CARS-2 Scoring

[frnc]

Background- our son has autism, it is very present, and we have had his pediatrician look at his first evaluation and she confirmed that he should have had a diagnosis at that time, along with some other autism specialists we have reached out to. Unfortunately, the new developmental specialist we are seeing is just not having it. I requested his medical records because she never sent them like she said she would and while reviewing them, I was wondering about his CARS-2 score. He is 3.5 (4 in December). His T Score is 33 and Percentile is 5. It states on there that above a 30 is in the autistic range and that this was observed during the first appointment. He had an appointment last week and while I was advocating, she said there is zero indication of any level of autism (we believe he is only at a level 1 as do the other professionals we have discussed this with and shared past evaluations with). Am I crazy or should he have got the level 1 diagnosis? Or can someone better explain this to me? We are very new at this medical side of things, and I want to make sure I am advocating for him fully with all the information.

 

[Neonatal RRT]

Just for reference, since many of us are adults here:

Childhood Autism Rating Scale Explained: CARS vs. CARS-2, Cutoffs, and Use Cases

One, keep in mind he is still quite young and even amongst neurotypical children in the population, there is quite a bit of variability at this age in terms of social skills, physical coordination, communication, and "testable intellect". With a "borderline" score of 33, was it a subjective opinion of the assessor? Is he presenting more autistic than the score would suggest... or the opposite... could he have scored a 27 by another assessor?

I've been working at one of the largest children's hospitals in the nation for nearly 40 years and as such a lot of experience with the developmental aspects of children, in general. I also see plenty of autistic children... usually more "profound" cases. All I might suggest is that I might not rely upon a CARS-2 score to convince me of autism in a 4 yr old, unless it is profound. These borderline cases of ASD1... I might keep it on your "radar" as a possibility... to be evaluated later... say in another 3-5 years when his socialization and communication skills mature a bit. Sometimes kids catch up to their peers once they get into school... and sometimes they don't. Regardless, if he seems to present with "deficits", then obviously, as a parent it's your responsibility to work on those with him. If those deficits do not improve or they seem "significant", then seek professional help. Case by case.