Childhood Autism Rating Scale 2 (CARS-2): The Childhood Autism Rating Scale Second Edition (CARS-2) stands as a pivotal tool in assessing and understanding autism spectrum disorders in children. This article delves into the intricacies of the CARS-2, focusing on its Standard Version and Higher Functioning Version Rating Booklet. This standardized measure is instrumental in evaluating individuals with diverse cognitive and communication abilities, ensuring tailored assessments for those with estimated overall IQs of 79 or lower, as well as those with higher IQs and proficient verbal skills. The CARS-2’s structured approach encompasses 15 key behavioral items, providing a comprehensive breakdown and illustrative examples to aid evaluators in discerning autism-related characteristics accurately.
The article not only outlines the rating process but also emphasizes the significance of distinguishing between typical and atypical behaviors. Furthermore, the scoring and interpretation sections guide professionals through a systematic procedure, featuring a detailed breakdown in the Childhood Autism Rating Scale 2 Sample Report, including valuable resources such as the childhood autism rating scale pdf. This comprehensive exploration positions the CARS-2 as a valuable tool in synthesizing diagnostic information, evaluating functional capabilities, providing constructive feedback to parents, and developing targeted interventions for children on the autism spectrum.
- Author: Eric Schopler, Ph.D., Mary E. Van Bourgondien, Ph.D., Glenna Janette Wellman, Ph.D., and Steven R. Love, PhD
- Publication Date: 2010
- Age Range: 3 Years and Up
- Administration Time: 5 to 10 Minutes
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Childhood Autism Rating Scale 2 (CARS-2) Items and Rating
This segment provides comprehensive guidance on conducting evaluations using the Childhood Autism Rating Scale 2 Standard Version. The CARS-2 Standard Version is recommended for evaluating individuals with estimated overall IQs of 79 or lower, those with significantly impaired communication, or individuals under the age of 6, irrespective of their estimated IQ. The individuals in the reference samples used for scoring the CARS-2 Standard Version were aged 2 or older.
For assessing individuals with IQs of 80 or higher, possessing relatively proficient verbal skills, and aged 6 or older, the CARS-2 Higher Functioning Version Rating Booklet should be utilized. It is crucial to emphasize that parents should not be tasked with completing either the CARS-2 Standard Version or the CARS-2 Higher Functioning Version. Instead, information from parents should be gathered using the CARS-2 Questionnaire for Parents or Caregivers (QPC).
Observations of Behavior
When assessing ratings, it is essential to compare an individual’s behavior to that of a typically developing person of the same age. Any observed behaviors that deviate from the norm for that age group should be evaluated in terms of their peculiarity, frequency, intensity, and duration. It is crucial to assess behavior without resorting to causal explanations. While some behaviors associated with autism may resemble those linked to other disorders, it is important to gauge the extent to which the individual’s behavior deviates from typical development, without passing judgments on whether it could be attributed to other medical, psychiatric, or cognitive disorders. The assigned rating values and the pattern of impairments will aid in distinguishing individuals with autism from those with other disorders.
Items of Childhood Autism Rating Scale 2 (CARS-2)
Total Number of Items: 15
The booklet delineates each of the 15 rating areas in the CARS-2 Standard Version. It provides a description of the behavior associated with each item, along with specific considerations discussed in the booklet. Following these considerations are examples that illustrate the criteria for assigning each rating value.
Item 1. Relating to People
Item 2. Imitation
Item 3. Emotional Response
Item 4. Body Use
Item 5. Object Use
Item 6. Adaptation to Change
Item 7. Visual Response
Item 8. Listening Response
Item 9. Taste, Smell, and Touch Response and Use
Item 10. Fear or Nervousness
Item 11. Verbal Communication
Item 12. Nonverbal Communication
Item 13. Activity Level
Item 14. Level and Consistency of Intellectual Response
Item 15. General Impressions
For each item, the booklet offers specific considerations, delving into nuanced aspects of behavior. To aid understanding, examples are provided that illustrate the criteria for assigning rating values. This detailed breakdown facilitates a thorough evaluation of a child’s behavior and helps in the accurate assessment of autism-related characteristics.
Rating of Childhood Autism Rating Scale 2 (CARS-2)
After gathering the necessary information, refer to the recorded notes in the observations section for each item to facilitate the rating process using the Childhood Autism Rating Scale 2 (CARS-2). The rating values for the 15 CARS-2 items range from 1 to 4.
A rating of 1 generally signifies that an individual’s behavior is within the normal limits for their age. A rating of 2 suggests mild abnormality compared to someone of the same age. A rating of 3 indicates a moderate abnormality for that age, while a rating of 4 signifies severe abnormality for someone of that age.
Additionally, utilize the midpoints (1.5, 2.5, and 3.5) when behavior falls between two categories. For instance, if the behavior is mild to moderately abnormal, it should be rated as 2.5. Therefore, 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
Each rating is associated with a specific description for each item.
Childhood Autism Rating Scale Scoring and Interpretation
The process of scoring the Childhood Autism Rating Scale 2 (CARS-2) Standard Version is presented as a clear and systematic procedure. Utilizing the CARS-2 booklet, evaluators are instructed to transfer ratings for all 15 categories to designated spaces. The next step involves summing these ratings to calculate the Total raw score. The severity of autism is then determined by referencing the Total raw score against established criteria, marked by making a checkmark in the corresponding Severity Group box. Further refinement of the evaluation includes obtaining a standard score, represented as a T-score. This is achieved by circling the appropriate value in the Raw score table located on the right side of the summary section.
The resulting T-score, displayed to the left of the circled value, provides a standardized metric for assessing autism severity. Additionally, the percentile rank corresponding to the Total raw score is identified, emphasizing a comprehensive analysis facilitated by the CARS-2 Standard Version. For a detailed understanding and application of this process, one can refer to the Childhood Autism Rating Scale 2 Sample Report and related materials, such as the childhood autism rating scale pdf.
Scoring the CARS-2 Standard Version involves a simple process:
Step 1: Copy the ratings for all 15 categories from the inner pages of the booklet to the corresponding spaces.
Step 2: Add up the ratings to determine the Total raw score.
Step 3: Identify the Severity Group associated with the Total raw score by marking the appropriate box.
Step 4: To derive a standard score in the form of a T-score, encircle the value matching the Total raw score in the provided Raw score table on the summary section’s right side.
Step 5: The T-score is the number printed to the left of the encircled value.
Step 6: The percentile rank corresponding to the Total raw score is indicated by the number printed to the left of the T-score value.
Benefits of Childhood Autism Rating Scale 2 (CARS-2)
1. Synthesize diagnostic information.
2. Evaluate functional capabilities.
3. Offer constructive feedback to parents.
4. Develop targeted interventions.
Features of Childhood Autism Rating Scale 2 (CARS-2)
CARS-2 incorporates improvements to enhance its applicability to individuals at the high-functioning end of the autism spectrum—those with average or higher IQ scores, better verbal skills, and more nuanced social and behavioral challenges.
- Standard Version Rating Booklet: Designed for individuals below the age of 6 or those with communication difficulties or below-average estimated IQs.
- High Functioning Individuals Rating Booklet: Utilized to assess verbally fluent individuals aged 6 and above, with IQ scores exceeding 80.
- Questionnaire for Parents or Caregivers: An ungraded scale that gathers information to inform both Standard and high-functioning ratings.
FAQs about Childhood Autism Rating Scale 2 (CARS-2)
What is the Childhood Autism Rating Scale 2 (CARS-2)?
The Childhood Autism Rating Scale 2 (CARS-2) is a standardized tool designed for assessing individuals with autism. It includes two versions: the Standard Version for those with estimated overall IQs of 79 or lower, and the Higher Functioning Version for individuals with IQs of 80 or higher and better verbal skills. The tool involves evaluating 15 specific areas of behavior to aid in diagnosing and determining the severity of autism.
How is behavior assessed using the CARS-2?
Behavior is assessed by comparing an individual’s behavior to that of a typically developing person of the same age. Any observed deviations are evaluated based on peculiarity, frequency, intensity, and duration. The assessment does not involve causal explanations, and the assigned rating values help distinguish individuals with autism from those with other disorders.
What are the items covered in the Childhood Autism Rating Scale 2 (CARS-2)?
The CARS-2 evaluates behavior across 15 items, including Relating to People, Imitation, Emotional Response, Body Use, Object Use, Adaptation to Change, Visual Response, Listening Response, and more. Each item is detailed in the assessment booklet with specific considerations and examples to aid in rating.
How is the Childhood Autism Rating Scale 2 (CARS-2) scored?
Scoring involves assigning ratings (1 to 4) to each of the 15 items, and the Total raw score is calculated by summing these ratings. The severity of autism is determined by referencing the Total raw score against established criteria, leading to a standard score (T-score) and a percentile rank. The process is outlined in a clear and systematic procedure.
What are the benefits of using the Childhood Autism Rating Scale 2 (CARS-2)?
The CARS-2 provides several benefits, including synthesizing diagnostic information, evaluating functional capabilities, offering constructive feedback to parents, and aiding in the development of targeted interventions. It serves as a valuable tool for comprehensive assessment and understanding of autism-related characteristics.
References:
- (CARS™2) Childhood Autism Rating Scale™, Second Edition
- Assessment in Speech Language Pathology A Resource Manual 5. Auflage, Kenneth G. Shipley, Julie G. McAfee [Buch]
- The American Academy of Pediatrics (AAP) in their guidelines on developmental surveillance and screening (AAP)
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