quality or associated with the same degree of impairment as behaviors that would clearly
meet relevant diagnostic criteria.

Recommendations

A.B. can be helped with strategies to develop her social relatedness, including
improving eye contact, increasing responsiveness to others’ initiations, engaging in
interactive social play, building imitation skills, and supporting her initiation of social
communications. Important considerations are ways to engage her attention to practice the
social-communication building blocks around joint attention, shared positive affect, and turn-
taking.
 References

Schopler, E., Van Bourgondien, M. E., Wellman, G. J., & Love, S. R. (2010).
Childhood Autism Rating Scale, Second Edition [Manual]. Torrance, CA: Western
Psychological Services.

Referecnes after introduction

Psychological Assessment Report

Background information (where hey are studying, development)

Which test is administered

BehVIOURAL Observations

Reccomendations in bullet points (what all interventions can be done)