An International Review of Autism Knowledge Assessment Measures

Background:  

Low-levels of knowledge about ASD symptoms, etiology and treatment can profoundly increase the amount of burden experienced by families with children diagnosed with ASD.  Lower ASD knowledge often results in the proliferation of stigmas and misconceptions that disadvantage families impacted by ASD (Khan et al., 2012). ASD-specific knowledge deficits also play a key role in current disparities in the timing and quality of ASD services throughout the United States and globally, particularly in low- and middle-income countries. 

Objectives:   A primary goal of this review was to examine global use of ASD knowledge measures published in peer-reviewed journals and assess measure adherence to psychometric standards guidelines that define “well-established assessment” practices (Cohen et al., 2008).

Methods:  

The present study conducted a systematic review of Western and International literature to examine quantitative measures used to specifically assess ASD knowledge published in. This review identified 39 unique ASD knowledge measures across 52 studies.

Results:

Peer-reviewed research reveals the construct of ASD knowledge has been examined in 18 different countries around the world, 50% (n = 26) were conducted in North America, 15% (n = 8) in the Eastern Mediterranean region, 13% (n = 7) in Europe, 10% (n = 5) in the Western Pacific region, 8% (n = 4) in Africa, and 4% (n = 2) in Southeast Asia.  Measures used in each study were evaluated in terms of psychometric strength. Of the 52 studies reviewed, only 7.7% were rated as using a measure with strong psychometric support compared to 46.2% that were rated as using a measure with no reported psychometric support. Most measures examined did not meet the definition for a “well-established assessment” as most researchers developed independent surveys for their specific study.  As evidence of this, among the 39 measures examining ASD knowledge, only four meet this best practice assessment standard (Stone, 1987; Bakare et al., 2008, Ross & Cuskelly, 2006; Segall, 2008).  Additionally, we examined subdomains of ASD of knowledge assessed. Of 39 different measures, 46.2% (n = 18) examined specific subdomains of ASD knowledge through the use of subscales, such as diagnosis and symptoms, etiology, and treatment (e.g., Bakare et al., 2009; Furnham & Buck, 2003; Heidgerken et al., 2005; Koyama et al., 2009; Kuhn & Carter, 2006; Segall & Campbell, 2012; Shaukat et al., 2014).

Conclusions:  

While demonstrating the international relevance of examining the construct of ASD knowledge, this review reveals important concerns about psychometric quality of ASD knowledge measures currently utilized and a lack of measurement consistency in the field.  Without defensible utility, inferences made from existing ASD knowledge instruments may counterproductively misguide efforts to study ASD knowledge and related constructs. Based on these findings, we present recommendations for the development of a cross-culturally valid and psychometrically sound measure of ASD knowledge is discussed. Progress toward a more psychometrically sound measure of ASD knowledge is imperative if we are to accurately assess the nature and extent of knowledge disparities and develop successful methods for reducing the impact of low ASD literacy on families.