Factor Structure and Psychometric Properties of the Revised Home Situations Questionnaire for Autism Spectrum Disorder

Background: The original Home Situations Questionnaire (HSQ; Barkley & Edelbrock, 1987) is a 16-item scale developed to examine the severity of noncompliant behavior in children with disruptive behavior disorders.  Previously, we reported on the factor structure of the HSQ in children with pervasive developmental disorders (Chowdhury et al., 2010). Consequently, we further revised the HSQ for use with children with autism spectrum disorder (ASD). To enhance the range of clinical situations covered and to improve reliability, we added seven new items describing home situations where a specific demand is placed on the child. 

Objectives: The purpose of the current investigation was to examine the psychometric properties of the revised and expanded 27-item version of the instrument (referred to as the HSQ-ASD).  We predicted that the seven new items would factor selectively on the previously reported Demand-Specific subscale. We also predicted clear evidence of convergent and divergent validity with measures of problem behavior, adaptive behavior, and IQ, as well as favorable test-retest reliability.

Methods:  Parents completed ratings of 242 disruptive children with ASD (mean age = 5.65 years, SD = 2.21) participating in one of two randomized clinical trials. We used Exploratory Factor Analysis (EFA), with Ordinary Least Squares as the discrepancy function and oblique Crawford-Ferguson quartimax rotations, to assess the factor structure of the HSQ. Pearson correlations were used to assess convergent and divergent validity, and Intra Class Correlations to assess test-retest reliability. 

Results: The EFA yielded a two-factor structure similar to that obtained in our previous psychometric examination (2010).  These two factors, with 12 items each, were Socially Inflexible (alpha = .84) and Demand-Specific (alpha = .89). The underlying themes of these two factors suggest that Social Inflexibility is congruent with deficits in social interactions and rigid adherence to routines that are part of ASD, whereas Demand Specific noncompliance appears to reflect oppositional behavior in response to typical daily requests. Three items that did not meet the cut-off factor loading were discarded from the final composition of the HSQ−ASD. Consistent with our prediction, the EFA confirmed that 6 of 7 newly added items loaded on the Demand-Specific factor. One-to-2-week test-retest reliability was statistically significant for almost all items and also statistically significant for the subscale totals (r= .57 for Socially Inflexible and .58 for Demand Specific). The pattern of correspondence between the HSQ–ASD and parent-rated problem behavior scores, clinician assessment of repetitive behavior, adaptive behavior, and IQ provided evidence for concurrent and divergent validity of the HSQ–ASD.

Conclusions:  In summary, the modified and expanded 24-item HSQ-ASD provides broad coverage of situations associated with noncompliance, thus supporting its use as an outcome measure for disruptive behaviors in this population. Limitations of this study include limited generalizability of findings since all participants were selected for presence of behavior problems.  Future studies will provide a valuable service by evaluating the HSQ-ASD in children with ASD unselected for disruptive behavior and also in adolescent populations with ASDs.