Childhood Autism Rating Scale (CARS)

The Childhood Autism Rating Scale (CARS) is a diagnostic tool used to identify autism in children and determine the severity of the condition. Developed in the early 1970s by Eric Schopler and his colleagues at the University of North Carolina at Chapel Hill, CARS remains one of the most widely used autism assessment instruments today. This article delves into the intricacies of CARS, its application in autism diagnosis, and its relevance to the services provided by Chicago ABA Therapy.

What is CARS?

CARS is a behavior rating scale that helps clinicians differentiate children with autism from those with other developmental disorders. The scale consists of 15 items, each addressing a specific characteristic commonly associated with autism. These characteristics include:

  1. Relating to People
  2. Imitative Behavior
  3. Emotional Response
  4. Body Use
  5. Object Use
  6. Adaptation to Change
  7. Visual Response
  8. Listening Response
  9. Taste, Smell, and Touch Response and Use
  10. Fear or Nervousness
  11. Verbal Communication
  12. Nonverbal Communication
  13. Activity Level
  14. Level and Consistency of Intellectual Response
  15. General Impressions

Each item is rated on a scale from 1 to 4, with higher scores indicating greater severity of symptoms. The total score can range from 15 to 60, with cutoffs indicating the likelihood of autism.

How CARS is Administered

Administering CARS involves direct observation of the child, interviews with parents or caregivers, and a review of the child’s developmental history. The assessment is typically conducted by a trained clinician, such as a psychologist, psychiatrist, or developmental pediatrician. Here’s a step-by-step guide to the administration process:

  1. Observation: The clinician observes the child in various settings, such as at home or in a clinical environment, to assess their behavior across different contexts.
  2. Interviews: Parents or caregivers provide insights into the child’s developmental history, behavior patterns, and specific concerns.
  3. Scoring: Based on the observations and interviews, the clinician rates each of the 15 items on the CARS scale.
  4. Interpretation: The total score is calculated and interpreted to determine the likelihood and severity of autism. Scores between 15-29.5 suggest non-autistic, 30-36.5 suggest mild to moderate autism, and 37-60 suggest severe autism.

Benefits of Using CARS

CARS offers several advantages in the diagnosis of autism:

  • Ease of Use: The scale is straightforward and can be administered relatively quickly.
  • Comprehensive: It covers a wide range of behaviors and developmental aspects, providing a holistic view of the child’s condition.
  • Consistency: CARS has been shown to have good reliability and validity, making it a trusted tool among clinicians.
  • Early Identification: Early diagnosis through CARS can lead to timely intervention, which is crucial for improving outcomes in children with autism.

CARS in the Context of Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a well-established therapeutic approach for individuals with autism. At Chicago ABA Therapy, we use evidence-based ABA techniques to help children develop essential skills and improve their quality of life. Understanding the role of CARS in diagnosing autism can enhance the effectiveness of our interventions in several ways:

  1. Individualized Treatment Plans: The detailed assessment provided by CARS allows our clinicians to create personalized treatment plans tailored to each child’s unique needs and strengths.
  2. Progress Monitoring: CARS can be used periodically to assess the child’s progress and make necessary adjustments to the treatment plan.
  3. Parental Involvement: The CARS assessment process encourages active participation from parents, fostering a collaborative approach to therapy.
  4. Outcome Measurement: By using CARS as a baseline and periodic measure, we can objectively evaluate the success of our ABA interventions.

How Chicago ABA Therapy Utilizes CARS

At Chicago ABA Therapy, we integrate the use of CARS in our comprehensive assessment process to ensure accurate diagnosis and effective treatment planning. Here’s how we utilize CARS in our services:

  • Initial Assessment: During the initial intake process, our trained clinicians use CARS to evaluate the child’s behaviors and developmental milestones.
  • Tailored Interventions: Based on the CARS scores, we design individualized ABA therapy programs that address specific areas of need, such as communication, social skills, and adaptive behaviors.
  • Ongoing Evaluation: We periodically reassess the child using CARS to monitor progress and make data-driven decisions regarding the continuation or modification of the treatment plan.
  • Family Support: We provide parents and caregivers with detailed feedback based on the CARS assessment, empowering them to support their child’s development at home and in the community.


The Childhood Autism Rating Scale (CARS) is a valuable tool in the early identification and ongoing assessment of autism. At Chicago ABA Therapy, we leverage the insights gained from CARS to deliver personalized, effective ABA interventions that make a meaningful difference in the lives of children with autism and their families. By staying informed about diagnostic tools like CARS, parents and caregivers can play an active role in their child’s therapeutic journey, ensuring they receive the best possible support and care.

For more information about our services and how we use CARS in our assessments, please contact Chicago ABA Therapy. We’re here to help you navigate your child’s developmental journey with expertise and compassion.

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"We were so happy with our experience with Chicago ABA. We began working with them when our son was almost 4, a few months after his autism diagnosis. It was such an amazing team to work with - everyone was professional, responsive, flexible, and worked so hard for our son to meet his goals, which he did beautifully. We worked together for almost 2 years before he left for kindergarten, and in that time period he met almost all of his goals. We went through several bumps in the road with behavioral difficulties, and the Chicago ABA team did an amazing job helping us problem solve, try new strategies and think of ways to translate those strategies at home. We couldn't recommend them more highly - anyone who works with Chicago ABA will be lucky to have the experience!"

"Chicago ABA Therapy is a boon for special needs kids and parents. They take a play-based, personalized approach and meet the kids where they are. They also go above and beyond - our ABA therapist took time to make sure we as parents understood every aspect of our child's experience, understood how to read his progress reports and generally made us feel a part of his therapy. My child loved all his therapists. Highly recommend the team!"

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