Childhood Autism Rating Scale™ – Second Edition (CARS-2) Overview The purpose of the Childhood Autism Rating Scale™ – Second Edition (CARS™-2; Schopler, Van Bourgondien, Wellman, & Love (2010) is to identify the presence of autism in children and to determine the severity of symptoms. The CARS™-2 has two versions: the Standard form, CARS™-2-ST, for individuals less than 6 years of age and those with communication difficulties or below-average estimated IQs; and the CARS™-2-HF for those 6 years and over who are verbally fluent and have IQ scores over 80. The CARS™-2-HF is designed to identify the more subtle characteristics of those with “highfunctioning” forms of ASD. The CARS™2 also includes a third form, the Questionnaire for Parents or Caregivers (CARS™-2QPC), for collecting information for use in making CARS™-2-ST and CARS™-2-HF ratings. Fifteen domains are rated on a 4-point scale. Based on informant or clinician observation, the clinician assigns ratings in each domain related to frequency, peculiarity, intensity, and duration. The CARS™-2 yields cutoff scores, standard scores, and percentiles.
August 2015
Childhood Autism Rating Scale™ – Second Edition (CARS-2) Summary Name of Tool/Author Childhood Autism Rating Scale – Second Edition (CARS-2) Schopler, Van Bourgondien, Wellman, & Love (2010).
Screening / Diagnosis D
Age Range*
Method of Administration/Format
CARS-2-ST: 2 years to < 6 and those with communication difficulties or below average estimated IQs
Two 15-item rating scales completed by clinician on a 7-point scale based on observation, parent report, and other records
CARS-2-HF: 6+ years for verbally fluent individuals with IQ scores over 80
Questionnaire for Parents or Caregivers (CARS-2-QPC), for collecting information for use in making CARS-2-ST and CARS2-HF. Yields cutoff scores, standard scores, and percentiles
August 2015
Approximate Time to Administer 5-10 min. to rate items (after gathering the information needed)
Subscales
Relating to People; Imitation (ST); SocialEmotional Understanding (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, & Touch Response and Use; Fear or Nervousness (ST); Fear or Anxiety (HF); Verbal Communication; Activity Level (ST); Thinking/Cognitive Integration Skills (HF); Level and Consistency of Intellectual Response; General Impressions
Childhood Autism Rating Scale™ – Second Edition (CARS-2)
Questionnaire for Parents or Caregiver™s (CARS-2-QPC™)
D
For parent or caregiver of an individual of any age.
*In years except where noted.
Unscored form: questionnaire completed by parent or caregiver. These responses become the framework for followup interview information.
5-10 min. to rate items (after gathering the information needed)
Early Development; Social; Emotional and Communication; Repetitive Behaviors; Play and Routines; Unusual Sensory Interests.
Availability: Western Psychological Services, http://bit.ly/1Fo5FUW
Research Author (Year)
Age Range (in years)
Sample Size
Topic Addressed
Outcome r = correlation
Rellini, Tortolani, Trillo, Carbone, & Montecchi (2004)
1.5–11
65
Criterion validity
Sensitivity for AU = 100% False negatives = 0
DiLalla & Rogers (1994)
2–6
69
Factor analysis
Yields three factors: social impairment, negative emotionality, and distorted sensory response
Pilowsky, Yirmiya, Shulman, & Dover (1998)
1.5–3.4
83
Concurrent validity
Agreement with ADI-R = 85.7%
Saemundsen, Magnússon, Smári, & Sigurdardóttir (2003)
1.8–9.5
54
Concurrent validity
Agreement with ADI-R = 66.7% when ADI-R AU definition is used
Magyar & Pandolfi (2007)
1.5–6.5
164
Factor analysis
Four factors identified: social communication, social interaction, stereotypes and sensory abnormalities, emotional regulation
August 2015
Childhood Autism Rating Scale™ – Second Edition (CARS-2)
Perry, Condillac, Freeman, DunnGeier, & Belair (2005)
2–6
274
Discriminative validity
88% agreement between CARS and clinical diagnosis; Sensitivity = 0.94; Specificity = 0.85; CARS negatively correlated with cognitive (r = -0.67) and adaptive (r = -0.69); ANOVA = 157.97; AU group mean> PDD-NOS>MR> Developmental delay and other groups
Stella, Mundy, & Tuchman (1999)
AU mean of 71.32 months; PDDNOS mean of 50.54
90
Factor analysis
Five-factor structure: disturbances in social orienting, communication and behavioral flexibility, emotional reactivity, consistency of cognitive performance and response to environment, odd sensory experiences
References DiLalla, D. L., & Rogers, S. J. (1994). Domains of the Childhood Autism Rating Scale: Relevance for diagnosis and treatment. Journal of Autism and Developmental Disorders, 24(2), 115–128. Magyar, C. I., & Pandolfi, V. (2007). Factor structure evaluation of the Childhood Autism Rating Scale. Journal of Autism and Developmental Disorders, 37(9), 1787–1794. Perry, A., Condillac, R. A., Freeman, N. L., Dunn-Geier, J., & Belair, J. (2005). Multi-site study of the Childhood Autism Rating Scale (CARS) in five clinical groups of young children. Journal of Autism and Developmental Disorders, 35(5), 625– 634. Pilowsky, T., Yirmiya, N., Shulman, C., & Dover, R. (1998). The Autism Diagnostic Interview – Revised and the Childhood Autism Rating Scale: Differences between diagnostic systems and comparison between genders. Journal of Autism and Developmental Disorders, 28(2), 143–151. Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F. (2004). Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) correspondence and conflicts with DSM-IV criteria in diagnosis of autism. Journal of Autism and Developmental Disorders, 34(6), 703–708. Saemundsen, E., Magnússon, P., Smári, J., & Sigurdardóttir, S. (2003). Autism Diagnostic Interview- Revised and the Childhood Autism Rating Scale: Convergence and discrepancy in diagnosing autism. Journal of Autism and Developmental Disorders, 33(3), 319–328.
August 2015
Childhood Autism Rating Scale™ – Second Edition (CARS-2)
Schopler, E., Van Bourgondien, M.E., Wellman, G.J., & Love, S.R. (2010). Childhood Autism Rating Scale (2nd ed.). Los Angeles, CA: Western Psychological Services. Stella, J., Mundy, P., & Tuchman, R. (1999). Social and nonsocial factors in the Childhood Autism Rating Scale. Journal of Autism and Developmental Disorders, 29(4), 307–317.
August 2015
