Development and Psychometric Evaluation of the AASPIRE Social Support Scale for Autistic Adults

Background: Social support is associated with health, well-being, and quality of life among autistic adults, yet existing social support measures have important limitations. Many were not developed with autistic people, may be difficult for autistic adults to use, and have limited psychometric evidence in autistic populations. We evaluated the psychometric properties of the AASPIRE Social Support Scale, an autism-informed measure adapted from Patient-Reported Outcomes Measurement Information System (PROMIS) social support scales through a community-based participatory research process. Methods: The AASPIRE Social Support Scale assesses five domains: Companionship, Emotional Support, Informational Support, Practical Support, and Social Isolation. Baseline data were analyzed from 859 autistic adults recruited through healthcare systems, disability service systems, and the broader U.S. autism community. Participants completed the measure independently (n=600), with support (n=189), or through caregiver report (n=70). We evaluated content validity, structural validity using confirmatory factor analysis, internal consistency, and measurement invariance across reporting approaches. We also explored differences in social support scores by reporting approach and participant characteristics. Results: The hypothesized five-factor structure demonstrated good fit, with strong item loadings supporting the five distinct but related social support domains. Internal consistency was high for the total scale and all subscales (α=0.87 to 0.95). Measurement invariance was supported across independent direct-report, supported direct-report, and caregiver report, indicating that the scale measured the underlying social support domains similarly across reporting approaches. Social support scores differed across reporting groups: participants reporting independently generally reported less support and greater isolation than participants completing the measure with support or through caregiver report. Exploratory analyses also identified differences by age and gender, but not race. Conclusions: The AASPIRE Social Support Scale is an accessible, reliable, and valid multidimensional measure of social support for autistic adults. Its comparable measurement properties across independent direct-report, supported direct-report, and caregiver report support its use in studies seeking to include autistic adults with diverse communication and support needs. The scale may be useful for evaluating social support and the effectiveness of services and interventions across heterogeneous autistic adult populations.