The CARS is a 15-item behavioral rating scale developed to identify children ages 2 years and older with autism, and to distinguish them from developmentally handicapped children without the autism syndrome. It provides quantifiable ratings based on direct behavior observation. The CARS is especially effective in discriminating between autistic children and those children who are considered trainable mentally retarded; it distinguishes children with autism in the mild to moderate range from children with autism in the moderate to severe range. It can also be used to evaluate adolescents or adults who have never received a diagnosis of autism.
Developed over a 15-year period, with more than 1,500 cases, the CARS includes items drawn from five of the most widely used systems for diagnosing autism. Each item covers a distinct characteristic, ability, or behavior. After observing the child and examining relevant information from parent reports and other records, the examiner rates the child on each item, using a 7-point scale, that indicates the degree to which the child's behavior deviates from that of a normal child of the same age. A total score is calculated by summing the individual ratings. Individuals who score above a given point are categorized as autistic. Scores falling within the autistic range are then divided into two categories: mild-to-moderate autism and severe autism. In addition to observations during formal testing sessions, the items can be rated from relevant medical records, classroom observations, and parent reports. Professionals such as special educators, school psychologists, speech pathologists, audiologists, and physicians, who have had only minimal exposure to autism, can easily be trained to administer the CARS.
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