Abstract
Our purpose in this study was to validate the Quality of Life for Children with Autism Spectrum Disorder scale. We first conducted an exploratory factor analysis to examine the factor structure. Results suggested that a three-factor model (Interpersonal Relationships, Self-Determination, and Emotional Well-Being) should be retained. Next, we conducted a confirmatory factor analysis to compare a higher-order factor model and additional models. Results showed acceptable model fit for the higher-order factor model. The scale had excellent reliability (α = .90) for the overall scale and for the three subscales (Interpersonal Relationships, α = .87; Self-Determination, α = .81; and Emotional Well-Being, α = .66). The 16-item scale showed convergent and divergent validity. Implications for future research and practice are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). American Psychiatric Publishing.
Barker, C., Pistrang, N., & Elliott, R. (1994). Research methods in clinical and counseling psychology. Wiley.
Bastiaansen, D., Koot, H. M., Bongers, I. L., Varni, J. W., & Verhulst, F. C. (2004). Measuring quality of life in children referred for psychiatric problems: Psychometric properties of the PedsQL 4.0 generic core scales. Quality of Life Research, 13, 489–495. https://doi.org/10.1023/B:QURE.0000018483.01526.ab
Bauminger, N. (2002). The facilitation of social-emotional understanding and social interaction in high-functioning children with autism: Intervention outcomes. Journal of Autism and Developmental Disorders, 32(4), 283–298. https://doi.org/10.1023/A:1016378718278
Benson, J., & Nasser, F. (1998). On the use of factor analysis as a research tool. Journal of Vocational Education Research, 23(1), 13–33
Bors, D. A., Vigneau, F., & Lalande, F. (2006). Measuring the need for cognition: Item polarity, dimensionality, and the relation with ability. Personality and Individual Differences, 40(4), 819–828. https://doi.org/10.1016/j.paid.2005.09.007
Burgess, A. F., & Gutstein, S. E. (2007). Quality of life for people with autism: Raising the standard for evaluating successful outcomes. Child and Adolescent Mental Health, 12(2), 80–86. https://doi.org/10.1111/j.1475-3588.2006.00432.x
Burke, B. G. (1999). Item reversals and response validity in the Job Diagnostic Survey. Psychological Reports, 85(1), 213–219. https://doi.org/10.2466/pr0.1999.85.1.213
Burns, G. L., Geiser, C., Servera, M., Becker, S. P., & Beauchaine, T. P. (2019). Application of the bifactor S-1 model to multisource ratings of ADHD/ODD symptoms: An appropriate bifactor model for symptom ratings. Journal of Abnormal Child Psychology, 48(7), 881–894. https://doi.org/10.1007/s10802-019-00608-4
Cabrera-Nguyen, P. (2010). Author guidelines for reporting scale development and validation results in the Journal of the Society for Social Work and Research. Journal of the Society for Social Work and Research, 1(2), 99–103. https://doi.org/10.5243/jsswr.2010.8
Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1(2), 245–276. https://doi.org/10.1207/s15327906mbr0102_10
Centers for Disease Control and Prevention (2020). Identifying autism among children: An easy-read summary. Retrieved October 4, 2020 from https://www.cdc.gov/ncbddd/autism/addm-community-report/an-easy-read-summary.html
Chalmers, R. P. (2018). On misconceptions and the limited usefulness of ordinal alpha. Educational and Psychological Measurement, 78(6), 1056–1071. https://doi.org/10.1177/0013164417727036
Chezan, L. C., Drasgow, E., & Grybos, E. M. (2020). Conversation skills and self-initiated interactions in young adults with autism and intellectual disability. Research in Autism Spectrum Disorder, 75, 1–12. https://doi.org/10.1016/j.rasd.2020.101554
Child, D. (2006). The essentials of factor analysis. (3rd ed.). Continuum.
Cholewicki, J., Drasgow, E., & Chezan, L. C. (2019). Parental perception of quality of life for children with autism spectrum disorder. Journal of Developmental and Physical Disabilities, 31, 575–592. https://doi.org/10.1007/s10882-019-09660-w
Claes, C., Van Hove, G., van Loon, J., Vandevelde, S., & Schalock, R. L. (2010). Quality of life measurement in the field of intellectual disabilities: Eight principles for assessing quality of life-related personal outcomes. Social Indicators Research, 98, 61–72. https://doi.org/10.1007/s11205-009-9517-7
Coghill, D., Danckaerts, M., Sonuga-Barke, E., & Sergeant, J. (2009). Practitioner review: Quality of life in child mental health-conceptual challenges and practical choices. Journal of Child Psychology and Psychiatry, 50(5), 544–561. https://doi.org/10.1111/j.1469-7610.2009.02008.x
Comrey, A. L., & Lee, H. B. (1992). A first course in factor analysis. (2nd ed.). Academic Press.
Crocker, L., & Algina, J. (1986). Introduction to classical and modern test theory. Holt, Rinehart, and Winston.
Cronbach, L. J. (1951). Coefficient alpha and their internal structure of tests. Psychometrika, 16, 297–334. https://doi.org/10.1007/BF02310555
Cummings, R. A. (1997). Assessing quality of life. In R. I. Brown (Ed.), Assessing quality of life for people with disabilities: Models, research, and practice. (pp. 116–150). Stanley Thornes.
Dancey, C. P., & Reidy, J. (2007). Statistics without maths for psychology. Pearson Education.
Dardas, L. A., & Ahmad, M. M. (2014). Validation of the world health organization’s quality of life questionnaire with parents of children with autistic disorder. Journal of Autism and Developmental Disorders, 44, 2257–2263. https://doi.org/10.1007/s10803-014-2110-1
de Vries, M., & Geurts, H. (2015). Influence of autism traits and executive functioning on quality of life in children with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 2734–2743. https://doi.org/10.1007/s10803-015-2438-1
Ding, R., He, W., Liu, J., Liu, T., Zhang, D., & Ni, S. (2021). Interpersonal regulation questionnaire (IRQ): Psychometric properties and gender differences in Chinese young adolescents. Psychological Assessment. https://doi.org/10.1037/pas0000997
Downs, J., Jacoby, P., Leonard, H., Epstein, A., Murphy, N., Davis, E., Reddihough, D., Whitehouse, A., & Williams, K. (2019). Psychometric properties of the quality of life inventory-disability (QI-Disability) measure. Quality of Life Research, 28, 783–794. https://doi.org/10.1007/s11136-018-2057-3
Feeny, D., Torrance, G. W., & Furlong, W. (1996). Health Utilities Index. In B. Spilker (Ed.), Quality of life and pharmacoeconomics. (2nd ed.). Lippincott- Raven Press.
Gau, S. S. F., Liu, L. T., Wu, Y. Y., Chiu, Y. N., & Tsai, W. C. (2013). Psychometric properties of the Chinese version of the social responsiveness scale. Research in Autism Spectrum Disorders, 7(2), 349–360. https://doi.org/10.1016/j.rasd.2012.10.004
Gignac, G. E. (2008). Higher-order models versus direct hierarchical models: Gas superordinate or breadth factor? Psychology Science, 50(1), 21
Gomez, J. L. C., de la Fuente Anuncibay, R., & Conde, R. M. S. (2010). Evaluation of the quality of life in people with autistic spectrum disorder. Vertex, 21(90), 117–125
Gomez, L. E., Alcedo, M. A., Arias, B., Fontanil, Y., Arias, V. B., Monsalve, A., & Verdugo, M. A. (2016). A new scale for the measurement of quality of life in children with intellectual disabilities. Research in Developmental Disabilities, 53–54, 399–410. https://doi.org/10.1016/j.ridd.2016.03.005
Gomez, L. E., Moran, M. L., Alcedo, M. A., Arias, V. B., & Verdugo, M. A. (2020). Addressing quality of life of children with autism spectrum disorder and intellectual disability. Intellectual and Developmental Disabilities, 59(5), 393–408. https://doi.org/10.1352/1934-9556-58.5.393
Gorsuch, R. L. (1983). Factor analysis. (2nd ed.). Erlbaum.
Granpeesheh, D., Tarbox, J., Dixon, D. R., Carr, E., & Herbert, M. (2009). Retrospective analysis of clinical records in 38 cases of recovery from autism. Annals of Clinical Psychiatry, 21(4), 195–204
Hofstede, G. (1984). The cultural relativity of the quality of life concept. Academy of Management Review, 9(3), 389–398. https://doi.org/10.5465/amr.1984.4279653
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
Ikeda, E., Hinckson, E., & Krägeloh, C. (2014). Assessment of quality of life in children and youth with autism spectrum disorder: A critical review. Quality of Life Research, 23, 1069–1085. https://doi.org/10.1007/s11136-013-0591-6
Johnson, R., & Morgan, G. (2016). Survey scales: A guide to development, analysis, and reporting. Guilford Publications.
Kaiser, H. F. (1960). The application of electronic computers to factor analysis. Educational and Psychological Measurements, 20, 141–151
Kamp-Becker, I., Schröder, J., Remschmidt, H., & Bachmann, C. J. (2010). Health-related quality of life in adolescents and young adults with high functioning autism-spectrum disorder. Psycho-Social Medicine, 7, 1–10. https://doi.org/10.3205/psm000065
Keith, K. D., & Schalock, R. L. (1994). The measurement of quality of life in adolescence: The quality of student life questionnaire. The American Journal of Family Therapy, 22, 83–87. https://doi.org/10.1080/01926189408251300
Kuhlthau, K., Orlich, F., Hall, T., Sikora, D., Kovacs, E., Delahaye, J., & Clemons, T. E. (2010). Health-related quality of life in children with autism spectrum disorders: Results from the Autism Treatment Network. Journal of Autism and Developmental Disorders, 40(6), 721–729. https://doi.org/10.1007/s10803-009-0921-2
Limbers, C., Heffer, R., & Varni, J. W. (2009). Health-related quality of life and cognitive functioning from the perspective of parents of school-aged children with Asperger’s Syndrome utilizing the PedsQL. Journal of Autism and Developmental Disorders, 39(11), 1529–1541. https://doi.org/10.1007/s10803-009-0777-5
Lindell, M. K., & Whitney, D. J. (2001). Accounting for common method variance in cross-sectional research designs. Journal of Applied Psychology, 86(1), 114–121. https://doi.org/10.1037/0021-9010.86.1.114
MacCallum, R. C., Widaman, K. F., Zhang, S., & Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4(1), 84–89
Matson, J. L. (2007). Determining treatment outcome in early intervention programs for autism spectrum disorders: A critical analysis of measurement issues in learning based interventions. Research in Developmental Disabilities, 28(2), 207–218. https://doi.org/10.1016/j.ridd.2005.07.006
Mattejat, F., & Remschmidt, H. (2006). ILK Inventar zur Erfassung der Lebensqualita¨t bei Kindern und Jugendlichen. [assessment instrument]. Bern.
McConachie, H., Mason, D., Parr, J. R., Garland, D., Wilson, C., & Rodgers, J. (2018). Enhancing the validity of a quality of life measure for autistic people. Journal of Autism and Developmental Disorders, 48, 1596–1611. https://doi.org/10.1007/s10803-017-3402-z
Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user’s guide (8th ed.). Author.
Myles, B. S., Bock, S. J., & Simpson, R. L. (2001a). Asperger Syndrome Diagnostic Scale (ASDS). [Assessment instrument]. PRO-ED.
Myles, B. S., Bock, S. J., & Simpson, R. (2001b). Asperger syndrome diagnostic scale examiner’s manual. Berlin: Pro Ed.
Nandy, K. (2012). Understanding and quantifying effect sizes. Retrieved April 2021, from http://nursing.ucla.edu/workfiles/research/Effect%20Size%204–9–2012.pdf
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory. McGraw-Hill.
Osborne, J. W. (2015). What is rotating in exploratory factor analysis? Practical Assessment, Research, and Evaluation, 20(1), 1–7. https://doi.org/10.7275/hb2g-m060
Plimley, I. A. (2007). A series of quality of life issues and people with autism spectrum disorders. British Journal of Learning Disabilities, 35, 205–213. https://doi.org/10.1111/j.1468-3156.2007.00448.x
Renty, J. O., & Roeyers, H. (2006). Quality of life in high-functioning adults with autism spectrum disorder: The predictive value of disability and support characteristics. Autism, 10(5), 511–524. https://doi.org/10.1177/1362361306066604
Riley, A. W., Robertson, J., Forrest, C. B., Green, B., Rebok, G., & Starfield, B. (2001). Manual for the child health and illness profile-child edition (CHIP-CE). The Johns Hopkins University.
Rodriguez, N. M., & Thompson, R. H. (2015). Behavioral variability and autism spectrum disorder. Journal of Applied Behavior Analysis, 48(1), 167–187. https://doi.org/10.1002/jaba.164
Roszkowski, M. J., & Soven, M. (2010). Shifting gears: Consequences of including two negatively worded items in the middle of a positively worded questionnaire. Assessment & Evaluation in Higher Education, 35(1), 113–130. https://doi.org/10.1080/02602930802618344
Schalock, R. L., & Alonso, M. A. V. (2002). Handbook on quality of life for human service practitioners. American Association on Mental Retardation.
Schalock, R. L., & Verdugo, M. A. (2013). The transformation of disability organization. Journal of Intellectual and Developmental Disabilities, 51(4), 273–286. https://doi.org/10.1352/1934-9556-51.4.273
Schalock, R. L., Keith, K. D., Verdugo, M. A., & Gomez, L. E. (2009). Quality of life model development and use in the field of intellectual disability. In R. Kober (Ed.), Enhancing the quality of life of people with intellectual disabilities: From theory to practice.Springer.
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23–74
Sheldrick, R. C., Neger, E. N., Shipman, D., & Perrin, E. C. (2012). Quality of life of adolescents with autism spectrum disorders: Concordance among adolescents’ self-reports, parents’ reports, and parents’ proxy reports. Quality of Life Research, 21(1), 53–57. https://doi.org/10.1007/s11136-011-9916-5
Shipman, D. L., Sheldrick, R. C., & Perrin, E. C. (2011). Quality of life in adolescents with autism spectrum disorders: Reliability and validity of self-reports. Journal of Developmental and Behavioral Pediatrics, 32(2), 85–89. https://doi.org/10.1097/DBP.0b013e318203e558
Smerbeck, A. (2019). The survey of favorite interests and activities: Assessing and understanding restricted interests in children with autism spectrum disorder. Autism, 23(1), 247–259. https://doi.org/10.1177/1362361317742140
Statistical Package for the Social Sciences. (2016). Statistics (Version 24.0) [Computer Software]. IBM Corp. Retrieved March 2021, from https://www.ibm.com/products/spss-statistics
Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics. (6th ed.). Pearson.
Tavernor, L., Barron, E., Rodgers, J., & McConachie, H. (2012). Finding out what matters: Validity of quality of life measurement in young people with ASD. Child Care, Health, and Development, 39(4), 592–601. https://doi.org/10.1111/j.1365-2214.2012.01377.x
Thompson, B. (2004). Exploratory and confirmatory factor analysis. American Psychological Association.
Tilford, J. M., Payakachat, N., Kovacs, E., Pyne, J. M., Brouwer, W., Nick, T. G., Bellando, J., & Kuhlthau, K. (2012). Preference-based health-related quality-of-life outcomes in children with autism spectrum disorders. PharmacoEconomics, 30(8), 661–679. https://doi.org/10.2165/11597200-000000000-00000
Travis, L. T., & Sigman, M. (1998). Social deficits and interpersonal relationships in autism. Mental Retardation and Developmental Disabilities Research Reviews, 4, 65–72
Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQLTM 4.0: Reliability and validity of the pediatric quality of life inventoryTM Version 4.0 Generic Core Scales in Healthy and Patient Populations. Medical Care, 39(8), 800–812
Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQL™* 4.0 as a pediatric population health measure: Feasibility, reliability, and validity. Ambulatory Pediatrics, 3(6), 329–341. https://doi.org/10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2
Wechsler, D. (1974). Manual for the Wechsler Intelligence Scale for Children-Revised. Psychological Corporation.
Wehmeyer, M. L., Shogren, K. A., Zager, D., Smith, T. E. C., & Simpson, R. (2010). Research-based principles and practices for educating students with autism: Self-determination and social interactions. Education and Training in Autism and Developmental Disabilities, 45(4), 475–486
White-Koning, M., Grandjean, H., Colver, A., & Arnaud, C. (2008). Parent and professional reports of the quality of life of children with cerebral palsy and associated intellectual impairment. Developmental Medicine and Child Neurology, 50(8), 618–624. https://doi.org/10.1111/j.1469-8749.2008.03026.x
Williams, W. C., Morelli, S. A., Ong, D. C., & Zaki, J. (2018). Interpersonal emotion regulation: Implications for affiliation, perceived support, relationships, and well-being. Journal of Personality and Social Psychology, 115(2), 224–254. https://doi.org/10.1037/pspi0000132
Wolfe, K., Pound, S., McCammon, M. N., Chezan, L. C., & Drasgow, E. (2019). A systematic review of interventions to promote varied social-communication behavior in individuals with autism spectrum disorder. Behavior Modification, 43(6), 790–818. https://doi.org/10.1177/0145445519859803
Woods, C. M. (2006). Careless responding to reverse-worded items: Implications for confirmatory factor analysis. Journal of Psychopathology and Behavioral Assessment, 28(3), 186–191. https://doi.org/10.1007/s10862-005-9004-7
Worthington, R., & Whittaker, T. (2006). Scale development research: A content analysis and recommendations for best practices. Counseling Psychologist, 34, 806–838. https://doi.org/10.1177/0011000006288127
Zumbo, B. D., Gadermann, A. M., & Zeisser, C. (2007). Ordinal versions of coefficients alpha and theta for Likert Rating Scales. Journal of Modern Applied Statistical Methods, 6(1), 21–29. https://doi.org/10.22237/jmasm/1177992180
Funding
No funding was received for conducting this study.
Author information
Authors and Affiliations
Contributions
Author contributions
Conceptualization: [Laura C. Chezan, Erik Drasgow, Judith M. Cholewicki]; Methodology: [** Liu, Ruyi Ding]; Writing—original draft preparation: [Laura C. Chezan]; Writing—review and editing: [Laura C. Chezan, Erik Drasgow, ** Liu]; Recruitment: [Laura C. Chezan, Adam Warman]. All authors commented on previous versions of the manuscript and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
All participants signed an electronic informed consent prior to participating in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Chezan, L.C., Liu, J., Cholewicki, J.M. et al. A Psychometric Evaluation of the Quality of Life for Children with Autism Spectrum Disorder Scale. J Autism Dev Disord 52, 1536–1552 (2022). https://doi.org/10.1007/s10803-021-05048-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-021-05048-y