Psychometric Validation and Age Extension of the Chinese Quality of Life for Children with Autism Spectrum Disorder Scale in Children Aged 0–12 Years: A Cross-Sectional Study

Abstract Background The Quality of Life for Children with Autism Spectrum Disorder scale (QOLASD) is a parent-proxy measure specifically designed for children with autism spectrum disorder. However, evidence supporting the Chinese version of this scale has been primarily derived from children aged 0–7 years. This study aims to evaluate the reliability, construct validity, age-related measurement invariance, and convergent validity of the Chinese scale in children aged 0–12 years with autism spectrum disorder (ASD). Methods This cross-sectional study included 358 children with ASD aged 0–12 years (81.3% male). Parents completed the Chinese version of the Quality of Life for Children with Autism Spectrum Disorder scale (QOLASD-C), and 326 children aged 2–12 years with complete data on both the QOLASD-C and the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) were included in the convergent validity analysis. Psychometric analyses included internal consistency, split-half reliability, construct validity, age-related measurement invariance, and convergent validity. Construct validity and measurement invariance were assessed using confirmatory factor analysis (CFA) and multigroup CFA with robust maximum likelihood estimation, respectively. Convergent validity was examined using Spearman correlations with the PedsQL 4.0. Results The total scale exhibited excellent internal consistency (Cronbach’s α = 0.914), with good reliability across all three dimensions. Confirmatory factor analysis indicated acceptable fit for the modified three-factor model. Measurement invariance was confirmed across the 0–7 and 8–12 year age groups. The QOLASD-C correlated positively with all PedsQL 4.0 dimensions (r = 0.146–0.366, all P < 0.01). Conclusions The QOLASD-C shows satisfactory reliability and validity for measuring quality of life in children with ASD aged 0–12 years. The scale is appropriate for cross-sectional description and screening in clinical settings and for population-based research in both preschool and school-age populations. However, its use for individual-level clinical decision-making or tracking change over time should await further longitudinal and multi-informant validation.