The psychoeducational profile, third edition (PEP-3) scale: A cross-cultural validation for Iranian children with autism

This study evaluated the cultural applicability of the Psychoeducational Profile-3 (PEP-3) for Iranian children with autism spectrum disorder (ASD). Using a multi-center design across 17 provinces, we assessed 524 children (349 ASD, 125 intellectual disabilities, 50 neurotypical controls) aged 2–19 years (M=7.83, SD=3.49). The PEP-3 demonstrated strong psychometric properties: excellent internal consistency (α=.85–.94), test-retest reliability (ICC=.82–.91), and moderate-to-high interrater reliability (r = .72–.85). Caregiver reports showed robust internal consistency (α=.95–.99) but lower parent-professional agreement, suggesting cultural variations in behavioral interpretation. Significant concurrent validity was found with CARS-2 (r = -.64 to −.71), GARS-2 (r = -.58 to −.69), and ADI-R (r = -.52 to −.61). Discriminant validity between ASD and neurotypical development was strong (p < .001 for all composites), but discrimination between ASD and intellectual disability was limited, indicating overlapping scores on the three domains assessed by PEP-3). An analysis of scores on the three domains based on median splits identified three clinically meaningful ASD subgroups: global delays (37%), global strengths (39%), and mixed profiles (24%), to assist with tailored educational planning. Culturally adapted components (Persian alphabet/numerals, modified reading passages) were well-received, though outdated visual materials require updating. Administration times (45–180 min) may limit clinical utility in resource-constrained settings, supporting development of a brief version. The PEP-3 demonstrates valid applicability for Iranian children with ASD when supplemented by caregiver input, contributing to culturally responsive assessment practices and providing implementation guidance for Iran's health and education systems. • Cross-Cultural Validation: First large-scale validation of PEP-3 for Persian-speaking children with ASD, addressing gap in culturally appropriate tools. • Rigorous Methodology: Multi-center study across 17 Iranian provinces with diverse sample (N=524: ASD, ID, controls). • Strong Psychometrics: High reliability (α=.85–.94, ICC=.82–.91) and convergent validity with CARS-2, GARS-2, ADI-R. • Cultural Adaptations: Successfully integrated Persian alphabet/numerals, showing clinical utility; visuals need updating. • Subgroup Identification: Analysis identified three ASD subgroups (global delays, even strengths, mixed profiles), enabling personalized education plans.