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Caregiver- and Child-Reported Anxiety Using an Autism-Specific Measure: Measurement Properties and Correlates of the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD) in Verbal Young People with ASD

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Abstract

Identifying and measuring anxiety in young people on the autism spectrum can be challenging. The present study investigated the use of the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD), a self- and caregiver-rated screening tool in a Singaporean sample of ninety-one verbal autistic youths and their caregivers. Internal consistency ranged from satisfactory to desirable (α = .74–.92). Convergent validity with medium-large effect size was established using a structured diagnostic interview, the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). ASC-ASD scores were positively associated with autistic symptoms and response patterns indicated strong endorsement of autism-specific items. The findings are discussed in relation to existing literature on assessment of anxiety in ASD and in light of the study’s strengths and limitations.

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Data Availability

The datasets analysed in our study are not publicly available as they contain potentially identifying or sensitive patient information, and open access sharing was not included in our ethics approval.

Notes

  1. The clinic serves young people with behavioural and emotional problems including those with ASD, ADHD and mood-related conditions such as anxiety and depression.

  2. Some participants received their clinical diagnosis before 2013, the year DSM-5 was published.

  3. English is one of Singapore’s four official languages and is the main language used in formal settings – education, administration, law and business.

  4. The Anxiety Disorders Interview Schedule with Autism Spectrum Addendum (ADIS/ASA; Kerns et al. 2017) was initially considered for the diagnostic interview as it is developed for children with ASD, however administration of this tool requires specialist training in the US which was not feasible.

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Acknowledgments

We gratefully acknowledge the resources provided by the Institute of Mental Health Research Fund for this study and would like to thank the participating families and clinical staff from the Child Guidance Clinic for their contribution.

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Author notes

  1. Chui Pin Soh

    Present address: Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore

  2. Iliana Magiati

    Present address: School of Psychological Science, University of Western Australia, Crawley, Australia

Authors and Affiliations

  1. Department of Psychology, National University of Singapore, Singapore, Singapore

    Chui Pin Soh & Iliana Magiati

  2. Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore

    Tze Jui Goh

  3. General Psychiatry, Institute of Mental Health, Singapore, Singapore

    Min Sung

  4. Child Guidance Clinic, #03-01 Health Promotion Board 3 Second Hospital Avenue, Singapore, 168937, Singapore

    Chui Pin Soh

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Contributions

All authors conceptualized and designed this research; CPS, TJG and MS participated in the acquisition of data; CPS, IM and TJG contributed to the interpretation and analysis of data, CPS was the lead author in drafting the paper with input and revisions by IM, TJG and MS. All authors read and approved the final manuscript.

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Appendix

Appendix

See Tables 8 and 9.

Table 8 Coordinates of Sensitivity and Specificity at Different Cut-off Values for ASC-ASD-C
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Table 9 Coordinates of Sensitivity and Specificity at Different Cut-off Values for ASC-ASD-P
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Soh, C.P., Goh, T.J., Magiati, I. et al. Caregiver- and Child-Reported Anxiety Using an Autism-Specific Measure: Measurement Properties and Correlates of the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD) in Verbal Young People with ASD. J Autism Dev Disord 51, 2646–2662 (2021). https://doi.org/10.1007/s10803-020-04739-2

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