The Westmead Feelings Program Intervention for Chinese Children With Autism Spectrum Disorder in Hong Kong

Primary outcomes

1. The Emotions Development Questionnaire - Parent Version (Hong Kong version)

   Time frame: Before the intervention

   The Emotions Development Questionnaire measures the emotional competence in children with autism spectrum disorders (ASD) at home and school, covering 5 subdomains, namely emotional understanding, empathy/theory of mind, emotional problem solving, emotional regulation, and emotion coaching skills. The scale consists of 29 items. Responses will be circled on a 5 point Likert scale, with 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, 5 = Always, 0 = Don't know. The minimum value of the scale is 0, and the maximum value is 145. Higher scores indicate better emotional competence.

2. The Emotions Development Questionnaire - Parent Version (Hong Kong version)

   Time frame: 18 weeks, immediately after the intervention

   The Emotions Development Questionnaire measures the emotional competence in children with ASD at home and school, covering 5 subdomains, namely emotional understanding, empathy/theory of mind, emotional problem solving, emotional regulation, and emotion coaching skills. The scale consists of 29 items. Responses will be circled on a 5 point Likert scale, with 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, 5 = Always, 0 = Don't know. The minimum value of the scale is 0, and the maximum value is 145. Higher scores indicate better emotional competence.

3. Emotion Development Questionnaire - Teacher Version (Hong Kong version)

   Time frame: Before the intervention

   The Emotions Development Questionnaire measures the emotional competence in children with ASD at home and school, covering 5 subdomains, namely emotional understanding, empathy/theory of mind, emotional problem solving, emotional regulation, and emotion coaching skills. The scale consists of 29 items. Responses will be circled on a 5 point Likert scale, with 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, 5 = Always, 0 = Don't know. The minimum value of the scale is 0, and the maximum value is 145. Higher scores indicate better emotional competence.

4. Emotion Development Questionnaire - Teacher Version (Hong Kong version)

   Time frame: 18 weeks, immediately after the intervention

   The Emotions Development Questionnaire measures the emotional competence in children with ASD at home and school, covering 5 subdomains, namely emotional understanding, empathy/theory of mind, emotional problem solving, emotional regulation, and emotion coaching skills. The scale consists of 29 items. Responses will be circled on a 5 point Likert scale, with 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, 5 = Always, 0 = Don't know. The minimum value of the scale is 0, and the maximum value is 145. Higher scores indicate better emotional competence.

5. Social Responsiveness Scale - 2 (SRS-2)

   Time frame: Before the intervention

   The SRS-2 identifies social impairment associated with autism spectrum disorders & distinguishes ASD from other disorders. It consists of 65 items. The questionnaire comprises five subscales: social awareness, social cognition, social communication, social motivation, restricted interests, and repetitive behavior. Items are scored on a four-point Likert-type scale, ranging from 1 = not true, 2 = sometimes true, 3 = often true, to 4 = almost always true. The minimum value of the scale is 65, and the maximum value is 260. Higher scores indicate more prominent ASD symptoms.

6. Social Responsiveness Scale - 2 (SRS-2)

   Time frame: 18 weeks, immediately after the intervention

   The SRS-2 identifies social impairment associated with autism spectrum disorders & distinguishes ASD from other disorders. It consists of 65 items. The questionnaire comprises five subscales: social awareness, social cognition, social communication, social motivation, restricted interests, and repetitive behavior. Items are scored on a four-point Likert-type scale, ranging from 1 = not true, 2 = sometimes true, 3 = often true, to 4 = almost always true. The minimum value of the scale is 65, and the maximum value is 260. Higher scores indicate more prominent ASD symptoms.

7. The Learning, Social and Emotional Adaptation Questionnaire Short-Form (Primary) (LSEAQ-S(P))

   Time frame: Before the intervention

   The LSEAQ-S(P) is a teacher report instrument measuring 53 essential adaptive behaviors for mainstream primary school students with ASD in Hong Kong. This questionnaire describes expected behaviors in school across three domains, namely, learning, social, and emotional adaptation, and an additional domain of restricted interests and repetitive behavior frequently observed in students with ASD. The questionnaire adopts four-point Likert scales for teachers to rate the frequency of the stated behavior observed in the previous month: 0 = the student never showed this behavior, 1 = the student showed this behavior less than half of the time,2= the student showed this behavior more than half of the time,3= the student nearly always showed this behavior.

   The restricted interests and repetitive behavior ratings were reverse-scored prior to analysis so that higher ratings indicated better adjustment in all domains. The minimum score for the scale is 0 and the maximum is 159.

8. The Learning, Social and Emotional Adaptation Questionnaire Short-Form (Primary) (LSEAQ-S(P))

   Time frame: 18 weeks, immediately after the intervention

   The LSEAQ-S(P) is a teacher report instrument measuring 53 essential adaptive behaviors for mainstream primary school students with ASD in Hong Kong. This questionnaire describes expected behaviors in school across three domains, namely, learning, social, and emotional adaptation, and an additional domain of restricted interests and repetitive behavior frequently observed in students with ASD. The questionnaire adopts four-point Likert scales for teachers to rate the frequency of the stated behavior observed in the previous month: 0 = the student never showed this behavior, 1 = the student showed this behavior less than half of the time,2= the student showed this behavior more than half of the time,3= the student nearly always showed this behavior.

   The restricted interests and repetitive behavior ratings were reverse-scored prior to analysis so that higher ratings indicated better adjustment in all domains. The minimum score for the scale is 0 and the maximum is 159.

9. Parenting Stress Index 4-Short Form

   Time frame: Before the intervention

   The Short Form features 36 items drawn from the full-length form divided into three domains (Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child).Self-reported responses will be scored on a 5-point Likert scale ranging from "1" (Strongly agree) to "5" (Strongly disagree). Subscale scores are calculated by summing the scores of relevant items. A total stress score is obtained by combining the three subscale scores. A higher score denoted higher level of parenting stress. The minimum total score for this scale is 36 and the maximum is 180.

10. Parenting Stress Index 4-Short Form

    Time frame: 18 weeks, immediately after the intervention

    The Short Form features 36 items drawn from the full-length form divided into three domains (Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child).Self-reported responses will be scored on a 5-point Likert scale ranging from "1" (Strongly agree) to "5" (Strongly disagree). Subscale scores are calculated by summing the scores of relevant items. A total stress score is obtained by combining the three subscale scores. A higher score denoted higher level of parenting stress. The minimum total score for this scale is 36 and the maximum is 180.