Ethical Considerations

This project has been reviewed by the University Research Ethics Committee and has been given a favourable ethical opinion for conduct. This approval was obtained from the ethics committee, documenting all procedures, materials, and data analytical methods. Additionally, the Consent form provided a detailed explanation of the current study's attention to human and participant rights issues throughout the course of the study. Due to the potentially sensitive nature of the study material, as well as the necessity to obtain underage participants, some ethical concerns may be

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evident within this study. For example, assessing QoL requires participants to reflect on potentially personal issues, such as family and social concerns (Oliver, 2010). This reflection may elicit exposure to some degree of psychological distress. As a result, all participants were instructed of their rights to omit any of the questions, as well as the right to stop at any time. Second, the utilisation of participants under the age of 18 requires parental or guardian consent prior to conducting the study (Oliver, 2010). Therefore, such consent was obtained from one or both of the participants' legal guardians. No coercion or incentives were used at any phase of this study.

All participants were provided with a contact number in order to receive more information about the nature and content of the study. This study strived to maximise participant and guardian confidentiality during all phases of the study. No identifying information were used during the data collection, analysis or reporting of results. Participants were provided with an identification code for the purposes of data analysis, and no personally identifying information was attached to the participants' actual names. Upon completion of the study, all data was locked in a file cabinet in the primary investigator's office to prevent any tampering or modification of the data. The electronic data was secured by password protected computer. The data will be destroyed after a period of seven years. As all instrumentation took place via Survey Monkey, participants have not had the opportunity to ask questions or clarify items with the primary investigator during the survey. However, all participants were provided with the primary investigator's contact information, and instructed to withhold from taking the survey until they have had a chance to speak with the primary investigator.

Children with ASD were considered a vulnerable population group, and warrant special consideration when attempting to include as participants within a

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study (Creswell, 2013). Therefore, stringent efforts were made to protect the rights and human dignity of these participants. Throughout the course of the study, children with ASD were allowed to complete any self-report items with the help of an advocate or specialist who is familiar with his or her condition. Participants, guardians and/or advocates were instructed of their rights as human participants during all phases of the study, as well as their rights to omit any components of the procedures and withdraw from the study at any point in time.

4.10. Conclusion

Results from this study are beneficial in understanding QoL experiences in KSA schoolchildren with ASD and neurotypical schoolchildren, as well as the dimensions of QoL within these schoolchildren. Results from this study may be useful in identifying how to improve QoL amongst KSA schoolchildren. Through working with parents regarding QoL, the KSA education system will ideally experience improved performance, as well as improved social outcomes on behalf of the schoolchildren. Furthermore, validating a QoL instrument for KSA schoolchildren is a critical step in designing more effective interventions for this population group. Similarly, little is known about autism in Saudi Arabia, and the adaptation of an instrument specifically for this population group is long overdue. Therefore, this study helps to further the understanding of QoL in schoolchildren with ASD and neurotipcal schoolchildren in Saudi Arabia, as well as to draw comparison with other cultures. Finally, this study provides evidence of the effectiveness of an intervention designed to improve QoL in schoolchildren with ASD. This information might be beneficial for KSA educators working with these special needs group.

Determining QoL has increased in significance within the Middle Eastern region of the world as practitioners have acknowledged the impact this state has on

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student's general health, well-being, and educational outcomes. Additionally, QoL seems to have a substantial impact on inducing beneficial academic outcomes in students. However, few empirical studies have systematically evaluated the impact of QoL on schoolchildren with ASD in Saudi Arabia. Therefore, the purpose of this study is to gain a better understanding of QoL in schoolchildren with ASD and neurotypical children in Saudi Arabia. Furthermore, this study intends to enhance the validation for a standardised QoL instrument in Arabic for schoolchildren with ASD and neurotypical schoolchildren.

A quantitative approach was utilised to evaluate QoL variables in KSA schoolchildren with ASD and neurotypical schoolchildren. A sample of KSA community schoolchildren with ASD, their parents, neurotypical schoolchildren and their parents were selected for participation in this study, and discrepancies in QoL were evaluated according to a standardised QoL assessment tool. This study consists of two phases, including: instrument translation and QoL assessment. First, the Kidscreen-52 was translated from English to Arabic as a first translation and the second translation by a native Arabic speaker who is also fluent in English. The assessment phase of this study was performed with a sample of KSA community schoolchildren and their parents within the public education system, and this phase was utilised to determine validity and reliability of the new instrument.

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