Children's Global Assessment Scale
Encyclopedia
The Children's Global Assessment Scale (CGAS) is a numeric scale (1 through 100) used by mental health clinicians and doctors to rate the general functioning of children under the age of 18.
(GAF) DSM-IV-TR
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a wide range of activities and has many interests (e.g., has hobbies or
participates in extracurricular activities or belongs to an organized group such as
Scouts, etc.); likeable, confident; ‘everyday’ worries never get out of hand; doing
well in school; no symptoms.
90-81 Good functioning in all areas; secure in family, school, and with peers; there may
be transient difficulties and ‘everyday’ worries that occasionally get out of hand
(e.g., mild anxiety associated with an important exam, occasional ‘blowups’ with
siblings, parents or peers).
80-71 No more than slight impairments in functioning at home, at school, or with peers;
some disturbance of behavior or emotional distress may be present in response
to life stresses (e.g., parental separations, deaths, birth of a sibling), but these are
brief and interference with functioning is transient; such children are only
minimally disturbing to others and are not considered deviant by those who know
them.
70-61 Some difficulty in a single area but generally functioning well (e.g., sporadic
or isolated antisocial acts, such as occasionally playing hooky or petty theft;
consistent minor difficulties with school work; mood changes of brief duration;
fears and anxieties which do not lead to gross avoidance behaviour; self-doubts);
has some meaningful interpersonal relationships; most people who do not know
the child well would not consider him/her deviant but those who do know him/her
well might express concern.
60-51 Variable functioning with sporadic difficulties or symptoms in several but not all
social areas; disturbance would be apparent to those who encounter the child in
a dysfunctional setting or time but not to those who see the child in other
settings.
50-41 Moderate degree of interference in functioning in most social areas or severe
impairment of functioning in one area, such as might result from, for example,
suicidal preoccupations and ruminations, school refusal and other forms of
anxiety, obsessive rituals, major conversion symptoms, frequent anxiety attacks,
poor to inappropriate social skills, frequent episodes of aggressive or other
antisocial behaviour with some preservation of meaningful social relationships.
40-31 Major impairment of functioning in several areas and unable to function in one of
these areas i.e., disturbed at home, at school, with peers, or in society at large,
e.g., persistent aggression without clear instigation; markedly withdrawn and
isolated behaviour due to either mood or thought disturbance, suicidal attempts
with clear lethal intent; such children are likely to require special schooling and/or
hospitalisation or withdrawal from school (but this is not a sufficient criterion for
inclusion in this category).
30-21 Unable to function in almost all areas e.g., stays at home, in ward, or in bed all
day without taking part in social activities or severe impairment in reality testing
or serious impairment in communication (e.g., sometimes incoherent or
inappropriate).
20-11 Needs considerable supervision to prevent hurting others or self (e.g., frequently
violent, repeated suicide attempts) or to maintain personal hygiene or gross
impairment in all forms of communication, e.g., severe abnormalities in verbal and
gestural communication, marked social aloofness, stupor, etc.
10-1 Needs constant supervision (24-hour care) due to severely aggressive or self-destructive
behaviour or gross impairment in reality testing, communication,
cognition, affect or personal hygiene.
Application
Ratings on a CGAS scale should be independent of specific mental health diagnoses. The scale is presented and described Schaffer D, Gould MS, Brasic J, et al. (1983) A children's global assessment scale (CGAS). Archives of General Psychiatry, 40, 1228-1231. Adults are evaluated on the Global Assessment Scale (GAS), which was revised to the Global Assessment of FunctioningGlobal Assessment of Functioning
The Global Assessment of Functioning is a numeric scale used by mental health clinicians and physicians to subjectively rate the social, occupational, and psychological functioning of adults, e.g., how well or adaptively one is meeting various problems-in-living. The scale is presented and...
(GAF) DSM-IV-TR
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
.
Score interpretation
100-91 Superior functioning in all areas (at home, at school and with peers); involved ina wide range of activities and has many interests (e.g., has hobbies or
participates in extracurricular activities or belongs to an organized group such as
Scouts, etc.); likeable, confident; ‘everyday’ worries never get out of hand; doing
well in school; no symptoms.
90-81 Good functioning in all areas; secure in family, school, and with peers; there may
be transient difficulties and ‘everyday’ worries that occasionally get out of hand
(e.g., mild anxiety associated with an important exam, occasional ‘blowups’ with
siblings, parents or peers).
80-71 No more than slight impairments in functioning at home, at school, or with peers;
some disturbance of behavior or emotional distress may be present in response
to life stresses (e.g., parental separations, deaths, birth of a sibling), but these are
brief and interference with functioning is transient; such children are only
minimally disturbing to others and are not considered deviant by those who know
them.
70-61 Some difficulty in a single area but generally functioning well (e.g., sporadic
or isolated antisocial acts, such as occasionally playing hooky or petty theft;
consistent minor difficulties with school work; mood changes of brief duration;
fears and anxieties which do not lead to gross avoidance behaviour; self-doubts);
has some meaningful interpersonal relationships; most people who do not know
the child well would not consider him/her deviant but those who do know him/her
well might express concern.
60-51 Variable functioning with sporadic difficulties or symptoms in several but not all
social areas; disturbance would be apparent to those who encounter the child in
a dysfunctional setting or time but not to those who see the child in other
settings.
50-41 Moderate degree of interference in functioning in most social areas or severe
impairment of functioning in one area, such as might result from, for example,
suicidal preoccupations and ruminations, school refusal and other forms of
anxiety, obsessive rituals, major conversion symptoms, frequent anxiety attacks,
poor to inappropriate social skills, frequent episodes of aggressive or other
antisocial behaviour with some preservation of meaningful social relationships.
40-31 Major impairment of functioning in several areas and unable to function in one of
these areas i.e., disturbed at home, at school, with peers, or in society at large,
e.g., persistent aggression without clear instigation; markedly withdrawn and
isolated behaviour due to either mood or thought disturbance, suicidal attempts
with clear lethal intent; such children are likely to require special schooling and/or
hospitalisation or withdrawal from school (but this is not a sufficient criterion for
inclusion in this category).
30-21 Unable to function in almost all areas e.g., stays at home, in ward, or in bed all
day without taking part in social activities or severe impairment in reality testing
or serious impairment in communication (e.g., sometimes incoherent or
inappropriate).
20-11 Needs considerable supervision to prevent hurting others or self (e.g., frequently
violent, repeated suicide attempts) or to maintain personal hygiene or gross
impairment in all forms of communication, e.g., severe abnormalities in verbal and
gestural communication, marked social aloofness, stupor, etc.
10-1 Needs constant supervision (24-hour care) due to severely aggressive or self-destructive
behaviour or gross impairment in reality testing, communication,
cognition, affect or personal hygiene.