1 - (SYM 3) the Childhood Adversity and Social Stress (CASS) Questionnaire, Parent Report Version: A Childhood Adversity Measure Tailored to Autistic Youth

Research suggests autistic youth experience both more traditional and distinct stressors relative to non-autistic youth. Findings from a literature review, qualitative interviews with autistic adults and caregivers and a Delphi poll of experts were used to develop an autism-tailored tool, the Childhood Adversity and Social Stress (CASS) questionnaire. The CASS includes 13 traditional and 7 autism-related adversities (e.g. stigma, marginalization, betrayal, restraint, and social interaction-related, sensory-related and change-related stress). After endorsing adversities, parents rate adversity regularity (occurring once, a few times, many times) and traumatic impact (i.e. event rated as “very upsetting for more than a few weeks,” “still upsetting” to the child) consistent with SAMSHA's (2014) definition of trauma as an event or circumstance that results in lasting mental harm. 

This study examined the occurrence, regularity and traumatic impact of CASS items as well as adversity profiles in 749 autistic youth ages 8-17 years (80.3% male) recruited via the Interactive Autism Network, an online research registry. Parents of youth completed the CASS along with other behavioral questionnaires (not reported). Latent class analysis (LCA) identified profiles of adversity exposure. 

Autism-related items, specifically stigma, change and interaction-related stress were among the most prevalent and traumatic adversities, endorsed as traumatic in >14-18% of the sample (Tables 1-2). Sensory-related stress was the most common adversity (67%), but less likely to be traumatic (28% of endorsed cases). Betrayal and marginalization were less common, but traumatic for >50% when endorsed–which was true for bullying, neglect and sexual abuse (67%). The most common traumatic adversity was bullying (affecting 21% youth). The majority of autism-related adversities were chronic (i.e. occurring “many times” for >40% of exposed youth). The LCA supported 3 adversity profiles: Sensory/Change Stress (49%), Social Exclusion (41%), and Complex Stress (10%). 

Using an autism-tailored measure, we found parents identified bullying, betrayal, stigma, marginalization, change-related and sensory-related stress as the most common traumatic adversities experienced within a large, mostly male community sample of autistic youth. Findings suggest that querying a broader range of adversities may enhance estimations of the occurrence and health implications of traumatic events amongst autistic populations.