Lexicon [Measures] - CARS
The Childhood Autism Rating Scale (CARS) a behavior observation scale intended to help diagnose autism and plan interventions/therapy. CARS is administered by a clinician through direct observation and interactions and involves structured and semi-structured activities to elicit specific behaviors. The tool is designed for children aged 2 years and older.
Limitations:
- CARS may not be suitable for individuals with co-occurring conditions or for assessing adults with autism.
- CARS is a subjective assessment tool that relies on the judgment of the observer which means inter-rater reliability may vary depending on the experience and training of the clinician.
- Focuses primarily on behaviors associated with autism and may not capture the full range of a child's abilities or challenges.
- Does not provide a definitive diagnosis of autism but rather serves as a quantitative measure of symptom severity.
15 Functional domains rated in CARS
- Relating to People: Ability to engage in reciprocal social interactions, such as sharing enjoyment, eye contact, and response to others' emotions.
- Imitation: ability to mimic the actions, expressions, or sounds of others.
- Emotional Response: Assesses the appropriateness and variety of the child's emotional expressions and responsiveness to emotional cues from others.
- Body Use: physical movements and coordination.
- Object Use: ability to play with toys and use objects in a 'socially appropriate' manner
- Adaptation to Change: Flexibility and response changes in their environment or routine.
- Visual Response: visual attention and responses to sounds and spoken language
- Listening Response: attention and reactions to auditory stimuli.
- Taste, Smell, and Touch Response and Use: responsiveness to different sensory stimuli
- Fear or Nervousness: reactions to potentially fear-inducing or anxiety-provoking situations.
- Verbal Communication: appropriateness and usefulness of the child's verbal communication.
- Non-verbal Communication: appropriateness and usefulness of the child's non-verbal communication.
- Activity Level: physical activity level during the assessment.
- Level and Consistency of Intellectual Response: problem-solving abilities and the consistency of their intellectual responses.
- General Impressions: observer's overall impression of the child's behavior during the assessment.
The items are scored on a scale of 1-4, with 1 representing no "abnormality" and 4 as severe abnormal (I personally cringe at this language with terms like "abnormal" which makes us sound like societal misfits and outcasts). Total score ranges from 15-60; scores below 30 suggest absence of autism or very mild symptoms; 30-36 score indicate mild-moderate autism and scores above 36 indicate severe autism.
History: CARS was developed by Eric Schopler, Robert J. Reichler, and Barbara Rochen Renner and was first published in 1988.
Reference:
Schopler, E., Reichler, R. J., & Renner, B. R. (1988). The Childhood Autism Rating Scale (CARS). Los Angeles: Western Psychological Services.
Reference:
Schopler, E., Reichler, R. J., & Renner, B. R. (1988). The Childhood Autism Rating Scale (CARS). Los Angeles: Western Psychological Services.
