• Developed to assess the training needs and professional skills of staff working in sexuality rehabilitation with SCI patients.
  • Four subscales are found within the questionnaire:
    • Knowledge (14 items)
    • Comfort (21 items)
    • Approach (5 items)
    • Attitudes (5 items)

Clinical Considerations

  • The KCAASS addresses a broad range of potential topics, which helps identify specific areas that should be focused on when developing sexual education programs for staff working within the spinal cord population.
  • Information elicited from this tool could enhance the quality and comfort of sexual education for both the staff and client.
  • The KCAASS was developed specifically for use within the SCI population.

ICF Domain

Body Function ▶ Functions of the Reproductive System


  • The KCAASS is administered by interview, but can be self-administered.
  • A four-point Likert scale is used for all subscales, where 1 = no knowledge/no discomfort/strongly disagree and 4 = excellent knowledge/high discomfort/strongly agree.
  • Approximately 10-15 minutes is required to complete the scale.

Number of Items





  • Summary scores for each of the four aspects of sexuality are calculated.
  • Higher scores represent greater knowledge and skills.
  • The subscales comfort, approach and attitude are reverse scored.
  • A maximum composite score of 200 is obtained by summing up the subscales.



Training Required

No formal training required. However, knowledge of disability and sexuality is beneficial.


Can be found in the appendix of the following article: https://link.springer.com/article/10.1023/A:1023510925729?LI=true

# of studies reporting psychometric properties: 2


MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

  • Scores for each scale provide an assessment of where education time should be allocated when creating a sexual education program.
  • No normative data have been established for the SCI population.
  • Published data for the SCI population is available for comparison (see Interpretability section of Study Details sheet).


Internal consistency is High for the total KCAASS (Cronbach’s a = 0.962) and the KCAASS subscales – knowledge (Cronbach’s a = 0.926-0.929), Comfort (Cronbach’s a = 0.972-0.977), Approach (Cronbach’s a = 0.835-0.865); Low to High for the KCAASS subscale Attitude (Cronbach’s a = 0.641-0.802); and Moderate to High for the KCAASS subscales Attitude (Cronbach’s a = 0.852), Knowledge (Cronbach’s a = 0.785), Comfort (Cronbach’s a = 0.966) and Approach (Cronbach’s a = 0.905).

(Kendall et al. 2003; Fronek et al. 2005; Rahman et al. 2016)


  • Low correlation between KCAASS attitude subscale and total:
    Attitude-total: r = 0.297

(Kendall et al. 2003)

  • Moderate to High correlation between KCAASS knowledge, comfort, approach subscale and total:
    Comfort-total: r = 0.938
    Knowledge-total: r = 0.757
    Approach- total: r = 0.676

(Kendall et al. 2003)

  • Moderate correlation between four KCAASS factors:
    Communalities value > 0.30 (range: 0.316-0.843)

(Rahman et al. 2016)


Pre and Post education subscale scores (knowledge, comfort, approach, and attitude) all showed significant change at P<.001.

(Fronek et al. 2005)

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the KCAASS for the SCI population.


Dr. Ben Mortenson, Jeremy Mak, Risa Fox

Date Last Updated

22 August 2020

Fronek P, Booth S, Kendall M, Miller D, Geraght T. The effectiveness of a sexuality training program for the interdisciplinary spinal cord injury rehabilitation team. Sex Disabil 2005;23:51-63.

Kendall M, Booth S, Fronek P, Miller D, Geraghty T. The development of a scale to assess the training needs of professionals in providing sexuality rehabilitation following spinal cord injury. Sex Disabil 2003;21:49-64.

Rahman PA, Budin SB, Kamaralzaman S, Kwain-Sang MY, Ishak I. Reliability and Validity of Adapted KCAASS Using Exploratory Factor Analysis. The Social Sciences. 2016; 11(21):5172-5177.