Chen Yuanxin, Wang Jingyi, Guo Yanqin, Zhu Zhuohong, Bai Xiaoyu, Li Xinying
Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
University of Chinese Academy of Sciences, Beijing, China.
Transl Pediatr. 2021 Feb;10(2):366-377. doi: 10.21037/tp-20-319.
In responding to the potential challenges in the transition from childhood to adulthood for individuals with autism spectrum disorders (ASD) in China, a novel conception of "ALSO" was proposed to bridge the transitional needs and early intervention. To facilitate the application of ALSO in early intervention, ALSOLIFE skills assessment system (ALSOLIFE Assessment) was developed to enable caregivers to evaluate their children's skills guided by the ALSO conception. Given that the critical shortage of qualified professionals in China, many caregivers of children with ASD must function as home therapists. To address the practical needs of Chinese families of children with ASD, ALSOLIFE Assessment is designed as a free, online, technology-assisted, self-operated and behavioral intervention approaches supported system. The assessment report then further served as the basis for caregivers to deliver the tailored educational intervention to their children. Although ALSOLIFE Assessment provides caregivers a home-based intervention program, it is still unclear whether its evaluation is reliable and accurate. Therefore, we conduct this study to investigate the reliability and validity of the ALSOLIFE Assessment.
A total of 1,050 children with ASD (1 to 10 years old) were recruited from 31 provinces of mainland China. Their caregivers participated simultaneously as ALSOLIFE Assessment evaluators. The testing results of Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) and Psychoeducational Profile-3 (PEP-3) were also collected for a portion of the child participants (VB-MAPP, N=34; PEP-3, N=31) to check criterion-related validity.
The reliability and validity of the ALSOLIFE Assessment satisfied psychometric requirements after the reduction from 511 to 464 items. Exploratory factor analysis (EFA) of ALSOLIFE Assessment scoring data yielded six factors, and confirmatory factor analysis (CFA) verified the best fitting construct model is a bifactorial model with one general factor and six group factors. Compared to the VB-MAPP and PEP-3, the ALSOLIFE Assessment exhibited good criterion-related validity across three levels: total scores, 6 skill domains, and 22 skill subdomains. The reliability tests indicated its strong internal consistency, test-retest reliability, and inter-rater reliability.
The reliability and validity of the revised ALSOLIFE Assessment (464-items) satisfied psychometric requirements. It is essential to develop validated and comprehensive evaluation tools, embedded on the needs of Chinese families of children with ASD.
为应对中国自闭症谱系障碍（ASD）患者从儿童期向成年期过渡的潜在挑战，提出了“ALSO”这一全新概念，以满足过渡需求并提供早期干预。为促进ALSO在早期干预中的应用，开发了ALSO生活技能评估系统（ALSOLIFE评估），使照护者能够在ALSO概念的指导下评估孩子的技能。鉴于中国合格专业人员严重短缺，许多ASD儿童的照护者必须充当家庭治疗师。为满足中国ASD儿童家庭的实际需求，ALSOLIFE评估被设计为一个免费的、在线的、技术辅助的、自我操作的且支持行为干预方法的系统。评估报告进而为照护者为孩子提供量身定制的教育干预提供了依据。尽管ALSOLIFE评估为照护者提供了一个基于家庭的干预方案，但其评估是否可靠和准确仍不明确。因此，我们开展本研究以调查ALSOLIFE评估的信度和效度。
从中国大陆31个省份招募了总共1050名ASD儿童（1至10岁）。他们的照护者同时作为ALSOLIFE评估的评估者参与。还收集了部分儿童参与者的言语行为里程碑评估与安置计划（VB-MAPP）和心理教育档案-3（PEP-3）的测试结果，以检验效标关联效度（VB-MAPP，N = 34；PEP-3，N = 31）。
在从511项减少到464项后，ALSOLIFE评估的信度和效度满足心理测量学要求。对ALSOLIFE评估评分数据进行探索性因素分析（EFA）得出六个因素，验证性因素分析（CFA）验证最佳拟合结构模型是一个具有一个一般因素和六个组因素的双因素模型。与VB-MAPP和PEP-3相比，ALSOLIFE评估在总分、6个技能领域和22个技能子领域三个层面均表现出良好的效标关联效度。信度测试表明其具有很强的内部一致性、重测信度和评分者间信度。
修订后的ALSOLIFE评估（464项）的信度和效度满足心理测量学要求。根据中国ASD儿童家庭的需求开发经过验证的综合评估工具至关重要。
