This innovative instrument, authored by the highly respected Sam Goldstein, Ph.D., and Jack A. Naglieri, Ph.D., is a norm-referenced assessment based on a nationally representative sample, designed to identify symptoms, behaviors, and associated features of the full range of Autism Spectrum Disorders.
The ASRS scale is an easy-to-use and convenient tool intended for psychologists, school psychologists, clinical social workers, physicians, counselors, psychiatric workers, and pediatric/psychiatric nurses.
The ASRS will assist you in the diagnostic process. ASRS items assess DSM-IV-TR™ symptom criteria for ASDs. When used in combination with other assessment information, results from the ASRS can help guide your diagnostic decisions, treatment planning, ongoing monitoring of response to intervention, and evaluating the effectiveness of a treatment program for a child with an ASD.
ASRS DSM-5 Scoring Update
The ASRS has been updated to provide a new scoring option for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition™ (DSM-5™) Symptom Scales.
The ASRS now has the following two scoring options for the MHS Online Assessment Center and the MHS Scoring Software:
- DSM-IV-TR®: DSM Symptom Scale is scored based on diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR).
- DSM-5: DSM Symptom Scale is scored based on diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5).
Scoring Software users can download the software by clicking on “Check for Updates” under the Help menu within the Scoring Software. The MHS Online Assessment Center system will be updated automatically. After the updates have been installed, users will have the option to choose to score with the DSM-IV-TR or DSM-5 criteria.
Updated DSM-5 hand-scored forms for the ASRS Full-length Parent and Teacher forms are now available for purchase. For pricing and ordering details, visit DSM-5 pricing or the pricing tab. DSM-IV-TR QuikScore™ Forms will be available until December 31, 2014.
- Purchase the DSM-5 Update: Technical Report #2 paper copy by contacting Client Services or select the pricing tab to place your order.
Product Code: ASRSUP Price: $15 - Complete the form to download the DSM-5 Update: Technical Report #2 for free. Once you have completed the form you will receive an email with the Technical Report #2.
www.mhs.com/asrsdsm5rep
Should you have any further questions, contact Client Services.
ASRS Scoring/Online Update
Please note there has been a scoring update to the ASRS for individuals who do not speak or speak infrequently.
The ASRS now has the following two scoring options for the MHS Online Assessment Center and the MHS Scoring Software:
- The standard scoring method which can be continued to be used for individuals without limited speech.
- An alternative scoring method is now available for individuals who do not speak or speak infrequently.
How to Use the Assessment
Using a five-point Likert rating scale, parents and teachers are asked to evaluate how often they observed specific behaviors in the child or adolescent in areas such as socialization, communication, unusual behaviors, behavioral rigidity, sensory sensitivity, and self-regulation.
You can choose between two versions: ASRS (2–5 Years) for ratings of children aged 2 to 5 and ASRS (6–18 Years) for ratings of children or adolescents aged 6 to 18. The ASRS can be easily and quickly completed and scored automatically with the ASRS online from any Internet connection. The ASRS can also be scored using the ASRS Scoring Software simply be entering responses from a completed paper-and-pencil administration into the software (ratings from paper-and pencil forms can also be scored online). Paper-and-pencil administrations on ASRS Quikscore forms can be scored by hand.
There is also a 15-item ASRS Short form available. The ASRS Short form provides an efficient way to screen large numbers of children for possible ASD and can be used for monitoring treatment progress.
Using a five-point Likert rating scale, parents and teachers are asked to evaluate how often they observed specific behaviors in the child or adolescent in areas such as socialization, communication, unusual behaviors, behavioral rigidity, sensory sensitivity, and self-regulation.
You can choose between two versions: ASRS (2–5 Years) for ratings of children aged 2 to 5 and ASRS (6–18 Years) for ratings of children or adolescents aged 6 to 18. The ASRS can be easily and quickly completed and scored automatically with the ASRS online from any Internet connection. The ASRS can also be scored using the ASRS Scoring Software simply be entering responses from a completed paper-and-pencil administration into the software (ratings from paper-and pencil forms can also be scored online). Paper-and-pencil administrations on ASRS Quikscore forms can be scored by hand.
There is also a 15-item ASRS Short form available. The ASRS Short form provides an efficient way to screen large numbers of children for possible ASD and can be used for monitoring treatment progress.
ASRS Scales ans Forms
- Social/Communication
- Unusual Behaviors
- Self-Regulation (ASRS [6–18 Years] only)
Treatment Scales
- Peer Socialization
- Adult Socialization
- Social/Emotional Reciprocity
- Atypical Language
- Stereotypy
- Behavioral Rigidity
- Sensory Sensitivity
- Attention/Self-Regulation (ASRS [2–5 Years] only)
- Attention (ASRS [6–18 Years] only)
Childhood Autism Rating Scale, Second Edition
(CARS)
The childhood-autism rating scale (CARS) is a behavior rating scale intended to help diagnose autism. CARS was developed by Eric Schopler, Robert J. Reichier, andBarbara Rochen Renner. The childhood-autism rating scale was designed to help differentiate children with autism from those with other developmental delays, such asintellectual disability.
Although there is no gold standard among rating scales in detecting autism, CARS is frequently used as part of the diagnostic process. Development of the CARS began in 1966 with the production of a scale that incorporated the criteria of Leo Kanner (1943) and Creak (1964), and characteristic symptoms of childhood autism.The original version of this test, the Autism Diagnostic Interview (ADI) was published in 1989 and was correlated to the ICD-10 definition of autism
The scale is used to observe and subjectively rate fifteen items.
- relationship to people
- imitation
- emotional response
- body
- object use
- adaptation to change
- visual response
- listening response
- taste-smell-touch response and use
- fear and nervousness
- verbal communication
- non-verbal communication
- activity level
- level and consistency of intellectual response
- general impressions
Scale
This scale can be completed by a clinician or teacher or parent, based on subjective observations of the child's behavior. Each of the fifteen criteria listed above is rated with a score of:
- 1 normal for child’s age
- 2 mildly abnormal
- 3 moderately abnormal
- 4 severely abnormal
- Midpoint scores of 1.5, 2.5, and 3.5 are also used
Total CARS scores range from a fifteen to 60, with a minimum score of thirty serving as the cutoff for a diagnosis of autism on the mild end of the autism spectrum.
Initial psychometrics for the CARS were determined using 537 children enrolled in the Treatment and Education of Autistic and related Communication handicapped Children (TEACCH) program over a ten-year period (Schopler et al., 1980). Fifty-one percent of the children studied scored above the cutoff score of thirty.
Schopler et al. (1980) observed the existence of a bimodal distribution among these scores, leading them to develop criteria to differentiate between those with mild to moderate autism and those with severe autism. Children with a score exceeding 36 and who received a rating of three or greater on at least five subscales were categorized as being severely autistic.
Internal consistency of the CARS was high, with a coefficient alpha of .94 (Schopler et al., 1988), indicating the degree to which all of the fifteen scale criteria scores constitute a unitary phenomenon, rather than several individual behaviors. Inter-rater reliability was established using two raters for 280 cases. The average reliability of .71 indicated good overall agreement between raters.
Twelve-month test-retest data was also collected, with a finding that the means were not significantly different from the first testing to the second.
Criterion-related validity was determined by comparing CARS diagnoses to diagnoses made independently by child psychologists and psychiatrists. Diagnoses correlated at r = .80, which indicated that the CARS diagnosis was in agreement with clinical judgments.
CARS has also been shown to have 100% predictive accuracy when distinguishing between groups of autistic and intellectually disabled children, which was superior to the ABC and Diagnostic Checklist (Teal & Wiebe, 1986).
Validity of the CARS under different settings is of particular importance to the present study. CARS scores of 41 children taken through parent interview were compared to scores derived from direct observation. Mean scores under the two conditions were not significantly different and the correlation of r = .83 further indicated good agreement.
In addition, diagnoses based on parent interview and direct observation agreed in 90% of the cases. The authors suggest that valid CARS ratings and diagnoses can be achieved through parent interview (Schopler et al., 1988).
Of the autism rating scales discussed, the CARS is the only scale used in research with adolescents or adults. Mesibov, Schopler, Schaffer, and Michal (1989) examined the diagnostic ability of the CARS in adolescents and adults with autism. This study compared the CARS scores of 89 individuals before the age of ten (mean age of 8.7 years), with their scores after the age of thirteen (mean age of 15.9 years). Fifty-nine of the original 89 participants were diagnosed with autism before the age of ten, with a mean CARS score of 38.47. For those 59 participants, adolescent CARS scores revealed a significant decrease, with a mean score of 35.54.
Significant improvement in adolescent scores (i.e. significant decreases in abnormal behavior) were found on the imitation, body use, object use, adaptation to change, listening response, sensory response and use, verbal communication, nonverbal communication, and activity level scales. The only score with a significant increase over time was the general impression scale.
It was suggested that a cutoff score of 27, as opposed to 30, be used when administering the CARS to adolescents and adults. This recommendation stemmed from the observation that when the cutoff score was lowered by three points (corresponding to the mean difference in scores between the two age groups), the percentage of individuals accurately diagnosed as autistic before age ten and after age thirteen jumped from 81% to 92%.
Overall, Mesibov et al. (1989) suggested that the CARS is a good screening instrument for adolescents and adults. While Mesibov et al.’s (1989) study provided valuable insight into the course of the disorder over time; the generalization of the use of the CARS on adults based on its results is premature. The mean age of participants in the “adolescent and adult” age group was only 15.9 years. As a result, the study failed to demonstrate the ability of the CARS to diagnosis autism in adults (i.e. individuals over 21 years old). The CARS has been used with adults in clinical settings, but researchers have yet to verify its diagnostic ability with this population.
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