# Psychometric Evaluation of the Attune & Stimulate‐Checklist for Assessing the Emotional State of People With Severe to Profound Intellectual Disabilities

## TL;DR

This study evaluated a checklist for assessing emotions in people with severe to profound intellectual disabilities and found it to be reliable and aligned with reports from caregivers.

## Contribution

The study provides psychometric validation for the Attune & Stimulate-checklist, a new tool for assessing emotional states in individuals with severe to profound intellectual disabilities.

## Key findings

- The checklist showed good inter-rater and test-retest reliability, except for one category.
- Observed emotional states aligned with caregiver reports on mood, functioning, and communication.
- Checklist-measured arousal was not linked to skin conductance, suggesting complex physiological-emotional relationships.

## Abstract

In response to the lack of well‐validated observation‐instruments assessing the emotions of people with severe to profound intellectual disabilities, the Attune & Stimulate‐checklist (A&S‐checklist) was psychometrically evaluated.

Video recordings of 102 adults with severe to profound intellectual disabilities were scored with the A&S‐checklist. Related constructs were assessed through proxy‐questionnaires and physiological measurement.

Good inter‐rater (ICC = 0.77–0.83) and moderate to good test–retest reliability (ICC = 0.70–0.81) were found, except for one seldomly scored A&S‐category. Moderate to strong associations were found between observed emotional states and informant reports of emotional functioning, adaptive functioning, communication and influence, and mood (r = 0.27–0.51; p < 0.05), except for negative mood. A&S‐checklist‐arousal was not statistically associated with skin conductance.

The A&S‐checklist showed adequate psychometric properties, making assessment of emotion more feasible. The lack of a straightforward link with physiologically measured arousal invites further investigation.

Trial Registration: This study was pre‐registered on Open Science Framework in the project https://osf.io/pba92 (Doodeman et al. 2020, August 27). The link to this registration is: Doodeman, T. W. M., Sterkenburg, P., & Schuengel, C. (2020, August 27). The Construct and Convergent Validity of the ‘Attune & Stimulate’ checklist for parents and caregivers of persons with severe intellectual disabilities. https://doi.org/10.17605/OSF.IO/PBA92

The Attune & Stimulate‐checklist was a reliable instrument to describe emotional states in persons with severe to profound intellectual disabilities.Observations with the Attune & Stimulate‐checklist were largely aligned with what informants reported about mood, emotional and adaptive functioning, and communication and influence.Observed arousal with the Attune & Stimulate‐checklist was not associated with skin conductance, an objective measure of arousal. The link between skin conductance and emotional wellbeing in a day‐to‐day setting may be more complex.The Attune & Stimulate checklist may facilitate further research on emotional wellbeing of people with severe to profound intellectual disabilities.

The Attune & Stimulate‐checklist was a reliable instrument to describe emotional states in persons with severe to profound intellectual disabilities.

Observations with the Attune & Stimulate‐checklist were largely aligned with what informants reported about mood, emotional and adaptive functioning, and communication and influence.

Observed arousal with the Attune & Stimulate‐checklist was not associated with skin conductance, an objective measure of arousal. The link between skin conductance and emotional wellbeing in a day‐to‐day setting may be more complex.

The Attune & Stimulate checklist may facilitate further research on emotional wellbeing of people with severe to profound intellectual disabilities.