Development of the Parent-Rated Anxiety Scale for Youth With Autism Spectrum Disorder

Lawrence Scahill, Luc Lecavalier, Robert T. Schultz, Andrea Nichole Evans, Brenna Maddox, Jill Pritchett, John Herrington, S. Gillespie, Judith Miller, R. Toby Amoss, Michael G. Aman, K. Bearss, Kenneth Gadow, Michael C. Edwards

Research output: Contribution to journalArticlepeer-review

72 Scopus citations


Objective: Anxiety is common in youth with autism spectrum disorder (ASD). There is no accepted outcome measure for anxiety in this population. Method: Following a series of focus groups with parents of youth with ASD, we generated 72 items (scored 0−3). Parents of 990 youth with ASD (aged 5−17 years; 80.8% male) completed an online survey. Factor analysis and item response theory analyses reduced the content to a single factor with 25 items. Youth with at least mild anxiety (n = 116; aged 5−17 years; 79.3% male) participated in a comprehensive clinical assessment to evaluate the validity and reliability of the 25-item Parent-Rated Anxiety Scale for ASD (PRAS-ASD). Results: In the online sample, the mean PRAS-ASD score was 29.04 ± 14.9 (range, 0−75). The coefficient α was 0.93. The item response theory results indicated excellent reliability across a wide range of scores with low standard errors. In the clinical sample (n = 116), the PRAS-ASD mean was 31.0 ± 15.6 (range, 1−65). Pearson correlations with parent ratings of ASD symptom severity, repetitive behavior, and disruptive behavior ranged 0.33 to 0.66, supporting divergent validity of the PRAS-ASD. Pearson correlation with a parent-rated measure of anxiety used in the general pediatric population of 0.83 supported convergent validity. A total of 40 participants (32 boys, 8 girls; mean age, 11.9 ± 3.4 years) returned at time 2 (mean, 12.2 days) and time 3 (mean, 24.2 days). Intraclass correlation showed test−retest reliabilities of 0.88 and 0.86 at time 2 and time 3, respectively. Conclusion: The 25-item PRAS-ASD is a reliable and valid scale for measuring anxiety in youth with ASD.

Original languageEnglish (US)
Pages (from-to)887-896.e2
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number9
StatePublished - Sep 2019


  • anxiety
  • autism
  • outcome measurement

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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