
Public awareness of autism spectrum disorder: A cross-sectional study using the Autism Spectrum Knowledge Scale – General Population version (ASKSG) tool.
Zahedeh Khoshnazar 1 ℗, Mehran Rostami Varnosfaderani 1, Fatemeh Fotovvati 2, Fatemeh Mohammadjani 3, Mohammadreza Asghari 3, MohammadMahdi Yeganeh 3, Parisa Hosseini Koukamari 4 ©
Abstract
Introduction: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by deficits in social communication and repetitive behaviors. Despite its growing global prevalence, public awareness remains low, hindering timely diagnosis, intervention, and inclusion. Assessing public knowledge requires valid, culturally adapted tools. The ASKSG is a comprehensive, reliable instrument based on current diagnostic standards. This study evaluates its validity in an Iranian population attending comprehensive health centers in .... Methods and Materials: This cross-sectional study aimed to validate the Persian version of the ASKSG. The questionnaire underwent forward and backward translation. Face validity was assessed qualitatively with experts and target group members. Content validity was evaluated both qualitatively and quantitatively. Fifteen professionals—including clinical psychologists, psychiatrists, pediatricians, occupational therapists, and health educators—reviewed items. The Content Validity Ratio (CVR) was calculated using Lawshe’s formula: CVR=nE−N/2N/2CVR = \frac{n_E - N/2}{N/2}CVR=N/2nE−N/2. Items with CVR ≥ 0.49 were retained. The Content Validity Index (CVI) was assessed for simplicity, relevance, and clarity, and items scoring ≥ 0.79 were considered acceptable. Subsequently, in a cross-sectional study, this tool was employed to assess awareness about the autism spectrum. Results: A total of 200 individuals participated (mean age = 33.3, SD = 9.38). Most were female (68.5%), urban residents (94%), and had no prior contact with individuals diagnosed with autism (75%). The majority held a bachelor’s degree (42.5%) and were married (59%). The mean autism knowledge score, assessed via the Persian ASKSG, was 11.71 (SD = 6.60), indicating low to moderate knowledge. Only 35% correctly identified autism prevalence in Iran, and 34% rejected the false claim that vaccines cause autism. While 58% recognized stereotyped behaviors and atypical play as core features, 47% believed or were unsure that lack of maternal affection causes autism, and 80% had similar views about treatment effectiveness. Additionally, 61.5% wrongly assumed most individuals with autism never learn to speak. Moreover, 89.5% believed only physicians should diagnose autism, and 77% were unaware that early signs may appear before age two. All items had impact scores above 1.5, and CVR and CVI values exceeded 0.99 and 0.79, respectively, confirming the questionnaire’s acceptable content validity. Additionally, the Cronbach’s alpha coefficient was 0.80, indicating good internal consistency. Conclusion and Discussion: Findings reveal significant gaps in public knowledge of autism spectrum disorder and persistent misconceptions about its cause, treatment, and early diagnosis. These results highlight the urgent need for appropriate strategies to address misconceptions, enhance awareness, and support early detection and intervention for ASD.
Keywords: Validation, psychometric properties, Autism, Knowledge, comprehensive health centers