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J Am Acad Child Adolesc Psychiatry. 2019 Feb 21. pii: S0890-8567(19)30124-8. doi: 10.1016/j.jaac.2018.10.016. [Epub ahead of print]

Development of the Parent-Rated Anxiety Scale for Youth With Autism Spectrum Disorder.

Author information

1
Marcus Autism Center, Emory University School of Medicine, Atlanta, GA. Electronic address: lawrence.scahill@emory.edu.
2
Ohio State University, Nisonger Center, Columbus, OH.
3
Center for Autism Research, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia.
4
Marcus Autism Center, Emory University School of Medicine, Atlanta, GA.
5
University of Washington, Seattle.
6
State University of New York at Stony Brook, NY.
7
Arizona State University, Tempe, AZ.

Abstract

OBJECTIVE:

Anxiety is common in youth with autism spectrum disorder (ASD). There is no accepted outcome measure for anxiety in this population.

METHOD:

Following a series of focus groups with parents of youth with ASD, we generated 72 items (scored 0-3). Parents of 990 youth with ASD (aged 5-17 years; 80.8% male) completed an online survey. Factor analysis and item response theory analyses reduced the content to a single factor with 25 items. Youth with at least mild anxiety (n = 116; aged 5-17 years; 79.3% male) participated in a comprehensive clinical assessment to evaluate the validity and reliability of the 25-item Parent-Rated Anxiety Scale for ASD (PRAS-ASD).

RESULTS:

In the online sample, the mean PRAS-ASD score was 29.04 ± 14.9 (range, 0-75). The coefficient α was 0.93. The item response theory results indicated excellent reliability across a wide range of scores with low standard errors. In the clinical sample (n = 116), the PRAS-ASD mean was 31.0 ± 15.6 (range, 1-65). Pearson correlations with parent ratings of ASD symptom severity, repetitive behavior, and disruptive behavior ranged 0.33 to 0.66, supporting divergent validity of the PRAS-ASD. Pearson correlation with a parent-rated measure of anxiety used in the general pediatric population of 0.83 supported convergent validity. A total of 40 participants (32 boys, 8 girls; mean age, 11.9 ± 3.4 years) returned at time 2 (mean, 12.2 days) and time 3 (mean, 24.2 days). Intraclass correlation showed test-retest reliabilities of 0.88 and 0.86 at time 2 and time 3, respectively.

CONCLUSION:

The 25-item PRAS-ASD is a reliable and valid scale for measuring anxiety in youth with ASD.

KEYWORDS:

anxiety; autism; outcome measurement

PMID:
30797036
DOI:
10.1016/j.jaac.2018.10.016

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