Evaluation of the PROMIS Pediatric Parent-Proxy Peer Relationships Measure in Children with

Autism Spectrum Disorder: A Developmental-Behavioral Pediatrics Research Network Study

Marisa Toomey, MD1, Justin Schwartz, MD4, Michele Laverdiere, MD6, Carolyn Bridgemohan, MD4,5, Noelle Huntington, PhD4,5, Ruth Stein, MD6,7, Ellen Silver, PhD6,7, Carole Tucker, PT, PhD2,3, Katherine Bevans, PhD1,2,
Christopher B. Forrest, MD, PhD1,2 and Nathan J. Blum, MD1,2. 1The Children's Hospital of Philadelphia, Philadelphia, PA; 2Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; 3Temple University,
Philadelphia, PA; 4Boston Children's Hospital, Boston, MA; 5Harvard Medical School, Boston, MA; 6Children's Hospital at Montefiore, Bronx, NY; 7Albert Einstein College of Medicine, Bronx, NY

Methods

Abstract
Background: The NIH Patient Reported Outcome Measurement
Information System (PROMIS) initiative has developed a freely available
measure of peer relationships that can be administered efficiently using
computerized adaptive testing (CAT). The PROMIS pediatric parent-proxy
Peer Relationships measure has not been evaluated in children with
Autism Spectrum Disorder (ASD).
Objective: To evaluate the PROMIS pediatric parent-proxy Peer
Relationships measure in 5-12 year old children with ASD.
Design/Methods: Participants were parents of 5-12 year old children with
ASD at one of three participating Developmental-Behavioral Pediatrics
Research Network (DBPNet) sites. These parents completed a
demographic form, the pediatric parent-proxy Peer Relationships
measure, and the Social Responsiveness Scale 2nd Edition (SRS-2), a
standardized measure of social skills concerns. The Peer Relationships
measure was completed using CAT, minimizing the number of items
administered while maintaining measurement precision.
Results: Ninety-seven parents participated in the study. The mean age of
the children was 8 years (SD 2.0), 89 percent were male, and mean IQ
was 85 (range: 39-138). The SRS-2 Total T-score mean was elevated (76,
SD 11). The CAT required just 5 items in 95 of the 97 participants to
achieve adequate levels of precision (equivalent to a reliability coefficient
of >0.90). The T-scores for the Peer Relationships measure were normally
distributed but shifted to the left. The mean T-score was 35.7 (SD 7),
which was approximately 1.5 SD below the mean in the measures
original standardization sample. There was a moderately strong negative
correlation between the Peer Relationships measure and the SRS-2 total
score (r=-0.58, p<0.001) and a mildly strong positive correlations between
the measure and the childs IQ (r = 0.23, p <0.03).
Conclusions: The PROMIS parent-proxy pediatric Peer Relationships
measure may be an efficient, precise, and valid measure of peer
relationships in 5-12 year old children with ASD.

Objectives
Aim: Evaluate the validity of the PROMIS pediatric parent-proxy
Peer Relationships measure in 5- 12 year old children with ASD.
Objective 1: Determine whether the PROMIS measure
assesses the full range of the trait with acceptable
precision in 5-12 year old children with ASD.
Objective 1.2: Determine whether ASD-specific symptom
severity and IQ are associated with scores on the PROMIS
measure in the manner predicted based on existing literature.
Hypotheses: Higher scores on the PROMIS measure
will be inversely associated with ASD severity and
positively associated with IQ.

Results

Recruitment Population:
Site registries (including the Autism Treatment Network at The
Childrens Hospital of Philadelphia)
Electronic medical record screen
Developmental-Behavioral Pediatrics clinics

Inclusion Criteria:
ASD diagnosis confirmed by DSM criteria and either Autism
Diagnostic Observation Schedule (ADOS) or Childhood Autism
Rating Scale (CARS)
IQ test or global developmental assessment performed at > 48
months of age
Parental fluency in English or Spanish

Mean T
score: 35.7
SD: 7.0

Exclusion Criteria:
IQ <25
Moderate or severe hearing loss
Moderate or severe vision impairment

Forms completed on Assessment Center:

Consent Form
Demographic Form
Pediatric parent-proxy Peer Relationships measure (via CAT)
SRS-2

Parenting Stress Index Short Form (PSI-SF)

PROMIS self-report Depression measure

Peer
Relationships
T Score

Demographics
N = 97
Child Age
Percent Male

SRS-2 Total T
Score

Mean or %

SD or
Range

89%

IQ

r: -0.58

r: 0.23

p<0.0001

p<0.03

Moderate negative correlation

with SRS-2 Total T score
Mild positive correlation with IQ

Conclusions

Race
Caucasian

69%

Non-Caucasian

31%

PROMIS pediatric parent-proxy Peer Relationships measure may

be an efficient, precise, valid measure of peer relationships in 5-12
year old children with ASD.

Non-Hispanic

73%

References

Hispanic

23%

Ethnicity

IQ

85

39-138

SRS Total T Score

76

11

Parent Education Level

66% college or
higher

1. DeWalt, D.A., Thiseen, D., Stucky, B.D., et al. (2013).. PROMIS Pediatric Peer Relationships
Scale: Development of a Peer Relationships Item Bank as Part of Social Health Measurement.
Healthy Psychology, 32(10), 1093-1103.
2. Orsmond, G.I., Krauss, M.W., and Seltzer, M.M. (2004). Peer Relationships and Social and
Recreational Activities Among Adolescents and Adults with Autism. Journal of Autism and
Developmental Disorders 34 (3), 245-256.
3. Walton, K.M. and Ingersoll, B.R. (2013). Improving Social Skills in Adolescents and Adults with
Autism and Severe to Profound Intellectual Disability: A Review of the Literature. Journal of
Autism and Developmental Disorders 43 (3), 594-615.

Printed by