Psychometric Validation of the Autism Impact Measure (AIM)

  • Richard HoughtonEmail author
  • Brigitta Monz
  • Kiely Law
  • Georg Loss
  • Stephanie Le Scouiller
  • Frank de Vries
  • Tom Willgoss


The Autism impact measure (AIM) is a caregiver-reported questionnaire assessing autism symptom frequency and impact in children, previously shown to have good test–retest reliability, convergent validity and structural validity. This study extended previous work by exploring the AIM’s ability to discriminate between ‘known-groups’ of children, and estimating thresholds for clinically important responses. Data were collected online and electronically on computer and mobile devices; hence, it was also possible to confirm other psychometric properties of the AIM in this format. This study provides confirmatory and additional psychometric validation of the AIM. The AIM offers a valid, quick and inexpensive method for caregivers to report core symptoms of autism spectrum disorder (ASD) including communication deficits, difficulties with social interactions and repetitive behaviors.


Autism spectrum disorder Outcome Treatment Symptoms Psychometric validation 



We are grateful to all the families in SPARK that participated in this study, as well as the SPARK clinical sites and SPARK staff. We also thank Tempus Dynamics, under contract with SPARK, for converting the study questionnaires into an electronic format and managing the study workflow.

Author contributions

BM, KL and TW had the study idea. RH, BM, KL, GL and TW participated in its design and coordination. SLS and FV reviewed the study protocol. RH and SLS performed the statistical analysis. All authors were involved in the interpretation of the data. RH made the first draft of the manuscript, after which, all authors made comments to draft versions and read and approved the final version.


This study was funded by F. Hoffmann-La Roche Ltd. KL’s time was supported by the Simons Foundation Autism Research Initiative and an infrastructure award (PPRN-1501-26462) from the Patient-Centered Outcomes Research Institute (PCORI).

Compliance with ethical standards

Conflicts of interest

RH, BM, GL, SLS and TW are full-time employees of F. Hoffmann-La Roche Ltd., which has drugs for autism under development. BM and TW holds stock options from F. Hoffmann-La Roche Ltd. KL is a research consultant with the Simons Foundation Autism Research Initiative which funds and operates SPARK. FV: none.

Informed consent

Informed consent was obtained from all individual participants included in the study. The study protocol was approved by Western IRB.

Supplementary material

10803_2019_4011_MOESM1_ESM.docx (51 kb)
Supplementary material 1 (DOCX 50 kb)


  1. Barthélémy, C., Roux, S., Adrien, J. L., Hameury, L., Guérin, P., Garreau, B., et al. (1997). Validation of the Revised Behavior Summarized Evaluation Scale. Journal of Autism and Developmental Disorders, 27, 139–153.CrossRefGoogle Scholar
  2. Chandler, S., Charman, T., Baird, G., Simonoff, E., Loucas, T., Meldrum, D., et al. (2007). Validation of the social communication questionnaire in a population cohort of children with autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1324–1332.CrossRefGoogle Scholar
  3. Constantino, J. N., & Gruber, C. P. (2012). Social responsiveness scale. SRS) (Torrance: Western Psychological Services.Google Scholar
  4. Coon, C. D., & Cappelleri, J. C. (2016). Interpreting change in scores on patient-reported outcome instruments. Ther. Innov. Regul. Sci., 50, 22–29.Google Scholar
  5. Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.CrossRefGoogle Scholar
  6. Deshpande, P. R., Rajan, S., Sudeepthi, B. L., & Abdul Nazir, C. P. (2011). Patient-reported outcomes: A new era in clinical research. Perspect. Clin. Res., 2, 137–144.CrossRefGoogle Scholar
  7. Engel, L., Beaton, D. E., & Touma, Z. (2018). Minimal clinically important difference: A review of outcome measure score interpretation. Rheumatic Diseases Clinics of North America, 44, 177–188.CrossRefGoogle Scholar
  8. Fayers, P. M., & Hays, R. D. (2014). Don’t middle your MIDs: regression to the mean shrinks estimates of minimally important differences. Qual. Life Res. Int. J. Qual. Life Asp. Treat. Care Rehabil., 23, 1–4.CrossRefGoogle Scholar
  9. Freeman, B. J., Ritvo, E. R., Yokota, A., & Ritvo, A. (1986). A scale for rating symptoms of patients with the syndrome of autism in Real life settings. J. Am. Acad. Child Psychiatry, 25, 130–136.CrossRefGoogle Scholar
  10. Kanne, S. M., Gerber, A. J., Quirmbach, L. M., Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A. (2011). The role of adaptive behavior in autism spectrum disorders: Implications for functional outcome. Journal of Autism and Developmental Disorders, 41, 1007–1018.CrossRefGoogle Scholar
  11. Kanne, S. M., Mazurek, M. O., Sikora, D., Bellando, J., Branum-Martin, L., Handen, B., et al. (2014). The autism impact measure (AIM): initial development of a new tool for treatment outcome measurement. Journal of Autism and Developmental Disorders, 44, 168–179.CrossRefGoogle Scholar
  12. Lord, C., Rutter, M., DiLavore, P.C., Risi, S., Gotham, K., and Bishop, S. (2012). Autism diagnostic observation schedule, second edition (Torrance, CA: Western Psychological Services).Google Scholar
  13. Mayes, S., & Calhoun, S. (2011). Impact of IQ, age, SES, gender, and race on autistic symptoms. Res. Autism Spectr. Disord., 5, 749–757.CrossRefGoogle Scholar
  14. Mazurek, M. O., Carlson, C., Baker-Ericzén, M., Butter, E., Norris, M., & Kanne, S. (2018). Construct Validity of the Autism Impact Measure (AIM). Disord: J. Autism Dev.CrossRefGoogle Scholar
  15. Mirenda, P., Smith, I. M., Vaillancourt, T., Georgiades, S., Duku, E., Szatmari, P., et al. (2010). Validating the repetitive behavior scale-revised in young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40, 1521–1530.CrossRefGoogle Scholar
  16. Monz, B., Houghton, R., Law, K., & Loss, G. (2019). Treatment patterns in children with autism in the United States. Autism Res., 12, 517–526.CrossRefGoogle Scholar
  17. Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003). Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Medical Care, 41, 582–592.Google Scholar
  18. Nunnally, J.C., and Bernstein, I.H. (1994). Psychometric theory (McGraw-Hill Companies).Google Scholar
  19. Rosen, T., E., Spaulding, C., J., Gates, J., A., and Lerner, M., D. (2019). Autism severity, co-occurring psychopathology, and intellectual functioning predict supportive school services for youth with autism spectrum disorder. Autism.Google Scholar
  20. Rosenberg, R. E., Kaufmann, W. E., Law, J. K., & Law, P. A. (2011). Parent Report of Community Psychiatric Comorbid Diagnoses in Autism Spectrum Disorders. Treat: Autism Res.CrossRefGoogle Scholar
  21. Rutter, M., Bailey, A., Berument, S. K., Le Couteur, A., & Lord, C. (2003). Social communication questionnaire. SCQ) manual (Los Angeles: Western Psychological Services.Google Scholar
  22. SPARK Consortium. (2018). SPARK: A US Cohort of 50,000 Families to Accelerate Autism Research. Neuron, 97, 488–493.CrossRefGoogle Scholar
  23. Spaulding, C. J., Lerner, M. D., & Gadow, K. D. (2017). Trajectories and correlates of special education supports for youth with autism spectrum disorder and psychiatric comparisons. Autism, 21, 423–435.CrossRefGoogle Scholar
  24. Wright, A., Hannon, J., Hegedus, E. J., & Kavchak, A. E. (2012). Clinimetrics corner: a closer look at the minimal clinically important difference (MCID). J. Man. Manip. Ther., 20, 160–166.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Personalized Health Care Data Science, Real World Data, F. Hoffmann-La Roche LtdBaselSwitzerland
  2. 2.School CAPHRIMaastricht UniversityMaastrichtThe Netherlands
  3. 3.Kennedy Krieger InstituteBaltimoreUSA
  4. 4.Johns Hopkins University School of MedicineBaltimoreUSA
  5. 5.Patient Centered Outcomes Research, Biometrics, Roche Products, LtdWelwyn Garden CityUK
  6. 6.Department of Clinical Pharmacy & ToxicologyMaastricht UMC+The Netherlands

Personalised recommendations