Utility of the Modified Anxiety Dimensional Observation Scale in Autistic Preschoolers with Varying Intellectual Functioning

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Hogan, A., Smith, K., Mian, N. D., Black, C., Hunt, E., Knott, C., Moser, C., Smith, J., Caravella, K. E., Hills, K. J., Fairchild, A., Carter, A. S., & Roberts, J. (2025). Utility of the Modified Anxiety Dimensional Observation Scale in Autistic Preschoolers with Varying Intellectual Functioning. Journal of Clinical Child & Adolescent Psychology, 55(1), 106-120. https://doi.org/10.1080/15374416.2025.2454647

Publication date: 24 Feb 2025 Added to AutiHub: 26 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
13
Publication authors identified as autistic
1 / 13 (7.7%)
  1. Abigail Hogan
  2. Kayla Smith *
  3. Nicholas D. Mian
  4. Conner Black
  5. Erin Hunt
  1. Chandler Knott
  2. Carly Moser
  3. Jenna Smith
  4. Kelly E. Caravella
  5. Kimberly J Hills
  1. Amanda Fairchild
  2. Alice S. Carter
  3. Jane Roberts

Abstract

OBJECTIVE: Co-occurring anxiety affects 40-80% of autistic individuals; however, little is understood about how anxiety manifests in young autistic children, especially those with intellectual disability (ID), partly due to the paucity of measures designed to assess anxiety symptoms in this population. The present study examined the utility of the Modified Anxiety Dimensional Observation Scale (M-Anx-DOS), an observational measure of anxiety-related behaviors, in preschool-aged autistic children with and without ID. METHOD: This study included 48 autistic children (Mean age = 43.96 months; 81.3% with ID) and 30 non-autistic (NA) controls (Mean age = 43.66 months). Anxiety-related behaviors were measured during the M-Anx-DOS. Parent-reported anxiety symptoms were assessed via the Preschool Anxiety Scale-Revised (PAS-R). RESULTS: Groups exhibited comparable scores on both the M-Anx-DOS and PAS-R. Within the autism group, a subset of M-Anx-DOS scores were related to age, autistic features, or IQ. The M-Anx-DOS exhibited excellent inter-rater reliability and acceptable internal consistency. Convergent validity was promising, with specific M-Anx-DOS scores correlated with parent-reported social, separation, and overall anxiety symptoms. M-Anx-DOS scores were not correlated with parent-reported ADHD or externalizing symptoms, suggesting strong discriminant validity. CONCLUSIONS: This study provides preliminary evidence of the reliability and validity of the M-Anx-DOS. These findings are promising given the importance of observational measurement of anxiety and lack of existing measures for this critical developmental period. Given the sample size and the complexity of identifying prodromal signs of anxiety in young autistic preschoolers with ID, future longitudinal work is essential to replicate and extend this work.

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These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:01.

Cited references
71
With a DOI
66
Without a DOI, from raw bibliography text
5
1 / 71 (1.4%) cited references include at least one author identified as autistic.
References with data to complete
2 / 71 (2.8%)
References with detected author names
69 / 71 (97.2%)
Without detected author names
2
Without a structured title
1
Without a stable identifier
4
References with raw author names still to review
1
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
415
From DOI or external metadata
415
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
2
121 / 415 (29.2%) names are linked to an author already present in AutiHub. 294 / 415 (70.8%) names are not yet linked.
Names linked to a person identified as autistic
10 / 415 (2.4%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 10 / 121 (8.3%). Distinct people identified as autistic: 10 / 343 (2.9%).
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