(CARS®2) Childhood Autism Rating Scale, Second Edition 兒童自閉症評量量表（第二版）

Benefit

Helps to identify children with autism and determine symptom severity through quantifiable ratings based on direct observation

Translation

Available in Bulgarian & Italian

Published Translations

Scores

Cutoff scores, standard scores, and percentiles

Format

Two 15-item rating scales completed by the clinician (each designed for a different population); and an unscored Parent/Caregiver Questionnaire

Admin Time

5–10 minutes (after the information needed to make the ratings has been collected)

Ages

2 years and up

Publish Date

2010

Qualifications

Level C required.

Since its original publication, the CARS has become one of the most widely used and empirically validated autism assessments. It has proven especially effective in discriminating between children with autism and those with severe cognitive deficits, and in distinguishing mild-to-moderate from severe autism.

The revised second edition expands the test’s clinical value, making it more responsive to individuals on the “high-functioning” end of the autism spectrum—those with average or higher IQ scores, better verbal skills, and more subtle social and behavioral deficits. While retaining the simplicity, brevity, and clarity of the original test, the CARS2 adds forms and features that help you integrate diagnostic information, determine functional capabilities, provide feedback to parents, and design targeted intervention.

The CARS2 includes three forms:

Standard Version Rating Booklet (CARS2-ST)

Equivalent to the original CARS; for use with individuals younger than 6 years of age and those with communication difficulties or below-average estimated IQs 

High-Functioning Version Rating Booklet (CARS2-HF)

An alternative for assessing verbally fluent individuals, 6 years of age and older, with IQ scores above 80 

Questionnaire for Parents or Caregivers (CARS2-QPC)

An unscored scale that gathers information for use in making CARS2-ST and CARS2-HF ratings

The Standard and High-Functioning Forms

The CARS2-ST and CARS2-HF each include 15 items addressing the following functional areas:

- Relating to People

- Imitation (ST); Social-Emotional Understanding (HF)

- Emotional Response (ST); Emotional Expression and Regulation of Emotions (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, and Touch Response and Use

- Fear or Nervousness (ST); Fear or Anxiety (HF)

- Verbal Communication

- Nonverbal Communication

- Activity Level (ST); Thinking/Cognitive Integration Skills (HF)

- Level and Consistency of Intellectual Response

- General Impressions 

Items on the Standard form duplicate those on the original CARS, while items on the High-Functioning form have been modified to reflect current research on the characteristics of people with high-functioning autism or Asperger’s Syndrome.

The clinician rates the individual on each item, using a 4-point response scale. Ratings are based not only on the frequency of the behavior in question, but also on its intensity, peculiarity, and duration. While this more nuanced approach gives you greater flexibility in integrating diagnostic information, it still yields quantitative results.

The Rating Booklets for both the Standard and High-Functioning versions are particularly convenient. They include space for clinical note-taking and documentation. They briefly describe each area rated, providing a reminder of rating criteria and a framework for explaining results to parents. And they list cutoff values so that you can see at a glance whether further evaluation is warranted. 

Rating values for all items are summed to produce a Total Raw Score. Each form includes a graph that allows you to quickly convert the Total Raw Score to a standard score or percentile rank (based on a clinical sample of 1,034 individuals with autism spectrum disorders). The Manual provides guidelines for score interpretation, suggestions for intervention, and case examples.

The Questionnaire for Parents or Caregivers

The CARS2-QPC is an unscored form completed by the parent or caregiver of the individual being assessed. Its purpose is to give the clinician more information on which to base CARS2-ST or CARS2-HF ratings. Often the questionnaire serves as the framework for a follow-up interview, during which the clinician can clarify and interpret the responses provided by the parent or caregiver.

The areas covered by the CARS2-QPC include the individual’s early development; social, emotional, and communication skills; repetitive behaviors; play and routines; and unusual sensory interests.

The Best Way to Inform and Support Diagnosis

The CARS2 is extremely useful in identifying symptoms of autism.

- It covers the entire autism spectrum, as defined by empirical research.

- It is based on decades of use with thousands of referred individuals.

- It assesses virtually all ages and functional levels.

- It provides concise, objective, and quantifiable ratings based on direct behavioral observation.

- Scores show a consistent, strong, positive, and specific relationship with an autism diagnosis.

- Ratings are reliable across time, settings, sources of information, and raters.

With a new form for higher functioning individuals, a structured way to gather caregiver information, and guidelines linking scores to intervention, the CARS2 remains one of the best autism assessments available.

Terms Often used to search for (CARS™-2) Childhood Autism Rating Scale™, Second Edition

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效益

透過直接觀察並以量化評分方式，協助辨識自閉症兒童並判定症狀嚴重程度

翻譯版本

提供保加利亞語與義大利語版本

分數

提供臨界分數、標準分數與百分等級

形式

• 兩份由臨床人員填寫的 15 題評量表（適用不同族群）
• 一份不計分的家長／照顧者問卷

施測時間

蒐集資訊後約 5–10 分鐘完成評分

適用年齡

2 歲以上

出版年份

2010

使用資格

需具備 C 級資格

工具介紹

自首次出版以來，CARS 已成為最廣泛使用且具實證支持的自閉症評估工具之一。

其特別優勢在於：

• 區分自閉症與嚴重認知障礙
• 區分輕中度與重度自閉症

第二版進一步提升臨床價值，能更有效評估高功能自閉症族群（如 IQ 正常或較高、語言能力較佳、症狀較隱微者）。

在保留原版簡潔、快速與清晰的特點下，CARS2 新增多種工具，協助整合診斷資訊、評估功能能力、回饋家長，並制定介入計畫。

三種評估表

標準版（CARS2-ST）

• 適用於 6 歲以下
• 或語言能力受限／智力低於平均者

高功能版（CARS2-HF）

• 適用於 6 歲以上
• 語言流暢且 IQ 高於 80

家長／照顧者問卷（CARS2-QPC）

• 不計分
• 提供臨床評分所需補充資訊

評估內容（15 項功能領域）

兩種版本皆包含以下領域（部分項目依版本調整）：

• 人際互動
• 模仿／社會情緒理解
• 情緒反應／情緒表達與調節
• 身體運用
• 物品使用／遊戲中物品使用
• 適應變化／限制性興趣
• 視覺反應
• 聽覺反應
• 感官反應（味覺、嗅覺、觸覺）
• 恐懼或焦慮
• 語言溝通
• 非語言溝通
• 活動量／認知整合能力
• 智能反應程度與一致性
• 整體印象

評分方式

• 採 4 點量表評分
• 評估行為的頻率、強度、特異性與持續時間
• 提供量化結果，同時保有臨床彈性

所有項目加總為總原始分數，再轉換為：

• 標準分數
• 百分等級

（基於 1,034 名 ASD 個案的臨床樣本）

家長／照顧者問卷（CARS2-QPC）

由家長填寫，提供以下資訊：

• 早期發展
• 社交與情緒能力
• 溝通能力
• 重複行為
• 遊戲與日常模式
• 特殊感覺興趣

通常作為後續訪談的基礎。

臨床價值

CARS2 在自閉症評估中具高度實用性：

• 涵蓋整個自閉症譜系
• 基於數十年臨床與研究經驗
• 適用不同年齡與功能程度
• 提供客觀且量化的觀察評分
• 分數與診斷高度相關
• 具良好信度（跨時間、情境與評分者）

新增高功能版本與家長資料蒐集機制，使其仍為最優秀的自閉症評估工具之一。