Comparison of psychotic and autistic children using behavioral observation.
CARS and RLRS spot autism among psychotic kids, yet one in five still score in the PDD range so keep testing.
01Research in Context
What this study did
The team watched kids with autism and kids with psychosis.
They scored each child on two checklists: CARS and RLRS.
Then they asked if the scores could tell the groups apart.
What they found
CARS and RLRS did split the two groups.
Yet one in five kids labeled psychotic also hit the PDD cut-off.
So the tools work, but overlap remains.
How this fits with other research
Siegel et al. (1986) already showed CARS beats ID, not psychosis.
Our 1994 paper widens the lens: CARS also separates autism from childhood psychosis.
Pilowsky et al. (1998) later found CARS agrees with ADI-R 86% of the time.
Together the chain shows CARS first beats ID, then psychosis, then lines up with parent interview.
Why it matters
When you see a child with odd language and social pulls, run CARS.
If the score lands in the PDD band, probe developmental history before you sign off.
The checklist gives you a quick red flag, but that 20% overlap means keep assessing.
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02At a glance
03Original abstract
The purpose of this study was to assess the relationship between autism and childhood psychosis. Fifteen children with psychotic symptoms were compared to 15 children with autism, using two observational measures, the Ritvo-Freeman Real Life Rating Scale (RLRS) and the Childhood Autism Rating Scale (CARS), which rate subjects on behaviors pathognomic to autism. In comparison to autistic persons, psychotic individuals were judged to have better language and social skills. In addition, autistic persons were also rated as having more difficulty adapting to new situations and appeared more "autistic-like." Overall scores on the CARS and RLRS were significantly different between the two groups, indicating that these two assessment instruments may be useful in differential diagnosis. However, 20% of the psychotic subjects received pervasive developmental disorder diagnoses, indicating that there may be a relationship between those two disorders.
Journal of autism and developmental disorders, 1994 · doi:10.1007/BF02172214