Preliminary Evidence for Differentiating Functional Performance in Preschool Children on the Autism Spectrum Using the Basic Activities of Daily Living Evaluation—Preschool Version

PURPOSE: The ability to perform basic activities of daily living is a core component of child development and participation. Despite its relevance, the availability of tools to assess these activities in preschoolers on the autism spectrum remains limited, particularly in the Spanish context. This study examined the psychometric properties and explored preliminary reference thresholds for interpreting functional performance of the Basic Activities of Daily Living Evaluation - Preschool Version (BADL-P), a culturally relevant and context-sensitive tool. METHODS: A total of 281 children (241 from the general population and 40 on the autism spectrum), aged 3-6 years, participated. THE BADL-P INCLUDES FOUR SCALES: Eating, Personal Hygiene, Dressing, and Daily Functioning (executive functioning during daily activities), comprising 84 items. Group differences, internal consistency, inter-scale correlations, and receiver operating characteristic (ROC) analyses were conducted to assess the instrument's discriminative validity as a measure of functional performance in preschool children, and to explore normative reference thresholds for differentiating between groups. RESULTS: Significant differences were observed between children from the general population and those on the autism spectrum across all scales, with large effect sizes in Dressing (rrb = 0.78) and Personal Hygiene (rrb = 0.88). The BADL-P demonstrated AUCs ranging from 0.88 to 0.94. CONCLUSIONS: This study provides preliminary evidence supporting the BADL-P as a culturally relevant and context-sensitive instrument for assessing functional performance in early childhood.