The CARS-2 Questions for Parents and Caregivers (CARS-2-QPC) is an unscored caregiver questionnaire developed by Eric Schopler, PhD, Mary E. Van Bourgondien, PhD, Glenna Janette Wellman, PhD, and Steven R. Love, PhD, as a component of the Childhood Autism Rating Scale, Second Edition (CARS2). The CARS-2-QPC is organized into seven sections covering early development, social and emotional skills, communication, repetitive behaviors, play and routines, and unusual sensory interests. It uses a 5-point Likert-type scale for rating item severity. While the CARS-2-QPC itself is unscored, its responses directly inform clinician ratings on the CARS-2-ST (Standard) or CARS-2-HF (High-Functioning) forms, which produce scored ASD severity ratings. The CARS-2 system as a whole has demonstrated strong psychometric properties in distinguishing ASD from other developmental disorders across diverse populations. Zentake's digital CARS-2-QPC enables practices to collect structured parent input securely before the clinical encounter, saving evaluation time and improving rating accuracy.
The CARS-2-QPC is an unscored form. It does not produce a numeric score on its own. Instead, parent and caregiver responses provide structured clinical context that the evaluating clinician uses to inform their own ratings on the CARS-2-ST or CARS-2-HF forms.
The CARS-2-ST (Standard) and CARS-2-HF (High-Functioning) each consist of 15 items rated on a 1 to 4 scale. Total scores range from 15 to 60. Interpretation thresholds are:
Some clinical practice applies a lower screening cutoff of approximately 25 for initial ASD concern flagging. Zentake can be configured to deliver the CARS-2-QPC prior to the clinical visit, ensuring the clinician has complete caregiver data before beginning their CARS-2-ST or CARS-2-HF rating.
Step 1: Identify the appropriate respondent. The CARS-2-QPC is completed by the parent or primary caregiver of the child or young adult being evaluated. With Zentake, the form can be sent directly to the caregiver via secure digital link before the appointment.
Step 2: Send the form in advance. Deliver the CARS-2-QPC to caregivers at least 24 to 48 hours before the evaluation appointment. Zentake sends automated reminders to ensure completion, improving pre-appointment preparedness.
Step 3: Guide caregivers through all seven sections. Sections cover early development history; social, emotional, and communication skills; repetitive behaviors; play and routines; and unusual sensory interests. The final section allows open-ended narrative responses. Zentake's digital form presents each section clearly with instructions.
Step 4: Review responses before the clinical encounter. The clinician reviews completed CARS-2-QPC responses before or at the start of the appointment. Zentake delivers completed forms to the clinician's dashboard instantly upon caregiver submission.
Step 5: Use responses to inform CARS-2 ratings and clinical interview. During the assessment, the clinician uses caregiver responses as a framework for follow-up questions and to inform item ratings on the CARS-2-ST or CARS-2-HF. Zentake stores all responses securely and can push them to the patient record in connected EMR systems.
Scoring: The CARS-2-QPC does not produce a score, but digital delivery via Zentake ensures responses are captured in a structured, searchable format rather than freehand paper notes.
Completion: Paper forms require in-clinic completion or mailing. Zentake sends a secure digital link caregivers can complete at home before the appointment.
Delivery: Paper forms are distributed in-person. Zentake delivers via SMS, email, or patient portal with automated reminders to ensure completion.
Data Storage: Paper forms are stored in physical files. Zentake stores all caregiver responses in a HIPAA-compliant cloud database with full audit trails and instant clinician access.
Longitudinal Tracking: Paper makes it difficult to compare caregiver reports over time. Zentake enables tracking of caregiver-reported behaviors across multiple evaluation timepoints.
Security: Paper forms risk unauthorized access. Zentake provides end-to-end encryption and role-based access controls.
Integration: Paper data requires manual transcription into EHR. Zentake integrates directly with EMR/EHR platforms to push caregiver intake data automatically.
Cost: Paper involves printing, handling, and manual data entry. Zentake eliminates redundant administrative workflows.
What does the CARS-2-QPC measure?
The CARS-2-QPC gathers structured caregiver observations across seven domains: early development; social, emotional, and communication skills; repetitive behaviors; play and routines; and unusual sensory interests. It is used to inform clinician ratings on the CARS-2-ST or CARS-2-HF rather than produce a standalone score. Zentake delivers it digitally to caregivers before the clinical evaluation.
Is the CARS-2-QPC scored?
No. The CARS-2-QPC is an unscored form. Caregivers rate items on a 5-point scale ("not a problem" to "severe problem"), but these ratings are used as clinical context rather than summed into a total score. The scored CARS-2-ST and CARS-2-HF forms, completed by clinicians, produce numeric ASD severity ratings.
What are the CARS-2-ST scoring thresholds?
The CARS-2-ST and CARS-2-HF both score from 15 to 60. Scores below 30 fall in the non-autistic range; scores of 30 to 36.5 indicate mild-to-moderate autism; and scores of 37 to 60 indicate severe autism. Some programs use a clinical screening cutoff of approximately 25.
Who developed the CARS-2?
The CARS-2 was developed by Eric Schopler, PhD, Mary E. Van Bourgondien, PhD, Glenna Janette Wellman, PhD, and Steven R. Love, PhD. The original CARS was first developed by Schopler and colleagues in 1980 at the University of North Carolina.
What age range is the CARS-2-QPC designed for?
The CARS-2 system is designed for individuals aged 2 years and older. The CARS-2-ST is used for children under 6 or those with significant communication impairment; the CARS-2-HF is designed for individuals 6 and older with higher verbal and intellectual functioning.
How long does the CARS-2-QPC take to complete?
Caregivers typically complete the CARS-2-QPC in 15 to 25 minutes. Zentake allows caregivers to complete it at home before the appointment, reducing in-clinic time and ensuring the clinician has all caregiver data ready at the start of the evaluation.
Who should administer the CARS-2-QPC?
The CARS-2-QPC is completed by the parent or primary caregiver. The clinician administering the evaluation (psychologist, developmental pediatrician, school psychologist) reviews and uses the responses to guide the clinical interview and inform their CARS-2 ratings.
Is the CARS-2-QPC free to use?
The CARS-2-QPC is a proprietary form published by Western Psychological Services (WPS) and requires purchase. Zentake can digitize and securely deliver licensed copies of the form within your practice's purchased materials. Contact Zentake to learn more.
1. 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.
2. Schopler E, Van Bourgondien ME, Wellman GJ, Love SR. Childhood Autism Rating Scale, Second Edition (CARS2). Los Angeles: Western Psychological Services; 2010.
3. Rellini E, Tortolani D, Trillo S, Carbone S, Montecchi F. Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) correspondence and conflicts with DSM-IV criteria in diagnosis of autism. Journal of Autism and Developmental Disorders. 2004;34(6):703-708.
4. Magyar CI, Pandolfi V. Factor structure evaluation of the Childhood Autism Rating Scale. Journal of Autism and Developmental Disorders. 2007;37(9):1787-1800.
Last updated: March 2026
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