Parental Acceptance and Understanding of Autistic Children (PAUACS) - an Instrument Development Study.

Currently there are no instruments designed to assess parents' acceptance and understanding of their autistic child. We aimed to develop and evaluate the reliability and validity of a parent-report scale assessing parents' acceptance and understanding of their autistic child - the Parental Acceptance and Understanding of Autistic Children Scale (PAUACS). A total of 158 parents (74 non-autistic, 42 autistic, 42 questioning; mean age 42.69 years) of autistic children (mean age 10.80 years) completed an online survey comprising the prototype PAUACS as well as validated measures of parental sensitivity, neurodiversity affirming attitudes, autistic traits, mental health, and child adjustment and family experience. A subsample of participants (n = 97; 61.4%) completed the PAUACS questionnaire a second time, 2 weeks later, to assess for test-retest reliability. The final 30-item scale demonstrated excellent internal reliability (α = 0.89) and test-retest reliability (intraclass correlation = 0.92). Exploratory factor analysis revealed a clean structure comprising four distinct factors: Understanding (α = 0.86), Innate (α = 0.74), Acceptance (α = 0.82), and Expectations (α = 0.73). Overall, the PAUACS demonstrates good construct validity. Preliminary evidence of convergent validity and divergent validity was demonstrated. Preliminary evidence suggests PAUACS is a reliable and valid tool in assessing parents' acceptance and understanding of autistic children.