A Training Module for Early
Interventionists
VT-ILEHP ASD LEND Program
2010
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A standardized tool for
screening children at risk &
assessing persons with autism
and other severe behavioral
disorders
Provides norm-referenced
information that can assist in
the diagnosis of Autism
Based on APA definition of
autism
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Changes made to the GARS to improve reliability &
reflect changes in understanding Autism:
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Structured parent interview form replaces the Early
Development subscale
Some items rewritten for clarity
Demographic characteristics of the normative sample were
keyed to 2000 U.S. Census data.
New norms created
Guidelines provided for interpreting subscale scores
Autism Index replaced the Autism Quotient
Instructional Objectives for Children Who Have Autism
included to assist in the formulation of instructional goals and
objectives based on the GARS-2 results
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Provides detailed
instructions on how to
administer the GARS-2
along with information
about reliability, validity,
normative population
Provides insights into
using GAR-S results with
Applied Behavior
Analysis programs
Provides standard scores
and %ile ranks
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Three subscales:
 Stereotyped Behaviors
 Communication
 Social Interaction
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Items 1-14 describe stereotyped behaviors,
motility disorders, and other unique and
atypical behaviors
Examples:
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Stares at hands, objects, or items in the environment
for at least 5 seconds.
Spins objects not designed for spinning (e.g. cups,
saucers, glasses…)
Flaps hands or fingers in front of face or at sides.
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Items 15-28 describe verbal and non-verbal
behaviors displayed by children with Autism
and Autism Spectrum Disorders.
Examples:
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Repeats words or phrases over and over.
Looks away or avoids looking at speaker when
name is called
Repeats unintelligible sounds (babbles) over and
over.
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Items 29-42 evaluate a child’s ability to relate
appropriately to people, events, and objects.
Examples:
Does not imitate other people when imitation is
required or desirable, such as in games or learning
activities.
 Withdraws, remains aloof, or acts standoffish in
group situations.
 Becomes upset when routines are changed.
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Rater=>completes 14
questions for each
subscale
 Teacher
 Parent
 Clinician
Examiner=>scores &
interprets the results
Can use structured
interview with the rater
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May be necessary for more than one person to
complete the rating based on relationship with the
child
 EXAMPLE: Classroom teacher rates the
Stereotyped Behaviors & Social Interactions while
SLP rates Communication.
Raters should read the questions carefully & ask
questions for clarification
Raters should not take into account a child’s age
when rating
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Four different measures of frequency
0 – Never observed – You have never seen the
individual behave in this manner.
 1 – Seldom observed – Individual behaves in
this manner 1-2 times per 6-hour period.
 2 – Sometimes observed – Individual behaves in
this manner 3-4 times per 6-hour period.
 3 – Frequently observed – Individual behaves in
this manner at least 5-6 times per 6-hour period.
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Parents are a good source of information about their
children’s behaviors.
Parents/caregivers describe child’s behavior before age 3
 First 10 questions deal with delays
 15 questions deal with abnormal functioning
 Questions are scored ‘yes’ or ‘no’
 Examiner can give examples to explain the behaviors
 ‘No’ responses indicate abnormality or developmental
delay
Necessary to have evidence that an individual
demonstrated delays before age 3 to diagnose Autism.
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Make sure all items in each subscale have been rated
Add raw scores for each item & total these
Find %ile rank and standard score for each subscale
Standard score (SS) of 7 or higher on a subscale indicates a
very likely possibility of Autism (based on a mean of 10;
standard deviation (SD) of 3)
SS of 4-6 on a subscale indicates a possibility of Autism
SS of 0-3 on a subscale indicates Autism is unlikely
Add up subscales to determine the Autism Index (based on
a mean of 100 & SD of 15
It is possible to use 2 subscales instead of 3 to determine
the Autism Index
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Normative scores come from a sample of 1,107 children
& young adults between the ages of 3 & 22 diagnosed
with Autism
Internal consistency & test-retest coefficients are large to
very large
Validity was demonstrated by confirming that:
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Items on the subscales are representative of the characteristics of
autism
Subscales are strongly correlated to each other and to the
performance of other tests that screen for autism
Scores discriminate persons with autism from persons with other
severe behavioral disorders as well as persons without
disabilities
5-year old, verbal female
Background: Kindergarten teacher noticed that she was not socializing with other
children & exhibited repetitive motions; school psychologist was asked to
complete the GARS-2. Beatrice was receiving speech-language services and her
SLP completed the Communication subscale of the GARS-2 while the
kindergarten teachers filled out the Stereotyped Behaviors and Social
Interaction subscales.
Subscale 1 - Stereotyped Behaviors:
Teacher reported frequently observing the following
behaviors:
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2. Stares at hand objects, or items in the environment for at least 5 seconds.
8. Spins objects not designed for spinning (e.g., saucers, cups, glasses)
9. Rocks back and forth while seated or standing.
12. Flaps hands or fingers in front of face or at sides.
Other behaviors were not observed.
QUESTIONS:
1. How often is ‘frequently observed’?
2. What is the subscale SS for Beatrice?
3. Does this mean Beatrice has Autism?
ANSWER:
1. Frequently observed means the individual behaves
in this manner at least 5-6 times per 6-hour period.
2. The subscale score is ___:
3. No, but her score indicates a high risk for Autism as
it is falls in the range of 7 or higher.
Subscale 2 - Communication: The SLP completed
the subscale & found that Beatrice sometimes
exhibited the following:
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17. Repeats words or phrases over and over.
18. Speaks or signs with flat tone, affect, or dysrhythmic
patters
28. Inappropriately answers questions about a statement
or brief story.
The SLP did not observe any other behaviors
listed on the subscale.
QUESTIONS:
1. Does this subscale indicate a risk of Autism?
ANSWER: Yes, Beatrice scored a __ on this subscale and as such there
is some indication of a possibility of Autism. Combined with the
Stereotyped Interactions data, there is an indication of a high risk
of Autism.
2. Was it appropriate for more than one adult to complete the
GARS-2?
ANSWER: Yes, each professional has a different perspective &
multiple raters who have the best view into a particular domain
can complete the subscales of the GARS-2.
Subscale 3 - Social Interaction: The kindergarten teacher
completed this subscale and found that Beatrice
sometimes:
 40. Becomes upset when routines are changed.
 42. Lines up objects in precise, orderly fashion and
becomes upset when the order is disturbed.
The teacher seldom observed Beatrice exhibiting the
following:
 31. Resists physical contact from others.
 33. Withdraws, remains aloof, or acts standoffish in
group situations.
QUESTION:
1. Does this subscale indicate a risk of Autism?
ANSWER: Yes, Beatrice scored a ___ on this subscale and
as such there is some indication of a possibility of
Autism. Combined with the Stereotyped Interactions
data, and the Communications subscale there is an
indication of a high risk of Autism.
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Beatrice was referred to a developmental
pediatrician for a developmental evaluation.
She was eventually diagnosed with PDDNOS.
She was referred to an intensive after school
intervention program.
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American Psychiatric Association. (2000). Diagnostic
and statistical manual of mental disorders (4th ed., text
rev.). Washington, DC: Author.
Autism Society of America (2003). What is Autism?
Retrieved January 5, 2005, from
http://www.autismsociety.org/site/pageserver?page
name=whatisautism
Gilliam, James E. (1995). Gilliam Autism Rating Scale.
Austin TX: PRO-ED.
Gilliam, James E. (2006). GARS-2; Gilliam Autism Rating
Scale, Second Edition, Examiner’s Manual. Austin, TX:
PRO-ED.