Psychometric Evaluation of the Attune & Stimulate-Checklist for Assessing the Emotional State of People With Severe to Profound Intellectual Disabilities.

The informant-reported analyses used only the control group of 55 participants, not the total sample of 102. Mood analyses were limited by timing: 22 participants were available for positive mood and interest, and 21 for negative mood, because videos were not always recorded within the 2-week questionnaire period. There is no gold standard for emotional state in this population, so validity rests on correlations with related constructs. The over-stimulated and negative aroused categories were rare in the sample, so their reliability and validity were poorly supported. Skin conductance was measured during free daily interaction, and movement could still affect the signal. The design was cross-sectional and correlational, so it cannot show that checklist scores cause or accurately detect specific emotions. Proxy questionnaires depend on caregiver interpretations of idiosyncratic behaviour.

The work was funded by ZonMw and the Bartiméus Fund. The skin conductance sensor sock was developed by Eindhoven University of Technology, Vrije Universiteit Amsterdam, and care-provider Bartiméus. The authors declared no conflicts of interest.

Do not treat the Attune & Stimulate checklist as a fully validated measure of all emotional states or as a physiological emotion test. The strongest evidence was for optimal aroused behaviour, while negative arousal and over-stimulation were rare and weakly supported, and observed arousal did not predict skin conductance.