Systematic COSMIN Review of Neurodiversity Attitudes and Knowledge Measures

Background: Many researchers seek to measure people’s knowledge of and attitudes toward neurodiversity concepts and advocacy. In this systematic literature review, we characterize measures of neurodiversity knowledge and attitudes and summarize studies that have used such measures. Methods: This study was funded by a Boston College Ignite grant aandwas preregistered on Prospero, ID# CRD420251013298. We searched ERIC, Education Source, PsycINFO, Scopus, Web of Science, and Sociological Abstracts databases on March 11, 2025. We hand searched the journal Neurodiversity on June 11, 2025. Inclusion criteria were that studies were peer-reviewed, published in English, and included a neurodiversity knowledge or attitudes measure. For formal validation studies, we follow the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for describing and evaluating measurement properties and study quality. Procedures include the COSMIN Risk of Bias checklist, the COSMIN Good Measurement Properties to rate study results, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system for synthesis and presentation. For studies in which a neurodiversity knowledge and/or attitude measure was used but not formally validated, we used an abbreviated coding scheme to assess their basic characteristics and whether they were incidentally validated on any of the nine measurement properties. Results: We located 13 studies: four validation studies of four neurodiversity attitudes measures, and nine studies using a neurodiversity knowledge and/or attitudes measure. All four measures received “very low” GRADE ratings for all aspects of content validity, and no measure received more than two “high” ratings across all measurement properties. Only one measure received a high GRADE rating corresponding with positive evidence, and this was for internal consistency of the Autism and Neurodiversity Attitudes Scale. Conclusions: We cannot recommend any of the measures we examined for use in research, but our findings suggest that continued efforts at validating these measures could be promising.