Speech Communication Disorders Program, Department of Human Services, School of Education and Human Services, University of Virginia, Charlottesville, VA.
Division of Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina, Chapel Hill, NC.
J Dev Behav Pediatr. 2021 Dec 1;42(9):717-725. doi: 10.1097/DBP.0000000000000968.
Parent-report screening tools for autism spectrum disorder (ASD) are widely used to promote early identification of children with or at risk for ASD. Most screening tools have been developed in English in the United States or United Kingdom; thus, translated versions are needed for use with culturally and linguistically diverse populations. Traditional translation methods include a forward translation, back translation, and review. However, when used in new cultural and linguistic contexts, this "forward-back" approach may have limitations, including differing psychometric properties compared with original instruments. This study presents a psychometric analysis of the forward-back translation methodology of an ASD screening tool.
A retrospective chart review design was used to examine Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R; Robins et al.) records from 2974 toddlers. Data were compared between caregivers who completed the original English M-CHAT-R and caregivers who completed its forward-back "Spanish-Western Hemisphere" translation to compare select psychometric properties of the 2 instruments.
Significant differences were observed between the 2 versions, including a higher overall risk score, higher initial screen-positive rate, and increased likelihood of leaving items blank among Spanish-speaking respondents.
Traditional translation methods seemed to affect select psychometric properties between translations of the M-CHAT-R. A more rigorous cultural adaptation approach may be necessary to maintain equivalence with the original instrument. Until new rigorous translations are available, it is recommended that language-specific screening tools continue to be used, along with recommended follow-up interviews, to avoid exacerbating existing health disparities.
自闭症谱系障碍（ASD）的家长报告筛查工具被广泛用于促进对有或有 ASD 风险的儿童的早期识别。大多数筛查工具都是在美国或英国用英语开发的；因此，需要翻译成适合文化和语言多样化人群使用的版本。传统的翻译方法包括正向翻译、反向翻译和审查。然而，当在新的文化和语言环境中使用时，这种“正向-反向”方法可能存在局限性，包括与原始工具相比具有不同的心理计量学特性。本研究对 ASD 筛查工具的正向-反向翻译方法进行了心理计量学分析。
采用回顾性图表审查设计，对 2974 名幼儿的改良婴儿自闭症检查表修订版（M-CHAT-R；Robins 等人）记录进行了检查。比较了完成原始英语 M-CHAT-R 的照顾者和完成其正向-反向“西半球西班牙语”翻译的照顾者的数据，以比较这两种工具的选择心理计量学特性。
观察到两种版本之间存在显著差异，包括整体风险评分较高、初始筛查阳性率较高以及西班牙语受访者更有可能留空项目。
传统的翻译方法似乎会影响 M-CHAT-R 翻译之间的选择心理计量学特性。可能需要更严格的文化适应方法来保持与原始工具的等效性。在新的严格翻译可用之前，建议继续使用特定语言的筛查工具，并进行推荐的随访访谈，以避免加剧现有的健康差距。
