Assessing Psychiatric Symptoms in Autistic Youth Using the K-CAT®.

PURPOSE: While highly prevalent, mental health (MH) challenges in autistic youth often go unrecognized due in part to the lack of an accurate, comprehensive MH assessment tool. The K-CAT® was developed to address barriers to identification of MH concerns in the general population offering efficient electronic measurement of up to nine MH domains. While several features support its use with autistic youth, the K-CAT® has neither been extensively used nor studied with this population. Therefore, this study evaluated how the K-CAT® performed with autistic youth with varying presentations. METHODS: One hundred fifty-five 7-to-17-year-old autistic youth without intellectual disability and their caregivers completed the K-CAT® and several additional measures remotely. Data on K-CAT® administration and results were analyzed and compared across relevant clinical characteristics, including age, language level, and autism severity. RESULTS: The K-CAT® identified a range of MH concerns, and prevalence estimates aligned with previous research. However, K-CAT® completion appeared more difficult for younger participants and for autistic youth with lower receptive language scores. Several K-CAT® Child Version scores were significantly associated with receptive language level whereas all K-CAT® Parent Version scores were associated with autism severity estimates. While K-CAT® results were highly correlated with existing measures, parent-child agreement was relatively low and variable across subgroups of autistic youth. CONCLUSIONS: Results may signal challenges with using the existing K-CAT® to assess autistic youth. K-CAT® adaptations are likely necessary to improve accessibility, linguistic clarity, and diagnostic specificity and will be important to promote scalable, equitable MH screening for autistic youth.