CARS-2: Autism Evaluation
The Childhood Autism Rating Scale Second Edition (CARS-2) is a 15-item clinical tool used to identify autism and gauge severity. Understanding your child's CARS-2 score is the first step toward building effective ABA therapy goals.
What to Expect
What to expect during a CARS-2 assessment session
A CARS-2 session is not a test in the traditional sense where a child passes or fails. It is a clinical observation where a specialist evaluates your child's behavior across 15 specific categories to determine where they fall on the spectrum.
The clinician observes how your child interacts with their environment, plays with objects, and engages with others. They are looking for specific behavioral markers defined by the Childhood Autism Rating Scale Second Edition (CARS-2).
You will likely be asked to complete the Questionnaire for Parents or Caregivers (CARS2-QPC). This provides the clinician with essential context regarding your child's behavior in familiar home settings.
The clinician rates 15 items, including imitation, emotional response, and body use, on a scale from 1 to 4. A score of 1 indicates behavior within age-appropriate limits, while a 4 indicates a severe departure from typical development.
Session length: 30 to 60 minutes. By combining direct observation with your firsthand experience, the clinician can generate a reliable CARS-2 scoring profile to guide the next steps in your child's care journey.
The 15 Assessment Categories
What the clinician evaluates
The clinician evaluates your child across 15 distinct categories to build a comprehensive picture of their development. Each category is scored on a scale from 1 to 4, including half-point increments for nuanced observation.
| # | Category | What the Clinician Evaluates |
|---|---|---|
| 01 | Relating to People | How the child interacts with others and responds to social cues. |
| 02 | Imitation | The ability to copy both verbal and physical actions. |
| 03 | Emotional Response | The appropriateness of emotional reactions to specific situations. |
| 04 | Body Use | Coordination and the presence of repetitive physical movements. |
| 05 | Object Use | How the child plays with toys and interest in specific parts of objects. |
| 06 | Adaptation to Change | Difficulty transitioning between activities or following new routines. |
| 07 | Visual Response | Unusual patterns of looking at people or objects. |
| 08 | Listening Response | Responses to sounds or whether the child appears not to hear. |
| 09 | Taste / Smell / Touch | Over- or under-sensitivity to sensory input. |
| 10 | Fear or Nervousness | Presence of unusual fears or lack of fear in dangerous situations. |
| 11 | Verbal Communication | Language use, including repetitive speech or unusual tone. |
| 12 | Nonverbal Communication | Use of facial expressions, gestures, and eye contact. |
| 13 | Activity Level | Whether the child is unusually active or lethargic. |
| 14 | Intellectual Functioning | Consistency of cognitive skills across different tasks. |
| 15 | General Impressions | The clinician's overall professional summary of the child's behavior. |
What the CARS-2 Scores Mean
Understanding the 1 to 4 scoring scale
Each category is rated based on how much the child's behavior differs from that of a typically developing child of the same age. These individual scores are totaled to determine the severity level, which helps Behavioral Innovations clinicians design a personalized ABA therapy plan tailored to your child's specific needs.
Behavior is appropriate for the child's age and developmental stage.
Behavior is slightly unusual or occurs with mild frequency.
Behavior is clearly unusual and interferes with daily functioning.
Behavior is highly unusual and significantly different from typical development.
From score to care plan: At Behavioral Innovations, the totaled CARS-2 score serves as the clinical foundation to design a personalized ABA therapy plan and begin treatment without delay.
Schedule NowFrequently Asked Questions
Common questions about the CARS-2
How long does a CARS-2 assessment take?
A typical session lasts between 30 and 60 minutes. This includes direct observation of the child by a trained clinician and time for the caregiver to complete the CARS2-QPC questionnaire.
What is the difference between the CARS2-ST and CARS2-HF?
The CARS2-ST (Standard Version) is designed for children under age 6 or those with significant communication challenges. The CARS2-HF (High-Functioning Version) is optimized for individuals age 6 and older who have higher verbal abilities and an IQ above 80.
Can a child "fail" the CARS-2 assessment?
No. There is no passing or failing grade. The CARS-2 is designed to accurately place a child on the spectrum so they can receive the specific level of evidence-based autism care they need to thrive.
What happens after I receive my child's CARS-2 scores?
Once the assessment is complete, the clinician will review the results with you. At Behavioral Innovations, these results are used to create a customized intervention plan, allowing for a seamless transition into behavioral therapy without waitlists.
Key Takeaways
The CARS-2 at a glance
The Childhood Autism Rating Scale is an observation-based clinical tool used to identify autism and determine its severity, rather than a pass/fail exam.
Clinicians evaluate behaviors across 15 areas, including social relating, imitation, and sensory responses, using a scale of 1 to 4.
The CARS-2 includes a Standard version (ST) for younger children or those with higher support needs, and a High-Functioning version (HF) for older children with stronger verbal skills.
At Behavioral Innovations, the CARS-2 scoring results serve as a clinical foundation to bridge the gap between diagnosis and personalized ABA therapy.
Schedule an Evaluation
Start with a CARS-2 evaluation at Behavioral Innovations
A CARS-2 assessment is the first step to understanding your child's needs and building a personalized ABA therapy plan. Our intake team will guide you through the process from the first call.
- No waitlist for evaluations
- Results reviewed with you by a clinician
- Direct transition into ABA therapy
- Insurance verification included