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Preliminary Validation of the PROMIS® Pediatric Parent-

Proxy Anxiety Measure in Children with Autism Spectrum


Disorder
Samantha R. Dunn DO, Nathan Blum MD, Judith Miller PhD, Ramkrishna Makani MD MPH
Children’s Hospital of Philadelphia, Division of Developmental and Behavioral Pediatrics

INTRODUCTION TABLES & FIGURES RESULTS


§ Autism spectrum disorder (ASD) affects ~1 Table 1. Demographics Mean Range Figure 1a: Histogram of T-scores on the § Table 1 summarizes the demographic characteristics of
(SD) or % PROMIS Pediatric Parent-Proxy Anxiety-
in 59 children 8a measure in children with ASD the study sample:
Child Age (years) 8.9 (3.4) 5-17
§ Higher rates of anxiety disorders in individuals with Percent Male Children 81.6 § The children in the sample were primarily male
ASD compared those without SRS-2 Total T-score 74.4 (10.8) 47-90 (82%)
Percent SRS-2 Total T-score >76 52
§ ~40% of pediatric ASD population § Age ranged from 5-17 years with a mean (SD) of
Childs Race
§ ~7% of the pediatric population without ASD Caucasian 80.5 8.9 (3.4) years
§ There is a need for measures of anxiety for children Black/African-American 10.3 § Parents were predominantly highly educated with
Asian/Asian Indian 4.6
with ASD that are meaningful, valid, efficient, and Multiple Races 3.4
67.5% having graduated from high school
responsive to interventions Other 1.1 § Figures 1a and 1b show the distribution of the T scores:
§ Patient Reported Outcomes measures (PROs) are Child Ethnicity
§ Mean T score (SD) on the Anxiety-8a was 54 (12)
Hispanic/Latino 12.6
essential to assessment of anxiety Not Hispanic/Latino 86.2 § Mean T score (SD) on the PSE-8a was 61 (9)
§ The Patient Reported Outcomes Measurement Missing 1.1 § Table 2 shows the correlations between the measures:
Parent Highest Education Level
Information Systems (PROMIS®) measures are item § The Anxiety-8a correlated moderately with the
Some High School 1.2
banks developed using qualitative methods, classical test High School Graduate or GED 4.6 Figure 1b: Histogram of T-scores on the SCARED (n=85, r=0.669, P<0.001) with highest
theory, and item-response theory Some College 16.1 PROMIS Pediatric Parent-Proxy correlation with the generalized anxiety subscale of
Associate Degree 10.3 Psychological Stress Experiences-8a
§ Two of the PROMIS® pediatric measures that may be measure in children with ASD the SCARED (r=0.656, p<0.001)
Bachelor’s Degree 28.7
relevant to anxiety in the pediatric ASD population are: Advanced Degree 39.1 § A T score of 60 or higher on the Anxiety-8a had
§ Anxiety-8a Child’s Insurance a sensitivity of 74%, and specificity of 80%
Public Insurance Only 35.6
§ Psychological Stress Experiences 8a (PSE-8a) Private Only 35.6
for identifying anxiety based on a positive score on
Other Only 3.4 the SCARED (total score > 25)
OBJECTIVE Public + Private 21.8 § The PSE-8a correlated moderately (n=85, r=0.560,
Private + Other 1.2
Assess the validity of the PROMIS® pediatric parent- Medicaid + Other 1.2 p<0.001) with the SCARED, with highest
proxy Anxiety-8a and PSE-8a measures in 5-17-year-olds Missing 1.2 correlation with the generalized anxiety subscale of
Classroom Type
with ASD the SCARED (r=0.534, p<0.001)
General Education 34.5
Special Education 31.0 § A T-score of 62 or higher on the PSE-8a had a
METHODS General + Special Education 29.9 sensitivity of 74% and specificity of 55% for
Does not attend school 4.6
identifying anxiety based on a positive score on the
§ Parents of 87 children aged 5-17 years with ASD
Table 2. Correlations 1 2 3 4 5 6 7 8 SCARED (total score > 25)
completed the following via REDCap:
§ PROMIS® pediatric parent-proxy Anxiety-8a
§ PROMIS® pediatric parent-proxy PSE 8a
1. Anxiety-8a T-score 1 .610** .669** .511** .656** .473** .453** .311**
CONCLUSION
2. PSE-8a T-score 1 .560** .409** .525** .325** .370** .506**
§ Social Responsiveness Scale, 2nd Edition (SRS-2) The PROMIS® pediatric parent-proxy Anxiety-8a
§ Screen for Child Anxiety Related Emotional 3. SCARED Total Score 1 .782** .729** .801** .767** .665**
measure may be an efficient and valid measure of anxiety
Disorders (SCARED) for 5-17-year-old children with ASD
4. SCARED Panic Score 1 .488** .588** .474** .444**
§ Demographic form
§ Data analysis included: 5. SCARED Generalized Anxiety score 1 .439** .400** .402**
§ Standard descriptive summaries
§ Histogram plotting of the distribution of the T-scores
6. SCARED Separation Anxiety score 1 .518** .590**
on the PROMIS® measures This project was supported in part by grant T77MC00012 and
§ Cronbach's alpha to assess the internal consistency grant T73MC00051 from the Maternal and Child Health Bureau, Health
7. SCARED Social Anxiety Score 1 .354**
Resources and Services Administration, U.S. Department of Health and
reliability of the measures Human Services. This information or content and conclusions are those of
§ Pearson correlations between the PROMIS® the author and should not be construed as the official position or policy of,
8. SCARED School Avoidance Score 1 nor should any endorsements be inferred by HRSA, HHS or the U.S.
measures and the SCARED ** Correlation is significant at the 0.01 level (2-tailed)

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