Test-Retest Reliability and Validity of the Autism Symptoms Questionnaire
Keywords:
autism spectrum disorder, reliability, behaviorAbstract
Although many instruments can measure symptoms in Autism Spectrum Disorder (ASD), only a few are directly based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criterion. One of these tools called the Autism Symptoms Questionnaire (ASQ) is directly based on the DSM-IV-TR criteria for ASD and has been used in several clinical studies. However, its basic psychometric characteristics such as reliability and validity have not been studied. In this study we analyze the data from 165 individuals that were seen in an autism multispecialty clinic whose caretakers completed the ASQ at least twice. In addition, concurrent to completing the ASQ, most caretakers also completed two other commonly used validated questionnaires used in autism research: the Social Responsiveness Scale (SRS) and the Aberrant Behavior Checklist (ABC). The data was analyzed using a mixed-model to control for within-subject variation and time between assessments. First, we found excellent test-retest reliability for the ASQ with statistically significant r values for the mixed-model. Reliabilities of 0.93, 0.94, 0.91 and 0.99 were found for the social, communication and stereotyped behavior subscales and total score, respectively. The Minimal Clinically Important Difference (MCID) was calculated as 0.11, 0.09, 0.12 and 0.04 points for the social, communication and stereotyped behavior subscales and total score, respectively. The r values for the mixed-model associating the ASQ with the SRS and ABC varied between subscales but were moderate to good in magnitude and statistically significant, demonstrating that the ASQ measures a valid psychometric construct. Overall, this study suggests that the ASQ has acceptable reliability. The ASQ’s close correspondence to the DSM criteria is a strength of this instrument. With further research, it may be possible to develop a similar tool based on the DSM-V criteria. It appears that a Minimal Clinically Important Difference is approximately 0.1 point on any subscale, providing validation that changes on the ASQ can be considered important.
References
Frye RE, DeLatorre R, Taylor HB, et al. Metabolic effects of sapropterin treatment in autism spectrum disorder: a preliminary study. Transl Psychiatry. 2013;3:e237.
Aman MG, Singh NN, Stewart AW, Field CJ. The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. Am J Ment Defic. 1985;89:485-491.
Kaat AJ, Lecavalier L, Aman MG. Validity of the aberrant behavior checklist in children with autism spectrum disorder. J Autism Dev Disord. 2014;44:1103-1116.
Frye RE, Slattery J, MacFabe DF, et al. Approaches to studying and manipulating the enteric microbiome to improve autism symptoms. Microb Ecol Health Dis. 2015;26:26878.
Constantino JN. The Social Responsiveness Scale. Los Angeles: Western Psychological Services; 2002.
Zhou H, Zhang L, Wu L, et al. Validity and reliability analysis of the Chinese parent version of the Autism Spectrum Rating Scale (6-18 years). Psychiatry Res. 2015. [epub]
Wigham S, McConachie H, Tandos J, Le Couteur AS. The reliability and validity of the Social Responsiveness Scale in a UK general child population. Res Dev Disabil. 2012;33:944-950.
Takei R, Matsuo J, Takahashi H, Uchiyama T, Kunugi H, Kamio Y. Verification of the utility of the social responsiveness scale for adults in non-clinical and clinical adult populations in Japan. BMC Psychiatry. 2014;14:302.
Wang J, Lee LC, Chen YS, Hsu JW. Assessing autistic traits in a Taiwan preschool population: cross-cultural validation of the Social Responsiveness Scale (SRS). J Autism Dev Disord. 2012;42:2450- 2459.
Bolte S. Brief Report: the Social Responsiveness Scale for Adults (SRS-A): initial results in a German cohort. J Autism Dev Disord. 2012;42:1998-1999.
Bolte S, Poustka F, Constantino JN. Assessing autistic traits: cross- cultural validation of the social responsiveness scale (SRS). Autism Res. 2008;1:354-363.
Duku E, Vaillancourt T, Szatmari P, et al. Investigating the measurement properties of the social responsiveness scale in preschool children with autism spectrum disorders. J Autism Dev Disord. 2013;43:860-868.
Pearl AM, Murray MJ, Smith LA, Arnold M. Assessing adolescent social competence using the Social Responsiveness Scale: should we ask both parents or will just one do? Autism. 2013;17:736-742.
Murray MJ, Mayes SD, Smith LA. Brief report: excellent agreement between two brief autism scales (Checklist for Autism Spectrum Disorder and Social Responsiveness Scale) completed independently by parents and the Autism Diagnostic Interview-Revised. J Autism Dev Disord. 2011;41:1586-1590.
Frye RE, Melnyk S, Macfabe DF. Unique acyl-carnitine profiles are potential biomarkers for acquired mitochondrial disease in autism spectrum disorder. Transl Psychiatry. 2013;3:e220.
Frye RE. Biomarkers of Abnormal Energy Metabolism in Children with Autism Spectrum Disorder. N A J Med Sci. 2012;5:141-147.
Mukaddes NM, Tutkunkardas MD, Sari O, Aydin A, Kozanoglu P. Characteristics of children who lost the diagnosis of autism: a sample from istanbul, Turkey. Autism Res Treat. 2014;2014:472120.
Tager-Flusberg H, Rogers S, Cooper J, et al. Defining spoken language benchmarks and selecting measures of expressive language development for young children with autism spectrum disorders. J Speech Lang Hear Res. 2009;52:643-652.
Luyster R, Qiu S, Lopez K, Lord C. Predicting outcomes of children referred for autism using the MacArthur-Bates Communicative Development Inventory. J Speech Lang Hear Res. 2007;5:667-681.
Tilford JM, Payakachat N, Kovacs E, et al. Preference-based health- related quality-of-life outcomes in children with autism spectrum disorders: a comparison of generic instruments. PharmacoEconomics. 2012;30:661-679.
Bavin EL, Kidd E, Prendergast L, Baker E, Dissanayake C, Prior M. Severity of autism is related to children's language processing. Autism Res. 2014;7:687-694.
