Abstract
This study examined the feasibility, acceptability, and psychometric characteristics of a web-based touchscreen app prototype designed to assess self-reported trauma exposure and symptoms in children with autism spectrum disorder (ASD). The prototype was piloted with 20 clinically referred children previously diagnosed with ASD and having various known trauma exposures. User satisfaction and reported ease of use was high. The measure was sensitive to reports of teasing and bullying, endorsed by 75% and 70% of participants, respectively. Validity was assessed via comparisons with the UCLA Posttraumatic Stress Disorder Reaction Index and analysis of participants’ trauma exposures and symptoms. Clinical implications are discussed including issues of trauma screening, diagnosis, and treatment planning for traumatized youth with ASD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adams, R. E., Fredstrom, B. K., Duncan, A. W., Holleb, L. J., & Bishop, S. L. (2014). Using self- and parent-reports to test the association between peer victimization and internalizing symptoms in verbally fluent adolescents with ASD. Journal of Autism and Developmental Disorders, 44(4), 861–872. https://doi.org/10.1007/s10803-013-1938-0.
Akshoomoff, N., Beaumont, J. L., Bauer, P. J., Dikmen, S. S., Gershon, R. C., Mungas, D., … Zelazo, P. D. (2013). VIII. NIH toolbox cognition battery (CB): Composite scores of crystallized, fluid, and overall cognition. Monographs of the Society for Research in Child Development, 78(4), 119–132.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th edn.). Arlington: American Psychiatric Publishing.
Baio, J., Wiggins, L., Christensen, D. L., et al. (2018). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 Sites, United States, 2014. MMWR Surveill Summ, 67(SS-6):1–23. https://doi.org/10.15585/mmwr.ss6706a1.
Becker, A., Hagenberg, N., Roessner, V., Woerner, W., & Rothenberger, A. (2004). Evaluation of the self-reported SDQ in a clinical setting: Do self-reports tell us more than ratings by adult informants? European Child & Adolescent Psychiatry, 13, II17–II24.
Berg, K. L., Shiu, C., Acharya, K., Stolbach, B. C., & Msall, M. E. (2016). Disparities in adversity among children with autism spectrum disorder: A population-based study. Developmental Medicine & Child Neurology, 58(11), 1124–1131. https://doi.org/10.1111/dmcn.13161.
Bleil Walters, J., Hughes, T. L., Sutton, L. R., Marshall, S. N., Crothers, L. M., Lehman, C., … Huang, A. (2013). Maltreatment and depression in adolescent sexual offenders with an autism spectrum disorder. Journal of Child Sexual Abuse, 22(1), 72–89. https://doi.org/10.1080/10538712.2013.735357.
Briere, J., Johnson, K., Bissada, A., Damon, L., Crouch, J., Gil, E., … Ernst, V. (2001). The trauma symptom checklist for young children (TSCYC): Reliability and association with abuse exposure in a multi-site study. Child Abuse & Neglect, 25(8), 1001–1014. https://doi.org/10.1016/S0145-2134(01)00253-8.
Brooks, B. A., Haynes, K., Smith, J., McFadden, T., & Robins, D. L. (2016). Implementation of web-based autism screening in an urban clinic. Clinical Pediatrics, 55(10), 927–934. https://doi.org/10.1177/0009922815616887.
Cohen, J. A., Bukstein, O., Walter, H., Benson, R. S., Chrisman, A., Farchione, T. R., … Stock, S. (2010). Practice parameter for the assessment and treatment of children and adolescent with posttraumatic stress disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 49(4), 414–430. https://doi.org/10.1097/00004583-201004000-00021.
Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64(5), 577–584. https://doi.org/10.1001/archpsyc.64.5.577.
Eklund, K., Rossen, E., Koriakin, T., Chafouleas, S. M., & Resnick, C. (2018). A systematic review of trauma screening measures for children and adolescents. School Psychology Quarterly, 33(1), 30–43. https://doi.org/10.1037/spq0000244.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258.
Geller, P. A., Neugebauer, R., Possemato, A. K., Walter, P., Dummit, E. S., & Silva, R. R. (2007). Psychometric properties of darryl, a cartoon based measure to assess community violence-related PTSD in children. Psychiatric Quarterly, 78(2), 157–168. https://doi.org/10.1007/s11126-006-9035-6.
Hoover, D. W. (2015). The effects of psychological trauma on children with autism spectrum disorders: A research review. Review Journal of Autism and Developmental Disorders, 2(3), 287–299.
Hoover, D. W., & Kaufman, J. (2018). Adverse childhood experiences in children with autism spectrum disorder. Current Opinion in Psychiatry, 31(2), 128–132. https://doi.org/10.1097/YCO.0000000000000390 [doi].
Kaat, A. J., & Lecavalier, L. (2015). Reliability and validity of parent- and child-rated anxiety measures in autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(10), 3219–3231. https://doi.org/10.1007/s10803-015-2481-y.
Kerns, C. M., Kendall, P. C., Zickgraf, H., Franklin, M. E., Miller, J., & Herrington, J. (2015). Not to be overshadowed or overlooked: Functional impairments associated with comorbid anxiety disorders in youth with ASD. Behavior Therapy, 46(1), 29–39. https://doi.org/10.1016/j.beth.2014.03.005 [doi].
Kerns, C. M., Newschaffer, C. J., Berkowitz, S., & Lee, B. K. (2017). Brief report: Examining the association of autism and adverse childhood experiences in the national survey of children’s health: The important role of income and co-occurring mental health conditions. Journal of Autism and Developmental Disorders, 47(7), 2275–2281. https://doi.org/10.1007/s10803-017-3111-7.
Kerns, C. M., Newschaffer, C. J., & Berkowitz, S. J. (2015). Traumatic childhood events and autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(11), 3475–3486. https://doi.org/10.1007/s10803-015-2392-y.
Kerns, C. M., Renno, P., Kendall, P. C., Wood, J. J., & Storch, E. A. (2017). Anxiety disorders interview schedule-autism addendum: Reliability and validity in children with autism spectrum disorder. Journal of Clinical Child and Adolescent Psychology, 46(1), 88–100. https://doi.org/10.1080/15374416.2016.1233501.
Kobak, K. A., Stone, W. L., Wallace, E., Warren, Z., Swanson, A., & Robson, K. (2011). A web-based tutorial for parents of young children with autism: Results from a pilot study. Telemedicine and e-Health, 17(10), 804–808. https://doi.org/10.1089/tmj.2011.0060.
Kuhn, E., Kanuri, N., Hoffman, J. E., Garvert, D. W., Ruzek, J. I., & Taylor, C. B. (2017). A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms. Journal of Consulting and Clinical Psychology, 85(3), 267–273. https://doi.org/10.1037/ccp0000163.
Kupersmidt, J. B., Stelter, R., & Dodge, K. A. (2011). Development and validation of the social information processing application: A web-based measure of social information processing patterns in elementary school-age boys. Psychological Assessment, 23(4), 834–847. https://doi.org/10.1037/a0023621.
Lanktree, C. B., Gilbert, A. M., Briere, J., Taylor, N., Chen, K., Maida, C. A., & Saltzman, W. R. (2008). Multi-informant assessment of maltreated children: Convergent and discriminant validity of the TSCC and TSCYC. Child Abuse & Neglect, 32(6), 621–625. https://doi.org/10.1016/j.chiabu.2007.10.003.
Layne, C. M., Greeson, J. K. P., Ostrowski, S. A., Kim, S., Reading, S., Vivrette, R. L., … Pynoos, R. S. (2014). Cumulative trauma exposure and high risk behavior in adolescence: Findings from the national child traumatic stress network core data set. Psychological Trauma: Theory, Research, Practice, and Policy, 6, S40–S49. https://doi.org/10.1037/a0037799.
Maclean, M. J., Sims, S., Bower, C., Leonard, H., Stanley, F. J., & O’Donnell, M. (2017). Maltreatment risk among children with disabilities. Pediatrics, 139(4), e20161817. https://doi.org/10.1542/peds.2016-1817.
Mahan, S., & Matson, J. L. (2011). Children and adolescents with autism spectrum disorders compared to typically developing controls on the behavioral assessment system for children, (BASC-2). Research in Autism Spectrum Disorders, 5(1), 119–125.
Maïano, C., Normand, C. L., Salvas, M., Moullec, G., & Aimé, A. (2016). Prevalence of school bullying among youth with autism spectrum disorders: A systematic review and meta-analysis. Autism Research, 9(6), 601–615. https://doi.org/10.1002/aur.1568.
Mannion, A., & Leader, G. (2013). Comorbidity in autism spectrum disorder: A literature review. Research in Autism Spectrum Disorders, 7(12), 1595–1616. https://doi.org/10.1016/j.rasd.2013.09.006.
Matson, J. L., & Cervantes, P. E. (2014). Commonly studied comorbid psychopathologies among persons with autism spectrum disorder. Research in Developmental Disabilities, 35(5), 952–962. https://doi.org/10.1016/j.ridd.2014.02.012.
Mayes, S. D., Gorman, A. A., Hillwig-Garcia, J., & Syed, E. (2013). Suicide ideation and attempts in children with autism. Research in Autism Spectrum Disorders, 7(1), 109–119. https://doi.org/10.1016/j.rasd.2012.07.009.
Mazefsky, C. A., Kao, J., & Oswald, D. P. (2011). Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 164–174. https://doi.org/10.1016/j.rasd.2010.03.006 [doi].
McKown, C., Russo-Ponsaran, N., Johnson, J. K., Russo, J., & Allen, A. (2016). Web-based assessment of children’s social-emotional comprehension. Journal of Psychoeducational Assessment, 34(4), 322–338. https://doi.org/10.1177/0734282915604564.
McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 52(8), 815–830. https://doi.org/10.1016/j.jaac.2013.05.011.
Mehtar, M., & Mukaddes, N. M. (2011). Posttraumatic stress disorder in individuals with diagnosis of autistic spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 539–546.
Neely, L., Rispoli, M., Camargo, S., Davis, H., & Boles, M. (2013). The effect of instructional use of an iPad® on challenging behavior and academic engagement for two students with autism. Research in Autism Spectrum Disorders, 7(4), 509–516. https://doi.org/10.1016/j.rasd.2012.12.004.
Neumann, M. M. (2018). Using tablets and apps to enhance emergent literacy skills in young children. Early Childhood Research Quarterly, 42, 239–246. https://doi.org/10.1016/j.ecresq.2017.10.006.
Praver, F., DiGiuseppe, R., Pelcovitz, D., Mandel, F. S., & Gaines, R. (2000). A preliminary study of a cartoon measure for children’s reactions to chronic trauma. Child Maltreatment, 5(3), 273–285. https://doi.org/10.1177/1077559500005003007.
Pynoos, R., & Steinberg, A. (2013). UCLA PTSD reaction index for DSM-5. Los Angeles: University of California Los Angeles.
Renk, K., & Phares, V. (2004). Cross-informant ratings of social competence in children and adolescents. Clinical Psychology Review, 24(2), 239–254. https://doi.org/10.1016/j.cpr.2004.01.004.
Schriber, R. A., Robins, R. W., & Solomon, M. (2014). Personality and self-insight in individuals with autism spectrum disorder. Journal of Personality and Social Psychology, 106(1), 112–130. https://doi.org/10.1037/a0034950.
Schutte, J. L., McCue, M. P., Parmanto, B., McGonigle, J., Handen, B., Lewis, A., … Saptono, A. (2015). Usability and reliability of a remotely administered adult autism assessment, the autism diagnostic observation schedule (ADOS) module 4. Telemedicine and e-Health, 21(3), 176–184. https://doi.org/10.1089/tmj.2014.0011.
Steinberg, A. M., Brymer, M. J., Kim, S., Briggs, E. C., Ippen, C. G., Ostrowski, S. A., … Pynoos, R. S. (2013). Psychometric properties of the UCLA PTSD reaction index: Part I. Journal of Traumatic Stress, 26(1), 1–9. https://doi.org/10.1002/jts.21780.
Storch, E. A., Larson, M. J., Ehrenreich-May, J., Arnold, E. B., Jones, A. M., Renno, P., … Wood, J. J. (2012). Peer victimization in youth with autism spectrum disorders and co-occurring anxiety: Relations with psychopathology and loneliness. Journal of Developmental and Physical Disabilities, 24(6), 575–590. https://doi.org/10.1007/s10882-012-9290-4.
Valenti, M., Ciprietti, T., Di Egidio, C., Gabrielli, M., Masedu, F., Tomassini, A. R., & Sorge, G. (2012). Adaptive response of children and adolescents with autism to the 2009 earthquake in L’Aquila, italy. Journal of Autism and Developmental Disorders, 42(6), 954–960.
Van der Meer, M., Bakker, A., Schrieken, B. A. L., Hoofwijk, M. C., & Olff, M. (2017). Screening for trauma-related symptoms via a smartphone app: The validity of smart assessment on your mobile in referred police officers. International Journal of Methods in Psychiatric Research. https://doi.org/10.1002/mpr.1579.
Zablotsky, B., Bradshaw, C. P., Anderson, C., & Law, P. A. (2013). The association between bullying and the psychological functioning of children with autism spectrum disorders. Journal of Developmental and Behavioral Pediatrics, 34(1), 1–8. https://doi.org/10.1097/DBP.0b013e31827a7c3a.
Zeedyk, S. M., Rodriguez, G., Tipton, L. A., Baker, B. L., & Blacher, J. (2014). Bullying of youth with autism spectrum disorder, intellectual disability, or typical development: Victim and parent perspectives. Research in Autism Spectrum Disorders, 8(9), 1173–1183. https://doi.org/10.1016/j.rasd.2014.06.001.
Acknowledgments
Measure development and this research were supported by a grant from the Verizon Wireless Company.
Author information
Authors and Affiliations
Contributions
DWH conceived of the study and the measure and drafted the manuscript. EMGR participated in the design of the study, coordinated the research, and helped to draft the manuscript.
Corresponding author
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Hoover, D.W., Romero, E.M.G. The Interactive Trauma Scale: A Web-Based Measure for Children with Autism. J Autism Dev Disord 49, 1686–1692 (2019). https://doi.org/10.1007/s10803-018-03864-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-018-03864-3