UCLA

Personalized assessment measures focusing on caregiver-reported problems have been found to be psychometrically robust and useful in monitoring the clinical response of typically developing children in psychological interventions due to the high sensitivity to change of such measures (e.g., Weisz et al., 2011). However, until recently, these measures have not addressed autism-related challenges, and there is still a need for a personalized assessment of children and youth with autism that 1) is broadly inclusive of the heterogeneity of autism-related needs, 2) addresses the critical perspective of caregivers, and 3) facilitates intervention monitoring for specific children. This project explores the development and psychometric properties of a newly developed personalized semi-structured interview for caregivers of children with autism drawing from the ratings methodology used in the Top Problems Assessment (TPA) developed by Weisz and colleagues (2011) in two phases. The newly developed semi-structured interview (known namely as the YTP-Interview) protocol addresses multiple autism-related clinical areas and identifies the top problems salient to the caregivers, allowing for rapid repeated administration throughout intervention. Through qualitative exploration, the pilot study (Phase 1) of the project found that extensive clinical information can be obtained from this personalized semi-structured interview. Caregivers reported individualized problems in relation to six clinical domains (e.g., externalizing behavior, peer engagement), demonstrating rich insight into their child’s specific challenges and needs. Phase 2 of the project examined the test-retest reliability, convergent and discriminant validity, sensitivity and specificity, and face validity of the YTP-Interview across six domains: Dysregulated and Disruptive Behavior, Anxiety and Depression, Restricted and Repetitive Behaviors, Peer Engagement in School and Community, Conversation and Friendship, and Self-Care Skills. Data was collected from 31 caregivers of children with autism at three time points: Baseline, Week 1, and Week 2 of intervention. Spearman’s rho correlations indicated strong test-retest reliability for all domains, with particularly high correlations for the Peer Engagement and Conversation and Friendship domains. The ROC curve analysis provided valuable insights into the utility of the YTP-Interview for identifying clinically significant problems in children with autism. The analysis revealed that the optimal cut-scores demonstrated acceptable levels of sensitivity and specificity across five of the six clinical areas. The face validity results demonstrated high accuracy across all domains, with percentages ranging from 98% to 100%. Furthermore, caregiver satisfaction with the YTP-Interview was overwhelmingly positive, with 100% of participants indicating they were very satisfied with the process. Overall, the findings suggest that the YTP-Interview is a reliable and valid tool for identifying and monitoring the top problems in children with autism as reported by their caregivers, demonstrating strong psychometric properties that support its use in clinical practice and research applications. The results from this study are promising, suggesting that this new measure has the potential to align assessment and intervention foci with the needs and aspirations of families.