Authors' Response to the Comments on "Cross-disciplinary Appraisal of Knowledge and Beliefs Regarding the Diagnosis of Autism Spectrum Disorders in India: A Cross-sectional Survey".

Harshe et al.[1] have commented that the comparison of knowledge about autism spectrum disorder (ASD) across groups of healthcare professionals[2] was unwarranted. It is a known fact that a multidisciplinary approach is preferred in the management of children with ASD.[3] Recent evidence also suggests an interdisciplinary approach being effective for the assessment of children with ASD.[4] Hence, knowledge about ASD in healthcare professionals is justified, given the multifaceted deficits in children with ASD. Furthermore, the literature on cross-disciplinary knowledge assessment[5, 6] also supports the claims of our study.[2] The survey questionnaire in our study assessed the professionals’ knowledge and beliefs about ASD, early ASD markers, and DSM-5 diagnostic criteria for ASD, which in turn is the basic knowledge required for identification and assessment of ASD. An estimation of minimum thresholds of knowledge for each professional group was beyond the scope of our study and requires further research.

To further answer the criticisms of Harshe et al.,[1] the instrument was modified, adapted, and validated before using it for the study purpose. The last para of the introduction is the formal statement of the aims and objectives (primary and secondary) of the study, and the outcome measures are the same as the measures in the objective statement(s). The justification for the objectives is also provided in the introduction para, before stating the aim and objectives.

Sharma and Andrade[7] have commented regarding the dropping of the self-efficacy section of the original questionnaire.[6] As mentioned in our paper, the participants were not comfortable answering self-efficacy and competence questions. Hence, it was not administered. Further, the study did not aim at measuring the self-efficacy the healthcare professionals had about assessment of children with ASD. The authors[7] further comment regarding replacing the self-efficacy section with the section on knowledge of DSM-5 criteria for ASD. The section on knowledge regarding the DSM-5 criteria for ASD is not a new one; rather, it already exists in the original questionnaire. The reliability measure of the overall scale, as well as this particular section on knowledge of DSM-5 criteria for ASD, was moderately good in the original study and, hence, in accordance with the reliability reported in our study.