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Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q)

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Abstract

ASD knowledge deficits contribute to disparities in the timing and quality of ASD services. To address the limitations with existing measures of ASD knowledge, we developed and examined the Autism Stigma and Knowledge Questionnaire (ASK-Q), which comprehensively assesses multiple subdomains of ASD knowledge while maintaining strong psychometric support and cross-cultural utility. ASK-Q items derived from the published research are organized into four subscales: (i) diagnosis, (ii) etiology, (iii) treatment, and (iv) stigma. ASK-Q items were selected based on ratings of face, construct, and cross-cultural validity by a group of 16 international researchers. Using Diagnostic Classification Modeling we confirmed the proposed factor structure and evaluated the statistical validity of each item among a lay sample of 617 participants.

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Notes

  1. To calculate the subscores, items that measure two subdomains are still counted as 1 point for each subdomain. For example, the maximum score on the D/S subdomain is equal to 18 and there are 17 simple structure items (see Table 5) and 1 complex item (Item 18 in Table 6).

References

  • Ables, E., Ashby, I., & Swiezy, N. (2011). Autism Knowledge Survey-Revised: Comparison of Knowledge across Role and Experience. Paper presented at the Applied Behavior Analysis International, Denver, CO.

  • Alqahtani, M. M. (2012). Understanding autism in Saudi Arabia: A qualitative analysis of the community and cultural context. Journal of Pediatric Neurology, 10(1), 15–22. doi:10.3233/JPN-2012-0527.

    Google Scholar 

  • Al-Sharbati, M. M., Al-Farsi, Y. M., Ouhtit, A., Waly, M. I., Al-Shafaee, M., Al-Farsi, O., … Al-Adawi, S. (2015). Awareness about autism among school teachers in Oman: A cross-sectional study. Autism: The International Journal of Research and Practice, 19(1), 6–13. doi:10.1177/1362361313508025.

    Article  Google Scholar 

  • Bakare, M. O., Agomoh, A. O., Ebigbo, P. O., Eaton, J., Okonkwo, K. O., Onwukwe, J. U., & Onyeama, G. M. (2009). Etiological explanation, treat-ability and preventability of childhood autism: a survey of Nigerian healthcare workers’ opinion. Annals of General Psychiatry, 8(6), 1–8. doi:10.1186/1744-859X-8-6.

    Google Scholar 

  • Bakare, M. O., Ebigbo, P. O., Ahamefule, O. A., & Nkem, C. M. (2008). Knowledge about childhood autism among health workers (KCAHW) questionnaire: Description, reliability and internal consistency. Clinical Practice and Epidemiology in Mental Health, 4, 17–24. doi:10.1186/1745-0179-4-17.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baron-Epel, O., Kaplan, G., Weinstein, R., & Green, M. S. (2010). Extreme and acquiescence bias in a bi-ethnic population. The European Journal of Public Health, 20(5), 543–548. doi:10.1093/eurpub/ckq052.

    Article  PubMed  Google Scholar 

  • Basha, S. (2014). First National Public Opinion Survey: Palestinians Knowledge and Understanding of Autism, 2014. Italian Journal of Special Education for Inclusion, 2(1), 87–96.

    Google Scholar 

  • Beatty, P. C., & Willis, G. B. (2007). Research synthesis: The practice of cognitive interviewing. Public Opinion Quarterly, 71(2), 287–311. doi:10.1093/poq/nfm006.

    Article  Google Scholar 

  • Behrend, T. S., Sharek, D. J., Meade, A. W., & Wiebe, E. N. (2011). The viability of crowdsourcing for survey research. Behavior Research Methods, 43(3), 800–813. doi:10.3758/s13428-011-0081-0.

    Article  PubMed  Google Scholar 

  • Bracken, B. A., & Barona, A. (1991). State of the art procedures for translating, validating and using psychoeducational tests in cross-cultural assessment. School Psychology International, 12, 119–132. doi:10.1177/0143034391121010.

    Article  Google Scholar 

  • Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s Mechanical Turk a new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6(1), 3–5. doi:10.1177/1745691610393980.

    Article  PubMed  Google Scholar 

  • Campbell, J., & Barger, B. D. (2011). Middle school students’ knowledge of autism. Journal of Autism and Developmental Disorders, 41(6), 732–740. doi:10.1007/s10803-010-1092-x.

    Article  PubMed  Google Scholar 

  • Campbell, J. M., Stoneman, Z., Greenberg, J. S., Gallagher, P., & Simmons, C. (2014). Knowledge of Autism for Parents with Low Literacy. Paper presented at the International Meeting for Autism Research, Atlanta, GA.

  • Capik, C., & Gozum, S. (2015). Psychometric features of an assessment instrument with likert and dichotomous response formats. Public Health Nursing, 32(1), 81–86. doi:10.1111/phn.12156.

    Article  PubMed  Google Scholar 

  • Cheremshynski, C., Lucyshyn, J. M., & Olson, D. L. (2013). Implementation of a culturally appropriate positive behavior support plan with a Japanese mother of a child with autism an experimental and qualitative analysis. Journal of Positive Behavior Interventions, 15(4), 242–253. doi:10.1177/1098300712459904.

    Article  Google Scholar 

  • Cohen, L. L., La Greca, A. M., Blount, R. L., Kazak, A. E., Holmbeck, G. N., & Lemanek, K. L. (2008). Introduction to special issue: Evidence-based assessment in pediatric psychology. Journal of Pediatric Psychology, 33(9), 911–915. doi:10.1093/jpepsy/jsj115.

    Article  PubMed  Google Scholar 

  • Collins, P. Y., Patel, V., Joestl, S. S., March, D., Insel, T. R., Daar, A. S., … Walport, M. (2011). Grand challenges in global mental health. Nature, 475(7354), 27–30. doi:10.1038/475027a.

    Article  PubMed  PubMed Central  Google Scholar 

  • Crocker, L., & Algina, J. (1986). Introduction to classical and modern test theory. Orlando, FL: Holt, Rinehart and Winston.

    Google Scholar 

  • Desai, M. U., Divan, G., Wertz, F. J., & Patel, V. (2012). The discovery of autism: Indian parents’ experiences of caring for their child with an autism spectrum disorder. Transcultural Psychiatry, 49(3–4), 613–637. doi:10.1177/1363461512447139.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dolan, R. P., Goodman, J., Strain-Seymour, E., Adams, J., & Sethuraman, S. (2011). Cognitive lab evaluation of innovative items in mathematics and English/language arts assessment of elementary, middle, and high school students. Retrieved from http://www.pearsonassessments.com/hai/images/tmrs/Cognitive_Lab_Evaluation_of_Innovative_Items.pdf.

  • Ericsson, K. A., & Simon, H. A. (1999). Protocol analysis: Verbal reports as data. Cambridge, MA: Massachusetts Institute of Technology.

    Google Scholar 

  • Farrugia, D. (2009). Exploring stigma: Medical knowledge and the stigmatisation of parents of children diagnosed with autism spectrum disorder. Sociology of Health & Illness, 31(7), 1011–1027.

    Article  Google Scholar 

  • Finn, J. A., Ben-Porath, Y. S., & Tellegen, A. (2015). Dichotomous versus polytomous response options in psychopathology assessment: Method or meaningful variance? Psychological Assessment, 27(1), 184. doi:10.1037/pas0000044.

    Article  PubMed  Google Scholar 

  • Furnham, A., & Buck, C. (2003). A comparison of lay-beliefs about autism and obsessive-compulsive disorder. International Journal of Social Psychiatry, 49(4), 287–307. doi:10.1177/0020764003494006.

    Article  PubMed  Google Scholar 

  • Furr, M. (2011). Scale construction and psychometrics for social and personality psychology. London: SAGE Publications Ltd.

    Book  Google Scholar 

  • Gillespie-Lynch, K., Brooks, P. J., Someki, F., Obeid, R., Shane-Simpson, C., Kapp, S. K., … Smith, & D, S. (2015). Changing college students’ conceptions of autism: an online training to increase knowledge and decrease stigma. Journal of Autism and Developmental Disorders, 45(8), 2553–2566. doi:10.1007/s10803-015-2422-9.

    Article  PubMed  Google Scholar 

  • Gilliam, J. E., & Coleman, M. (1982). A survey of knowledge about autism among experts and caregivers. Behavioral Disorders, 7(3), 189–196.

    Google Scholar 

  • Gray, D. E. (2002). ‘Everybody just freezes. Everybody is just embarrassed’: Felt and enacted stigma among parents of children with high functioning autism. Sociology of Health & Illness, 24(6), 734–749.

    Article  Google Scholar 

  • Haimour, A. I., & Obaidat, Y. F. (2013). School Teachers’ Knowledge about Autism in Saudi Arabia. World Journal of Education, 3(5), 45. doi:10.5430/wje.v3n5p45.

    Article  Google Scholar 

  • Harrison, A. J., Slane, M. M., Hoang, L., & Campbell, J. M. (2016). An International review of autism knowledge assessment measures. Autism. doi:10.1177/1362361316638786.

    PubMed  Google Scholar 

  • Hartley-McAndrew, M., Doody, K. R., & Mertz, J. (2014). Knowledge of autism spectrum disorders in potential first-contact professionals. North American Journal of Medical Sciences, 7(3), 97–102. doi:10.7156/najms.2014.0703097.

    Google Scholar 

  • Høegh, M. C., & Høegh, S.-M. (2009). Trans-adapting outcome measures in rehabilitation: Cross-cultural issues. Neuropsychological Rehabilitation, 19(6), 955–970. doi:10.1080/09602010902995986.

    Article  PubMed  Google Scholar 

  • Jegatheesan, B., Miller, P. J., & Fowler, S. A. (2010). Autism from a religious perspective: A study of parental beliefs in South Asian Muslim immigrant families. Focus on Autism and Other Developmental Disabilities, 25, 98–109. doi:10.1177/1088357610361344.

    Article  Google Scholar 

  • Khatri, G. K., Onta, S. R., Tiwari, S., & Choulagai, B. P. (2011). Knowledge and management practices of paediatricians about autism spectrum disorder in Kathmandu, Nepal. Journal of Nepal Paediatric Society, 31(2), 98–104. doi:10.3126/jnps.v31i2.4640.

    Article  Google Scholar 

  • Kuhn, J. C., & Carter, A. S. (2006). Maternal self-efficacy and associated parenting cognitions among mothers of children with autism. American Journal of Orthopsychiatry, 76(4), 564–575. doi:10.1037/0002-9432.76.4.564.

    Article  PubMed  Google Scholar 

  • Ling, C. Y., Mak, W. W., & Cheng, J. N. (2010). Attribution model of stigma towards children with autism in Hong Kong. Journal of Applied Research in Intellectual Disabilities, 23(3), 237–249. doi:10.1111/j.1468-3148.2008.00456.x.

    Article  Google Scholar 

  • Lozano, L. M., García-Cueto, E., & Muñiz, J. (2008). Effect of the number of response categories on the reliability and validity of rating scales. Methodology, 4(2), 73–79. doi:10.1027/1614-2241.4.2.73.

    Article  Google Scholar 

  • Luong, J., Yoder, M. K., & Canham, D. (2009). Southeast Asian parents raising a child with autism: A qualitative investigation of coping styles. The Journal of School Nursing, 25(3), 222–229. doi:10.1177/1059840509334365.

    Article  PubMed  Google Scholar 

  • Magaña, S., Lopez, K., Aguinaga, A., & Morton, H. (2013). Access to diagnosis and treatment services among Latino children with autism spectrum disorders. Intellectual and Developmental Disabilities, 51(3), 141–153. doi:10.1352/1934-9556-51.3.141.

    Article  PubMed  Google Scholar 

  • Mak, W. W., & Kwok, Y. T. (2010). Internalization of stigma for parents of children with autism spectrum disorder in Hong Kong. Social Science & Medicine, 70(12), 2045–2051. doi:10.1111/j.1468-3148.2008.00426.x.

    Article  Google Scholar 

  • Mandell, D. S., Wiggins, L. D., Yeargin-Allsopp, M., Carpenter, L. A., Daniels, J., Thomas, K. C., … Kirby, R. S. (2009). Racial/Ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99(3), 493–498. doi:10.2105/AJPH.2007.131243.

    Article  PubMed  PubMed Central  Google Scholar 

  • Muhammad, Z., Al-Deen, L. D., & Muhsin, H. A. (2013). Knowledge about childhood autism among care providers in Baghdad. Arab Journal of Psychiatry, 24(1), 27–31. doi:10.12816/0000095.

    Article  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2005). Mplus: Statistical analysis with latent variables: User’s guide. Los Angeles: Muthén & Muthén.

    Google Scholar 

  • Naqvi, N. C., Johnson, H. L., Sophal, S., Vibol, D., Sophearin, D., & Verkuilen, J. (2014). Cambodian Caregiver’s Self-Efficacy and Knowledge Beliefs Regarding their Children with Developmental Disabilities–An Exploratory Study. International Journal of Disability, Community and Rehabilitation, 13, (published online ahead of print).

  • Obeid, R., Daou, N., DeNigris, D., Shane-Simpson, C., Brooks, P. J., & Gillespie-Lynch, K. (2015). A cross-cultural comparison of knowledge and stigma associated with autism spectrum disorder among college students in Lebanon and the United States. Journal of Autism and Developmental Disorders, 45(11), 3520–3536. doi:10.1007/s10803-015-2499-1.

    Article  PubMed  Google Scholar 

  • Olivier, M. A., & Ah Hing, A. D. (2009). Autistic spectrum disorder (ASD): Parental challenges and strategies. Vulnerable Children and Youth Studies, 4(1), 58–66. doi:10.1080/17450120802290572.

    Article  Google Scholar 

  • Perry, A., Condillac, R. A., & Freeman, N. L. (2002). Best practices and practical strategies in the assessment and diagnosis of autism. Journal on Developmental Disabilities, 9(2), 61–75.

    Google Scholar 

  • Rahbar, M. H., Ibrahim, K., & Assassi, P. (2011). Knowledge and attitude of general practitioners regarding autism in Karachi, Pakistan. Journal of Autism and Developmental Disorders, 41(4), 465–474. doi:10.1007/s10803-010-1068-x.

    Article  PubMed  Google Scholar 

  • Rupp, A., Templin, J., & Henson, R. (2010). Diagnostic measurement: Theory, methods, and applications. New York: Guilford.

    Google Scholar 

  • Samadi, S. A., McConkey, R., & Kelly, G. (2012). The information and support needs of Iranian parents of children with autism spectrum disorders. Early Child Development and Care, 182(11), 1439–1453. doi:10.1080/03004430.2011.616931.

    Article  Google Scholar 

  • Segall, M. J. (2011). Exploring Student and Teacher Variables Related to Inclusion of Students with Autism Spectrum Disorder in General Education Classrooms. (Dissertation), University of Georgia.

  • Shapiro, D. N., Chandler, J., & Mueller, P. A. (2013). Using Mechanical Turk to study clinical populations. Clinical Psychological Science, 1(2), 213–220. doi:10.1177/2167702612469015.

    Article  Google Scholar 

  • Shaukat, F., Fatima, A., Hussein, M. A. G., Ismail, O., & Zehra, N. (2014). Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi. Journal of Pakistan Medican Association, 64(11), 1331–1334.

    Google Scholar 

  • Shtayermman, O. (2009). An exploratory study of the stigma associated with a diagnosis of Asperger’s syndrome: The mental health impact on the adolescents and young adults diagnosed with a disability with a social nature. Journal of Human Behavior in the Social Environment, 19(3), 298–313. doi:10.1080/10911350902790720.

    Article  Google Scholar 

  • Shyu, Y.-I. L., Tsai, J.-L., & Tsai, W.-C. (2010). Explaining and selecting treatments for autism: Parental explanatory models in Taiwan. Journal of Autism and Developmental Disorders, 40(11), 1323–1331. doi:10.1007/s10803-010-0991-1.

    Article  PubMed  Google Scholar 

  • Singh, K., Ang, S. H., & Leong, S. M. (2003). Increasing replication for knowledge accumulation in strategy research. Journal of Management, 29(4), 533–549. doi:10.1016/S0149-2063(03)00024-2.

    Article  Google Scholar 

  • Stone, W. L. (1987). Cross disciplinary perspectives on autism. Journal of Pediatric Psychology, 12, 615–630. doi:10.1093/jpepsy/12.4.615.

    Article  PubMed  Google Scholar 

  • Stone, W. L., & Rosenbaum, J. L. (1988). A comparison of teacher and parent views of autism. Journal of Autism and Developmental Disorders, 18(3), 403–414. doi:10.1007/BF02212195.

    Article  PubMed  Google Scholar 

  • Templin, J., & Bradshaw, L. (2013). Measuring the reliability of diagnostic classification model examinee estimates. Journal of Classification, 30(2), 251–275.

    Article  Google Scholar 

  • Voelkel, H., LeCroy, C. W., Williams, L. R., & Holschuh, J. (2013). The Full Spectrum: Hispanic Understanding of Autism Best Practices in Mental Health (Vol. 9, pp. 31–46). Chicago: Lyceum Books, Inc.

    Google Scholar 

  • Wang, J., Zhou, X., Xia, W., Sun, C., Wu, L., & Wang, J. (2012). Autism awareness and attitudes towards treatment in caregivers of children aged 3–6 years in Harbin, China. Social Psychiatry and Psychiatric Epidemiology, 47(8), 1301–1308. doi:10.1007/s00127-011-0438-9.

    Article  PubMed  Google Scholar 

  • Zucker, S., Sassman, C., & Case, B. J. (2004). Cognitive labs. San Antonio, TX: Harcourt Assessment, 10(11), 2006.

    Google Scholar 

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Author Contributions

AJH participated in the design and coordination of the study, acquired data, participated in the development of the pilot version of the measure, aided in interpretation of statistical results, and the writing of the manuscript; LPB lead the statistical analyses and interpretation of results, and made a substantial contribution to drafting and revising the manuscript; NCN participated in the design of the study, participated in the development of the pilot version of the measure and participated in the drafting and revision of the manuscript; MLP participated in the coordination of the study, acquired data, and contributed substantially to drafting and revising the manuscript; JMC participated in the design of the study, participated in the development of the pilot version of the measure and participated in the drafting and revision of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Educational Psychology, University of Georgia, Aderhold Hall 110 Carlton Street, Athens, GA, 30602, USA

    Ashley J. Harrison, Laine P. Bradshaw & Madison L. Paff

  2. The Center for Autism and Behavioral Education Research, Athens, GA, USA

    Ashley J. Harrison

  3. Iona College, New Rochelle, NY, USA

    Nilofer C. Naqvi

  4. University of Kentucky, Lexington, KY, USA

    Jonathan M. Campbell

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  1. Ashley J. Harrison
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  2. Laine P. Bradshaw
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  3. Nilofer C. Naqvi
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  4. Madison L. Paff
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  5. Jonathan M. Campbell
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Corresponding author

Correspondence to Ashley J. Harrison.

Appendix

Appendix

See Table 9.

Table 9 ASK-Q questions with subscales, citations and mean scores on validity questions rated by international researchers
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Harrison, A.J., Bradshaw, L.P., Naqvi, N.C. et al. Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q). J Autism Dev Disord 47, 3281–3295 (2017). https://doi.org/10.1007/s10803-017-3242-x

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