Validation of the 36-item and 12-item self-report World Health Organization Disability Assessment Schedule II (WHODAS-II) in individuals with autism spectrum disorder.
The 12- and 36-item WHODAS-II self-report forms are reliable for measuring disability in autistic adults without intellectual disability.
01Research in Context
What this study did
Park et al. (2019) tested two short forms of the World Health Organization Disability Assessment Schedule II. They wanted to know if autistic adults without intellectual disability could reliably fill out the 36-item or 12-item version about their own challenges.
The team checked internal consistency, item-total links, and factor structure. All steps followed standard psychometric rules.
What they found
Both forms held together well. Items hung with their own factors and scores stayed steady.
The authors say the WHODAS-II self-report is 'psychometrically sound' for autistic adults who do not have ID.
How this fits with other research
Riches et al. (2016) and Sasson et al. (2022) also gave thumbs-up to new tools, but their clients had multiple or sensory disabilities plus ID. Those groups needed observer scales or adapted screeners. Ho's study flips the lens: it shows that when ID is absent, autistic adults can speak for themselves.
Sappok et al. (2013) saw mixed results with ADOS and ADI-R in adults with ID. Over-diagnosis was a risk. Ho's positive findings on the WHODAS-II do not clash; they simply shift the focus from diagnosis to self-reported daily functioning in a higher-functioning slice of the spectrum.
Tsakanikos et al. (2011) validated the DAS behavior scale for adults with ID. Like Ho, they found good internal consistency, but their tool targets behavior problems, not disability breadth. Together the papers give BCBAs two validated choices: use DAS for behavior counts and WHODAS-II for life-impact reports, picking the match for each client's profile.
Why it matters
If you serve autistic adults who live, study, or work without daily support, the 12-item WHODAS-II gives a quick, valid snapshot of where they struggle. You can track progress after social-skills training or job coaching in minutes, not hours, and the client supplies the data themselves.
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02At a glance
03Original abstract
The World Health Organization Disability Assessment Schedule II (WHODAS-II) is one of the most widely used generic assessments for measuring disability levels in both clinical and nonclinical populations, with sound psychometrics that is also aligned with the International Classification of Functioning framework. However, its psychometric properties have not been explored extensively in individuals with autism spectrum disorder (ASD). This study examined the psychometric properties of the 36-item and 12-item Self-Report WHODAS-II from 109 individuals diagnosed with ASD and without intellectual disability (IQ ≥ 70). Participants were consecutively recruited from the Brain and Mind Centre in New South Wales, Australia. The WHODAS-II showed adequate internal consistency for all domain scores (α = 0.78-0.97 for 36-item) and for the summary scale (α = 0.95 for 36-item; 0.86 for 12-item). All items also exhibited satisfactory correlations with their respective domain (r = 0.39-0.94 for 36-item) and summary scores (r = 0.42-0.71 for 36-item; 0.42-0.67 for 12-item), except item 4.5 "sexual activity" from the 36-item WHODAS-II (r = 0.19). Concurrent validity was shown by moderate correlations between similar constructs across the WHODAS-II and the World Health Organization Quality of Life BREF (Ps < 0.05). The second-order 7-factor model showed the best fit for the 36-item WHODAS-II, while the second-order 6-factor model demonstrated an acceptable fit for the 12-item WHODAS-II. The model fit could be improved with some modifications. The Schmid-Leiman transformation further confirmed the appropriateness of the second-order factor structure. Overall, the results indicated that the WHODAS-II is a viable generic self-report measure for disability in autistic individuals without ID. Autism Res 2019, 12: 1101-1111. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The majority of autistic people have a disability with a profound or severe limitation in their core activities. However, there is currently limited research identifying reliable and valid self-report measures for disability in the autistic population. This study examined the psychometric properties of the World Health Organization Disability Assessment Schedule II (WHODAS-II) from 109 autistic individuals without intellectual disability. Our results suggest that the WHODAS-II is a viable generic self-report measure for disability in autistic individuals.
Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1002/aur.2115