Development and Validation of the Autism Behavior Assessment Scale (ABAS)

Background: Autism Spectrum Disorder (ASD) encompasses a range of neurodevelopmental conditions characterized by impairments in social communication, restricted and repetitive behaviors, and sensory sensitivities. Despite increased awareness, timely diagnosis in Türkiye remains limited due to the lack of culturally appropriate, psychometrically robust assessment tools. Objective: This study aimed to develop, validate, and standardize the Autism Behavior Assessment Scale (ABAS) as a reliable and culturally adapted tool for assessing ASD-related behaviors in individuals aged 3-24 years in Türkiye. Methods: Employing a three-phase, nine-step scale development framework, data were gathered from 1275 informants (parents and professionals) across 14 provinces. The ABAS comprises 36 items rated on a three-point Likert scale, spanning four subscales: Restricted Repetitive Behaviors & Sensory Sensitivity (RRBSS), Social Interaction (SI), Social Communication (SC), and Non-Developmental Speech (NDS). Psychometric analyses included exploratory and confirmatory factor analysis, reliability testing, and validation against established instruments. Results: The four-factor structure was confirmed via EFA and CFA with excellent model fit. The ABAS demonstrated strong internal consistency (α = 0.91-0.96), test-retest reliability (r = 0.83), and criterion validity (r = 0.93 with GARS-2-TV; r = 0.84 with U-ODKL). Discriminant validity analyses showed that the ABAS accurately differentiated individuals with ASD from individuals with intellectual disabilities (ID) and individuals with hearing impairments (AUC = 0.99). Conclusions: The ABAS is a psychometrically sound, developmentally sensitive, and culturally grounded instrument for identifying and monitoring ASD-related behaviors in Türkiye. It holds promise for improving early detection and guiding educational and clinical interventions.