Development of the Behavioral Inflexibility Scale for Children with Autism Spectrum Disorder and Other Developmental...

Area of Science:

• Developmental Psychology
• Clinical Psychology
• Pediatric Psychiatry

Background:

• Behavior inflexibility (BI) is characterized by rigid behavioral patterns, hindering adaptation to environmental changes.
• Existing measures may not adequately capture BI in children with autism spectrum disorder (ASD) and other developmental disabilities.

Purpose of the Study:

• To develop and validate a parent-reported outcome measure for behavior inflexibility (BI) in children with ASD and related developmental disabilities.
• To establish the psychometric properties of the new scale, including reliability and validity.

Main Methods:

• A multi-step iterative process involving expert feedback, literature review, and focus groups generated 62 candidate items.
• A consensus process refined the items to a final 38-item scale.
• Parents of 943 children with ASD (ages 3-18) completed an online survey, with a subset providing test-retest data.

Main Results:

• Factor analyses supported a single-construct measurement for the 38 items of the Behavioral Inflexibility Scale (BIS).
• The BIS demonstrated high internal consistency (α = 0.97) and temporal stability (r = 0.92).
• Correlations with related measures, such as the Repetitive Behavior Scale-Revised and Social Communication Questionnaire, indicated good convergent validity.

Conclusions:

• The 38-item BIS is a valid and reliable parent-reported measure for assessing behavior inflexibility in children with ASD.
• The scale effectively captures the range of BI severity, from mild to severe, in this population.
• The BIS can be a valuable tool for clinicians and researchers evaluating BI in children with developmental disabilities.