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Childhood Autism Rating Scale (CARS)3

Childhood Autism Rating Scale (CARS) Test

In just 2 minutes, the Childhood Autism Rating Scale (CARS) Test helps you review autistic features and related behaviors in a child. The result can indicate the level of traits across several areas, supporting clearer self-reflection and a more focused understanding of the child’s profile.

Questions: 102 minutes

Childhood Autism Rating Scale: situation and reply bubbles

October 2, 2025October 2, 2025Material has been updatedOctober 2, 2025Material has been published

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Daniel Hall Psychologist · Test reviewer

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Scale Explorer

How the Scales are Structured

Aggression And Self-InjuryAASI

Measures the severity of aggressive and self-aggressive behaviors that may affect a child's adaptation in the context of autistic symptoms.

example score2/4

2/4Lowexample score

1 – 2Low

3 – 4High

A score of 2 falls in the Low range, indicating mild or infrequent aggression or self-aggression as observed during the assessment.

Sleep DisturbancesSD

Assesses the presence and severity of sleep disturbances commonly observed in children with autism spectrum features.

example score2/4

2/4Mild to Moderateexample score

1Minimal/None

2 – 3Mild to Moderate

4Severe

A score of 2 suggests mild to moderate sleep-related difficulties are present.

Presence of FearsPoF

Assesses the presence and severity of fears that may accompany autistic-spectrum symptoms in children.

example score2/4

2/4Moderateexample score

1Low/Absent

2 – 3Moderate

4High

A score of 2 indicates a moderate level of fears that are present but not prominent.

Presence of Stereotyped BehaviorsPoSB

Assesses how strongly the child shows stereotyped, rigid patterns of behavior and restricted interests.

example score2/4

2/4Moderateexample score

1Minimal

2 – 3Moderate

4Marked

A score of 2 indicates a moderate presence of stereotyped or rigid behavior patterns that are observable but not pervasive across situations.

Adaptation to ChangeAtC

Measures how well the child adapts to changes in environment, routine, and expectations.

example score2/4

2/4Low flexibilityexample score

1 – 2Low flexibility

3 – 4Better flexibility

A score of 2 suggests low flexibility, with noticeable difficulty adjusting to routine or environmental changes.

Impairments in DialogueIiD

Assesses the degree of difficulty a child shows in sustaining flexible, synchronized, and emotionally responsive back-and-forth dialogue.

example score2/4

2/4Mildexample score

1 – 2Mild

3 – 4Moderate–Severe

A score of 2 suggests mild disruptions in dialogue, with some difficulties in reciprocity or emotional responsiveness while basic conversational exchange is generally possible.

Speech Structure and Development ImpairmentsSSaDI

Assesses the degree of impairment in the structure and developmental progression of a child’s speech skills.

example score3/4

3/4Moderate impairmentexample score

1 – 2Mild/No notable impairment

3Moderate impairment

4Severe impairment

A score of 3 indicates a moderate level of difficulty in speech structure and developmental speech skill formation.

Impairments in Understanding Social Rules and RolesIiUSRaR

Measures how well the child understands and follows age-appropriate social rules and roles in everyday interactions.

example score3/4

3/4Notable difficultiesexample score

1 – 2Minimal difficulties

3Notable difficulties

4Marked difficulties

A score of 3 indicates notable difficulties understanding and applying social rules and roles, which may affect adaptation across common social situations.

Impairments in Cooperative ActivityIiCA

Measures the degree of difficulty a child shows in collaborating with others during shared play and group interactions.

example score3/4

3/4Moderate impairmentexample score

1 – 2Low impairment

3Moderate impairment

4High impairment

A score of 3 indicates moderate difficulties with collaborative activities, such as limited or inconsistent participation in group games and interactions.

Communication ImpairmentsCI

Assesses the severity of a child’s communication difficulties, including initiating and maintaining social contact.

example score3/4

3/4Moderateexample score

1 – 2Mild

3Moderate

4Severe

A score of 3 indicates moderate communication difficulties, suggesting noticeable challenges in establishing and sustaining social interaction.

Childhood Autism Rating Scale Total ScoreCARSTS

Measures the severity of autistic traits in children by providing a quantitative symptom level score.

example score21/40

21/40Moderate traitsexample score

10 – 20.5Minimal–Mild traits

20.5 – 28.5Moderate traits

28.5 – 40Severe–Profound traits

A score of 21 falls in the Moderate traits range, indicating a moderate level of autistic symptom manifestations on this scale.

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DATA-BASED USER COHORTS

Who Usually Takes This Test?

School psychologists and clinicians

46%OF USERS

Professionals use it to quickly rate autism symptom severity in children aged 6–12 to guide support planning and track change.

Parents seeking clarity

34%OF USERS

Caregivers take it to better understand how pronounced a child’s autism-related behaviors may be and what to discuss next with specialists.

Special education teams

20%OF USERS

Teachers and support staff use it to document functional impact in the classroom and help tailor learning and behavioral supports.

BASED ON AGGREGATED, ANONYMIZED DATA FROM TENS OF THOUSANDS OF FREUDLY USERS.

Benchmarking

See How You Compare

Once you complete the test, your results are compared with real-world data from people in your country.
Below is a preview of how scores are typically distributed across each scale.

Shaded area — where most people score

Dot — the average

You — your score lands on each curve after the test— your score, after the test

Aggression and Self-AggressionAaS

You?

Average2.8

Typical rangeTypical2.4 – 3.2

Possible1 – 4

Sleep DisordersSD

You?

Average2.7

Typical rangeTypical2.2 – 3.2

Possible1 – 4

Presence of FearsPoF

You?

Average2.5

Typical rangeTypical2 – 2.9

Possible1 – 4

Presence of stereotypical activity patternsPosap

You?

Average1.9

Typical rangeTypical1.4 – 2.5

Possible1 – 4

Adapting to ChangeAtC

You?

Average2.7

Typical rangeTypical2.2 – 3.3

Possible1 – 4

Disruptions in DialogueDiD

You?

Average2.6

Typical rangeTypical2.1 – 3

Possible1 – 4

Disorders of Speech Structure and DevelopmentDoSSaD

You?

Average2.4

Typical rangeTypical1.8 – 3

Possible1 – 4

Impairments in Understanding Social Rules and RolesIiUSRaR

You?

Average2.1

Typical rangeTypical1.7 – 2.5

Possible1 – 4

Impairments in Collaborative AbilityIiCA

You?

Average2.1

Typical rangeTypical1.7 – 2.6

Possible1 – 4

Communication DisordersCD

You?

Average3.1

Typical rangeTypical2.6 – 3.6

Possible1 – 4

Quantitative Scale for Assessing Childhood AutismQSfACA

You?

Average24.9

Typical rangeTypical19.9 – 30

Possible10 – 40

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SAMPLE QUESTIONS

Example Questions From the Test

The assessment may be conducted using any information that reflects the child’s behavior during the time period of interest (as close as possible to the time of testing), including results of a psychologist’s evaluation, information provided by parents, observations by educators and healthcare personnel, and, of course, the examiner’s own observations at the time of the assessment.

- These signs are absent.
- 5 – Shows one to two of the listed signs very rarely; otherwise behavior remains within normal limits.
- Three to four signs are present but the child does not show them in all situations.
- 5 – One to two signs are clearly present and occur often.
- Three to four signs are clearly present and occur often.
- 5 – These signs make contact with the child intermittent and mostly productive only for activities the child currently wants to do.
- These signs make contact with the child impossible for engaging them in purposeful activity.
- No signs of impairment are present.
- 5 – Shows 1–2 of the listed signs very rarely; otherwise behavior remains within normal limits.
- Three or four signs are present, but the child does not show them in all situations.
- 5 – One or two signs are clearly present and occur often.
- The signs are fully present and constant, but with adult persistence the child can repeat something or follow instructions.
- 5 – These signs make the child productive only in the activity the child wants to do at the moment.
- These signs indicate that the child cannot be engaged in shared activity.
- These features are absent.
- 5 – Shows one to two of the listed features very rarely; otherwise behavior remains within normal limits.
- Three to four features are observed, and the child does not show them in all situations.
- 5 – One to two features are clearly present and occur often.
- These features are present fully and consistently, but with persistent adult guidance the child can correct behavior and follow rules; however, without organizing influence the child again ignores rules.
- 5 – These features make it difficult to attend public events with the child or for the child to be in a group of children.
- These features make the child’s behavior unmanageable.

These are 3 of the 10 real questions — the rest appear in the test. No sign-up needed to start.

WHAT THE TEST MEASURES

Childhood Autism Rating Scale (CARS) Test - Description and methodology of the test

autism

Parents, caregivers, and clinicians who need a structured view of a child’s behavior can use the Childhood Autism Rating Scale (CARS) Test to organize observations across everyday situations. As a childhood autism assessment, it highlights patterns in communication, flexibility, social participation, and associated behaviors. The result helps identify areas for closer discussion and follow-up.

What This Assessment Explores

The questionnaire examines social communication, shared activity, understanding of social rules, speech development, flexibility, repetitive behavior, fears, sleep, aggression, and self-injury. These themes cover core autistic features and associated behaviors that can affect adaptation at home, school, or in groups.

It is intended for an adult who knows the child well enough to compare behavior across situations. As an autism rating scale, it can show whether concerns cluster around interaction, communication, rigidity, regulation, or safety, while also revealing uneven patterns, such as marked difficulty with change alongside milder dialogue concerns. The result describes observed characteristics; it does not by itself explain their cause, developmental context, or the child’s specific future needs.

Methodology and Evidence Base

Responses use ordered descriptions from 1 to 4, with half-point choices; higher descriptions indicate greater frequency, persistence, interference, or intensity. The profile reports total and domain results. The CARS questionnaire is conceptually consistent with Childhood Autism Rating Scale (CARS), its 1980 study and 1988 manual; Magyar and Pandolfi’s 2007 factor study examined its structure. This online 10-item presentation is not independently standardized against the full instrument, so interpret scores with developmental history and direct observation rather than as a diagnosis.

The displayed scales and ranges are:

Communication Impairments, Impairments in Dialogue, Speech Structure and Development Impairments, Impairments in Understanding Social Rules and Roles, and Impairments in Cooperative Activity each use 1-4 and describe communication, language, social understanding, and cooperation.
Adaptation to Change, Presence of Stereotyped Behaviors, Presence of Fears, Sleep Disturbances, and Aggression And Self-Injury each use 1-4 and describe flexibility, repetitive patterns, regulation, and safety concerns.
Childhood Autism Rating Scale Total Score uses 10-40: Minimal-Mild traits 10-20.5, Moderate traits 20.5-28.5, and Severe-Profound traits 28.5-40.

Author: Eric Schopler, Robert J. Reichler

Literature:

Schopler E, Reichler RJ, DeVellis RF, Daly K. Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS). Journal of Autism and Developmental Disorders. 1980;10(1):91-103. 10.1007/BF02408436
Schopler E, Reichler RJ, Renner BR. The Childhood Autism Rating Scale (CARS). Los Angeles, CA: Western Psychological Services; 1988.
Magyar CI, Pandolfi V. Factor structure evaluation of the Childhood Autism Rating Scale. Journal of Autism and Developmental Disorders. 2007;37(9):1787-1794. 10.1007/s10803-006-0313-9

Updated: 2025-10-02