Children's Activity Rating Scale (CARS): description and calibration.

A five-level Children's Activity Rating Scale (CARS) was designed to categorize the intensity of physical activities and discriminate between levels of energy expenditure in young children. The CARS was used by trained observers over a 12-month period to assess physical activities of 3-4 year-old children during field observations. Agreement among observers using the CARS was 84.1% for 389 paired observation periods. The energy expenditure for each level was assessed by measuring VO2s and heart rates of 5-6 year-old children (12 boys, 13 girls) while they performed eight activities representing the CARS levels. Mean VO2s for the eight activities in Levels 1-5 ranged from 7.1 to 37.5 ml.kg BW-1.min-1 (1 to 5.42 METS; 14.5% to 80.6% of VO2max). Mean heart rates ranged from 89 to 183 b.min-1 for activities in Levels 1-5. VO2s and heart rates at each level were significantly different from all other levels. These data demonstrate that the CARS encompasses a wide range of energy expenditures, discriminates between levels of energy expenditure, and can be used by trained observers to reliably evaluate physical activity and estimate energy expenditure of young children.