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The Childhood Autism Rating Scale: C.A.R.S
The Childhood Autism Rating Scale: C.A.R.S
Rater: _________________________________________________________________
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Total Score
18 21 24 27 30 33 36 39 42 45 48
51 54 57 60
Non-Autistic Mildly-Moderately
Severely
Autistic
Autistic
Directions: For each category, use the space provided below each scale for
taking notes concerning the behaviors relevant to each scale. After you have
finished observing the child, rate the behaviors relevant to each item of the scale.
For each item, circle the number which corresponds to the statement that best
describes the child. You may indicate the child is between two descriptions by
using ratings 1.5, 2.5 or 3.5. Abbreviated rating criteria are presented for each
scale. See chapter 2 of the manual for detailed rating criteria.c
I. RELATING TO PEOPLE
2. Mildly abnormal relationships: The child may avoid looking the adult in the eye, avoid
the adult or become fussy. If interaction is forced be excessively shy, not be as
responsive to the adult as is typical or cling to parents somewhat more than most
2.5 children of the same age.
3
Moderately abnormal relationships: The child shows aloofness (seems unaware of
3.5 adult) at times. Persistent and forceful attempts are necessary to get the child’s
4. attention at times. Minimal contact is initiated by the child.
Severely abnormal relationships: The child is consistently aloof or unaware of what the
adult is doing. He or she almost never responds or initiates contact with the adult. Only
the most persistent attempts to get the child’s attention have any effect.
Observations:
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II. IMITATION
1 Appropriate Imitation: The child can imitate sound, words and movements
which are appropriate for his or her skill level.
1.5
2. Mildly abnormal imitation: The child imitates simple behaviors such as clapping or
single verbal sounds most of the time: occasionally imitates only after prodding or after
2.5 a delay.
3.
Moderately abnormal imitation: The child imitates only part of the time and requires a
3.5 great deal of persistence and help from the adult; frequently – imitates only after a
4. delay.
Severely abnormal imitation: The child rarely or never imitates sounds, words or
movements even with prodding and assistance from the adult.
Observations:
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Observations:
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Severely abnormal body use: Intense or frequent movements of the type listed above
are signs of severely abnormal body use. These behaviors may persist despite
attempts to discourage them or invoice the child in other activities.
Observations:
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V. OBJECT USE
1. Appropriate use and interest in toys and other objects: The child shows normal interest
in toys and other objects appropriate for his or her skill level and uses these toys in an
1.5 appropriate manner.
2.
Mildly inappropriate Interest in or use of toys and other objects: The child may show a
2.5 typical interest in a toy or play with it in an inappropriately childish way (e.g. banging or
3. sucking on the toy).
Repetitively Inappropriate Interest or use of toys and other objects: The child may
show little interest in toys and other objects or may be preoccupied with using an
3.5 object or toy in some strange way. He or she may focus on some insignificant part of a
4. toy, become fascinated with light reflecting. In the object, repetitively move some part
of the object or play with one object excessively.
Severely Inappropriate Interest in or use of toys or other objects: The child may
engage in the same behaviors as above, with greater frequency and intensity. The
child is difficult to distract when engaged in these inappropriate activities.
Observations:
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Observations:
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Observation:
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Observation:
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Severely abnormal use of and response to taste, smell and touch: The child is
preoccupied with smelling, tasting or feeling objects more for the sensation than for
normal exploration or use of the objects. The child may completely ignore pain or react
very strongly to slight discomfort.
Observation:
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X. FEAR OR NERVOUSNESS
1. Normal fear or nervousness: The child’s behavior is appropriate both to the situation
1.5 and to his or her age.
2.
Mildly abnormal fear or nervousness: The child occasionally shows too much or too
2.5 little fear or nervousness compared to the reaction of a normal child of the same age to
3. a similar situation.
3.5 Modernly abnormal fear or nervousness: The child shows either quite a bit more or
4. quite a bit less fear than is typical even for a younger child in a similar situation.
Severely abnormal fear or nervousness: Fears persist even after repeated experience
with harmless events or objects. It is extremely difficult to calm or comfort the child.
The child may conversely fall to show appropriate regard to hazards which other
children of the same age avoid.
Observations:
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Severely abnormal verbal communication: Meaningful speech is not used. The child
may make infantile squeals weird or animal like sounds, complex noises approximating
speech or may show persistent, bizarre use of some recognizable words or phrases.
Observations:
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Severely abnormal use of nonverbal communication: The child only uses bizarre or
peculiar gestures which have no apparent meaning and shows no awareness of the
meanings associated with the gestures or facial expressions of others.
Observations:
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1. Normal activity level for age and circumstances: The child is neither more active nor
less active than a normal child of the same age in a similar situation.
1.5
2. Mildly abnormal activity level: The child may either be mildly restless or some what
“lazy” and slow moving at times. The child’s activity level interferes only slightly with his
2.5 or her performance.
3.
Moderately abnormal activity level: The child may be quite active and difficult to
restrain. He or she may have boundless energy and may not go to sleep readily at
3.5 night. Conversely the child may be quite lethargic and need a great deal of prodding to
3. get him or her to move about.
Severely abnormal activity level: The child exhibits extremes of activity or inactivity and
may even shift from one extreme to the other.
Observations:
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1. Intelligence is normal and reasonably consistent across various areas: The child is as
intelligent as typical children of the same age and does not have any unusual
1.5 intellectual skills or problems.
2.
Mildly abnormal intellectual functioning: The child is not as smart as typical children of
2.5 the same age: skills appear fairly evenly retarded across all areas.
3.
Moderately abnormal intellectual functioning: In general the child is not as smart as
3.5 typical children of the same age: However the child may function nearly normally in
4. one or more intellectual areas.
Severely abnormal intellectual functioning: While the child generally is not as smart as
the typical child of his age, he or she may function even better than the normal child of
the same age in one or more areas.
Observations:
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Observations:
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