Validation of Assamese Version of Rashtriya Bal Swasthya Karyakram (RBSK) Tool for Early Detection of Developmental Delay and Autism Spectrum Disorder.

OBJECTIVE

To develop and validate the Assamese version of the Rashtriya Bal Swasthya Karyakram (RBSK) screening tool for developmental delay (1-72 months) and autism (15-24 months) and to assess its diagnostic accuracy in comparison with the Developmental Profile-3 (DP-3) and the All India Institute of Medical Sciences (AIIMS)-Modified INCLEN Diagnostic Tool for autism spectrum disorder (INDT-ASD).

METHODS

A cross-sectional study was conducted from January to December 2024 at a tertiary care hospital in India. The RBSK screening tool for developmental delay and autism was translated into Assamese through a standardized process involving forward translation, back-translation, expert review, and pilot testing (n = 10). Children aged 1-72 months were recruited from the outpatient department. Developmental delay was assessed using the Developmental Profile-3 (DP-3) and ASD in children aged 15-24 months using the AIIMS-Modified INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD) tool. Diagnostic accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive values, Cohen's kappa statistic, and area under receiver operating characteristic (AUROC) curves.

RESULTS

A total of 139 children with mean (SD) age 30.5 (12.2 months) were enrolled. The Assamese version of the RBSK screening tool demonstrated a sensitivity and specificity of 94.1% and 84.9%, respectively, for developmental delay, and 89.5% and 93.8%, respectively, for ASD. Agreement with reference tools was high (Cohen's kappa = 0.85 for DP-3, 0.83 for AIIMS-Modified INDT-ASD). The tool showed excellent discriminative performance with AUROC (95%CI) of 0.94 (0.89, 0.98) for developmental delay and 0.92 (0.85, 0.98) for ASD.

CONCLUSION

The validated Assamese version of the RBSK screening tool for developmental delay and autism is an accurate screening tool in Assamese-speaking population.