Childhood Autism Rating Scale
Typed by Karen, submitted by Libby. Unknown copyright, don't copy!
Directions: Rate the behaviors relevant to each item of the scale. Add the 15 scores
and use the scale at the end.
Not responsible for typos :-)
I. Relating to People
1 No evident of difficulty or abnormality in relating to people - The child's behavior is
appropriate for his or her age. Some shyness, fussiness, or annoyance at being told what
to do may be observed, but not to an atypical degree.
1.5 (if between these points)
2 Mildly abnormal relationships - The child may avoid looking the adult in the eye, avoid
the adult or become fussy if interaction is forced, be excessively shy, not be as
responsive to the adult as is typical, or cling to parents somewhat more than most
children of the same age.
2.5 (if between these points)
3 Moderately abnormal relationships - The child shows aloofness (seems unaware of adult)
at times. Persistent and forceful attempts are necessary to get the child's attention at
times. Minimal contact is initiated by the child.
3.5 (if between these points)
4 Severely abnormal relationships - The child is consistently aloof or unaware of what the
adult is doing. He or she almost never responds or initiates contact with the adult. Only
the most persistent attempts to get the child's attention have any effect.
II. Imitation
1 Appropriate imitation - The child can imitate sounds, words, and movements which are
appropriate for his or her skill level.
1.5 (if between these points)
2 Mildly abnormal imitation - The child imitates simple behaviors such as clapping or
single verbal sounds most of the time; occasionally, imitates only after prodding or after
a delay.
2.5 (if between these points)
3 Moderately abnormal imitation - The child imitates only part of the time and requires a
great deal of persistence and help from the adult; frequently imitates only after a delay.
3.5 (if between these points)
4 Severely abnormal imitation - The child rarely or never imitates sounds, words, or
movements even with prodding and assistance from the adult.
III. Emotional response
1 Age-appropriate and situation-appropriate emotional responses - The child shows the
appropriate type and degree of emotional response as indicated by a change in facial
expression, posture, and manner.
1.5 (if between these points)
2 Mildly abnormal emotional responses - The child occasionally displays a somewhat
inappropriate type or degree of emotional reactions. Reactions are sometimes unrelated to
the objects or events surrounding them.
2.5 (if between these points)
3 Moderately abnormal emotional responses - The child shows definite signs of
inappropriate type and/or degree of emotional response. Reactions may be quite inhibited
or excessive and unrelated to the situation; may grimace, laugh, or become rigid even
though no apparent emotion-producing objects or events are present.
3.5 (if between these points)
4 Severely abnormal emotional responses - Responses are seldom appropriate to the
situation; once the child gets in a certain mood, it is very difficult to change the mood.
Conversely, the child may show wildly different emotions when nothing has changed.
IV. Body Use
1 Age appropriate body use - The child moves with the same ease, agility, and coordination
of a normal child of the same age.
1.5 (if between these points)
2 Mildly abnormal body use - Some minor peculiarities may be present, such as clumsiness,
repetitive movements, poor coordination, or the rare appearance of more unusual movements.
2.5 (if between these points)
3 Moderately abnormal body use - Behaviors that are clearly strange or unusual for a child
of this age may include strange finger movements, peculiar finger or body posturing,
staring or picking at the body, self-directed aggression, rocking, spinning,
finger-wiggling, or toe-walking.
3.5 (if between these points)
4 Severely abnormal body use - Intense or frequent movements of the type listed above are
signs of severely abnormal body use. These behaviors may persist despite attempts to
discourage them or involve the child in other activities.
V. Object Use
1 Appropriate use of, and interest in, toys and other objects - The child shows normal
interest in toys and other objects appropriate for his or her skill level and uses these
toys in an appropriate manner.
1.5 (if between these points)
2 Mildly inappropriate interest in, or use of, toys and other objects - The child may show
atypical interest in a toy or play with it in an inappropriate childish way (e.g., banging
or sucking on the toy).
2.5 (if between these points)
3 Moderately inappropriate interest in, or use of, toys and other objects - The child may
show little interest in toys or other objects, or may be preoccupied with using an object
or toy in some strange way. He or she may focus on some insignificant part of a toy,
become fascinated with light reflecting off the object, repetitively move some part of the
object, or play with one object exclusively.
3.5 (if between these points)
4 Severely inappropriate interest in, or use of, toys or other objects - The child may
engage in the same behaviors as above, with greater frequency and intensity. The child is
difficult to distract when engaged in these inappropriate activities.
VI. Adaptation to Change
1 Age appropriate response to change - While the child may notice or comment on changes in
routine, he or she accepts these changes without undue distress.
1.5 (if between these points)
2 Mildly abnormal adaptation to change - When an adult tries to change tasks the child may
continue the same activity or use the same materials.
2.5 (if between these points)
3 Moderately abnormal adaptation to change - The child actively resists changes in
routine, tries to continue the old activity, and is difficult to distract. He or she may
become angry and unhappy when an established routing is altered.
3.5 (if between these points)
4 Severely abnormal adaptation to change - The child shows severe reactions to change. If
a change is forced, he or she may become extremely angry or uncooperative and respond with
tantrums.
VII. Visual Response
1 Age appropriate visual response - The child's visual behavior is normal and appropriate
for that age. Vision is used together with other senses as a way o explore a new object.
1.5 (if between these points)
2 Mildly abnormal visual response - The child much be occasionally reminded to look at
objects. The child may be more interested in looking at mirrors or lighting than peers,
may occasionally stare off into space, or may also avoid looking people in the eye.
2.5 (if between these points)
3 Moderately abnormal visual response - The child must be reminded frequently to look at
what he or she is doing. He or she may stare into space, avoid looking people in the eye,
look at objects from an unusual angle, or hold objects very close to the eyes.
3.5 (if between these points)
4 Severely abnormal visual response - The child consistently avoids looking at people or
certain objects and may show extreme forms of other visual peculiarities described above.
VIII. Listening Response
1 Age appropriate listening response - The child's listening behavior is normal and
appropriate for age. Listening is used together with other senses.
1.5 (if between these points)
2 Mildly abnormal listening response - There may be some lack of response, or mild
overreaction to certain sounds. Responses to sounds may be delayed, and sounds may need
repetition to catch the child's attention. The child may be distracted by extraneous
sounds.
2.5 (if between these points)
3 Moderately abnormal listening response - The child's responses to sounds vary; often
ignores a sound the first few times it is made; may be startled or cover ears when hearing
some everyday sounds.
3.5 (if between these points)
4 Severely abnormal listening response - The child overreacts and/or under reacts to
sounds to an extremely marked degree, regardless of the type of sound.
IX. Taste, Smell, and Touch Response and Use
1 Normal use of, and response to, taste, smell, and touch - The child explores new objects
in an age appropriate manner, generally by feeling and looking. Taste or smell may be used
when appropriate. When reacting to minor, everyday pain, the child expresses discomfort
but does not overreact.
1.5 (if between these points)
2 Mildly abnormal use of, and response to, taste, smell, and touch - The child may persist
in putting objects in his or her mouth; may smell or taste inedible objects; may ignore or
overreact to mild pain that a normal child would express as discomfort.
2.5 (if between these points)
3 Moderately abnormal use of, and response to, taste, smell, and touch - The child may be
moderately preoccupied with touching, smelling, or tasting objects or people. The child
may either react too much or too little.
3.5 (if between these points)
4 Severely abnormal use of, and response to, taste, smell, and touch - The child is
preoccupied with smelling, tasting, or feeling objects more for the sensation than for
normal exploration or use of the objects. The child may completely ignore pain or react
very strongly to slight discomfort.
X. Fear or Nervousness
1 Normal fear or nervousness - The child's behavior is appropriate both to the situation
and to his or her age.
1.5 (if between these points)
2 Mildly abnormal fear or nervousness - The child occasionally shows too much of too
little fear or nervousness compared to the reaction of a normal child of the same age in a
similar situation.
2.5 (if between these points)
3 Moderately abnormal fear or nervousness - The child shows either quite a bit more or
quite a bit less fear than is typical even for a younger child in a similar situation.
3.5 (if between these points)
4 Severely abnormal fear or nervousness - Fears persist even after repeated experience
with harmless events or objects. It is extremely difficult to calm or comfort the child.
The child may, conversely, fail to show appropriate regard for hazards which other
children of the same age avoid.
XI. Verbal Communication
1 Normal verbal communication, age and situation appropriate.
1.5 (if between these points)
2 Mildly abnormal verbal communication - Speech shows overall retardation. Most speech is
meaningful; however, some echolalia or pronoun reversal may occur. Some peculiar words or
jargon may be used occasionally.
2.5 (if between these points)
3 Moderately abnormal verbal communication - Speech may be absent. When present, verbal
communication may be a mixture of some meaningful speech and some peculiar speech such as
jargon, echolalia, or pronoun reversal. Peculiarities in meaningful speech include
excessive questioning or preoccupation with particular topics.
3.5 (if between these points)
4 Severely abnormal verbal communication - Meaningful speech is not used. The child may
make infantile squeals, weird or animal-like sounds, complex noises approximating speech,
or may show persistent, bizarre use of some recognizable words or phrases.
XII. Nonverbal Communication
1 Normal use of nonverbal communication, age and situation appropriate.
1.5 (if between these points)
2 Mildly abnormal use of nonverbal communication - Immature use of nonverbal
communication; may only point vaguely, or reach for what he or she wants, in situations
where same-age child may point or gesture more specifically to indicate what he or she
wants.
2.5 (if between these points)
3 Moderately abnormal use of nonverbal communication - The child is generally unable to
express needs or desires nonverbally, and cannot understand the nonverbal communication of
others.
3.5 (if between these points)
4 Severely abnormal use of nonverbal communication - The child only uses bizarre or
peculiar gestures which have no apparent meaning, and shows no awareness of the meanings
associated with the gestures or facial expressions of others.
XIII. Activity Level
1 Normal activity level for age and circumstances - The child is neither more active nor
less active than a normal child of the same age in a similar situation.
1.5 (if between these points)
2 Mildly abnormal activity level - The child may either be mildly restless or somewhat
"lazy" and slow moving at times. The child's activity level interferes only
slightly with his or her performance.
2.5 (if between these points)
3 Moderately abnormal activity level - The child may be quite active and difficult to
restrain. He or she may have boundless energy and may not go to sleep readily at night.
Conversely, the child may be quite lethargic, and need a great deal of prodding to get him
or her to move about.
3.5 (if between these points)
4 Severely abnormal activity level - The child exhibits extremes of activity or inactivity
and may even shift from one extreme to the other.
XIV. Level and Consistency of Intellectual Response
1 Intelligence is normal and reasonably consistent across various areas - The child is as
intelligent as typical children of the same age and does not have any unusual intellectual
skills or problems.
1.5 (if between these points)
2 Mildly abnormal intellectual functioning - The child is not as smart as typical children
of the same age; skills appear fairly retarded across all areas.
2.5 (if between these points)
3 Moderately abnormal intellectual functioning - In general, the child is not as smart as
typical children of the same age; however, the child may function nearly normally in one
or more intellectual areas.
3.5 (if between these points)
4 Severely abnormal intellectual functioning - While the child is not as smart as the
typical child of his age, he or she may function even better than the normal child of the
same age in one or more areas.
XV. General Impressions
1 No autism - The child shows none of the symptoms characteristic of autism.
1.5 (if between these points)
2 Mild autism - The child shows only a few symptoms or only a mild degree of autism.
2.5 (if between these points)
3 Moderate autism - The child shows a number of symptoms or a moderate degree of autism.
3.5 (if between these points)
4 Severe autism - The child shows many symptoms or an extreme degree of autism.
15-30 - Non-autistic
30-37 - Mildly-Moderately autistic
37-60 - Severely autistic
September 12, 1998 Shannon
Anderson
