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Content Validity of the K-CAT® Assessing Mental Health Challenges in Autism: A Mixed Methods Analysis of Perspectives from Autistic Youth, Caregivers, and Clinicians

J Autism Dev Disord. 2026 May 28. doi: 10.1007/s10803-026-07367-4. Online ahead of print.

ABSTRACT

PURPOSE: Mental health (MH) challenges in autistic youth are often under-identified due in part to limited availability of assessment tools developed or adapted for the autism population. The K-CAT®, a battery of computerized adaptive tests assessing up to nine MH domains in the general population, shows promise in addressing this need. Because these general instruments may not be valid or acceptable for use with autistic individuals, we evaluated the K-CAT®‘s content validity for autistic youth with input from the autism community.

METHODS: Feedback was obtained from autistic youth, caregivers, and clinicians on the K-CAT® through a mixed methods research design. One-hundred-fifty-one youth and caregivers provided feedback on ease of administration, relevance, comprehensiveness, and comprehensibility of the K-CAT® overall. Thirty youth/caregiver dyads and 15 clinicians then participated in the mixed methods study of the K-CAT® at the module- and item-level.

RESULTS: While participants had positive impressions of the K-CAT® overall, weaknesses were identified by most participants and several recommendations for change were provided. The modules identified as most challenging were the Mania, Oppositional Defiant Disorder, and Conduct Disorder (CD) modules of the Child Version and the CD, Mania, and Anxiety modules of the Parent Version. The most commonly reported concerns were comprehension/clarity issues and symptom overlap between MH conditions and autism.

CONCLUSIONS: Modifications to the K-CAT® appear both necessary and feasible. Findings will inform the development of a K-CAT® Autism Version, which has the potential to transform the detection and monitoring of MH symptoms in autistic youth.

PMID:42207447 | DOI:10.1007/s10803-026-07367-4

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