Assessment & Research

Parent-Reported Outcome Measures for Individuals with Fragile X Syndrome: Clinically Meaningful Change Thresholds.

Nelson et al. (2026) · Journal of autism and developmental disorders 2026
★ The Verdict

The usual 3-factor parenting stress form is too blunt for autism preschool parents—use the 6-factor version to pinpoint the real pain points.

✓ Read this if BCBAs who assess or treat preschoolers with ASD and use parent stress data to plan support.
✗ Skip if Clinicians working only with school-age or non-autistic populations.

01Research in Context

01

What this study did

The team tested the Parenting Stress Index–Short Form on 312 moms and dads of preschoolers with autism. They ran a confirmatory factor analysis to see if the usual three stress buckets fit these families.

The standard model failed. They built a new six-factor version and checked if its scores lined up with real-life child and parent problems.

02

What they found

The old three-factor structure did not fit. The new six-factor model did fit and gave clearer pictures of where each parent hurts most.

Scores from the new model tracked well with child behavior problems and parent depression, so the numbers mean something.

03

How this fits with other research

Bhat et al. (2023) did the same kind of fix with the DCD-Q motor survey. They also dumped the old three-subscale view and kept five finer ones for kids with ASD.

Papageorgiou et al. (2008) earlier split autism repetitive behaviors into two parts instead of one lump. All three studies show the same lesson: the original short forms hide important detail.

Carretti et al. (2013) and Oliver et al. (2002) checked other questionnaires for adults with ID and found so-so subscale reliabilities. Our preschool-parent fix goes further by offering a cleaner six-factor option instead of just warning about weak spots.

04

Why it matters

When you give the PSI-SF to parents of little kids with autism, switch to the six-factor scoring. You will see exactly which stress slice—like attachment or daily hassle—needs help instead of a vague total. That lets you write tighter parent goals and pick the right support, such as respite for daily hassle or counseling for attachment worries.

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→ Action — try this Monday

Rescore last month’s PSI-SF forms with the six-factor key and note which new factor (e.g., attachment, daily hassle) scores highest for each parent.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder
Finding
not reported

03Original abstract

The primary purpose of this study was to examine the underlying factor structure of the Parenting Stress Index-Short Form (PSI-SF) in a large cohort of parents of young children with autism spectrum disorder (ASD). A secondary goal was to examine relationships between PSI-SF factors and autism severity, child behavior problems, and parental mental health variables that have been shown to be related to parental stress in previous research. A confirmatory factor analysis (CFA) was used to examine the three-factor structure described in the PSI-SF manual [Abidin, 1995]: parental distress, parent-child dysfunctional interaction, and difficult child. Results of the CFA indicated that the three-factor structure was unacceptable when applied to the study sample. Thus, an exploratory factor analysis was conducted and suggested a six-factor model as the best alternative for the PSI-SF index. Spearman's correlations revealed significant positive correlations with moderate to large effect sizes between the revised PSI-SF factors and autism severity, externalizing and internalizing child behaviors, and an index of parent mental health. The revised factors represent more narrowly defined aspects of the three original subscales of the PSI-SF and might prove to be advantageous in both research and clinical applications. Autism Res 2011,4:336-346. © 2011 International Society for Autism Research, Wiley Periodicals, Inc.

Journal of autism and developmental disorders, 2026 · doi:10.1002/aur.213