Reliability and validity of the Pediatric Anxiety Rating Scale modified for autism spectrum disorder.
Brenna B Maddox, Luc Lecavalier, Judith S Miller and 9 others
PMID 32476441WHAT IT FOUND
The modified Pediatric Anxiety Rating Scale (PARS-ASD) reliably measures anxiety severity in autistic youth, including those with lower IQs.
It takes under 20 minutes, requires brief training, and correlates strongly with parent-reported anxiety scales while distinguishing anxiety from core autism symptoms.
Key findings
01The PARS-ASD demonstrated excellent internal consistency and good to excellent test-retest and inter-rater reliability.
02The scale correlated most strongly with other parent-reported anxiety measures (PRAS-ASD and SCARED), supporting its validity as an anxiety-specific tool distinct from general behavior or autism severity.
03The study included children with IQ scores as low as 47, and modifications reduced reliance on verbal expression in favor of observable behaviors, making it suitable for non-speaking or intellectually disabled youth.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was one of convenience and not representative of all autistic youth; most participants were Caucasian and from higher socioeconomic backgrounds. Validity conclusions rely solely on parent-report measures for comparison; the study did not include self-report, teacher-report, or behavioral observations. The study did not include a formal diagnostic assessment of co-occurring psychiatric conditions. The sample included a range of anxiety severity but was not a clinical trial population, so sensitivity to treatment change has not yet been tested.
Declared interests
Funded by the NIH (Extramural) and non-US government sources. The authors declare no specific conflicts of interest in the provided text, though they note the senior author (LS) led the modification and training.
The easy way to misread this
Do not use the PARS-ASD as a diagnostic tool for specific anxiety disorders. It measures overall anxiety severity and is designed to complement, not replace, multi-informant assessments. Also, note that the study did not test if the scale detects changes in anxiety over time due to treatment, so it should not be used alone to judge intervention efficacy.