M-CHAT Mexican Version Validity and Reliability and Some Cultural Considerations

Abstract

The Modified Checklist for Autism in Toddlers (M-CHAT) questionnaire is a brief measure available in Spanish which needs to be validated for the Mexican population. Parents of children from (1) community with typical development (TD) and (2) psychiatric outpatient unit completed the CBCL/1.5–5 and the Mexican/MM-CHAT-version. The study sample consisted of 456 children (age M = 4.46, SD = 1.12), 74.34% TD children and 26.65% with Autism Spectrum Disorders (ASD). The MM-CHAT mean score for failed key items was higher for the ASD group compared with the TD group. Internal consistency for the Mexican/M-CHAT version was .76 for total score and .70 for the 6 critical items. Correlations between the MM-CHAT and the CBCL/1.5: PDD and Withdrawn subscales and with ADI-R dimensions: B non verbal) and A were high, and were moderate with ADI-R dimensions B1 (verbal) and C The failure rate of the MM-CHAT between the groups did not reproduce all the critical items found in other studies. Although the instrument has good psychometric properties and can be used for screening purposes in primary settings or busy specialized psychiatric clinics, these results support evidence for cultural differences in item responses, making it difficult to compare M-CHAT results internationally.

Clinical Validity of the ADI-R in a US-Based Latino Population

“…To determine if the use of the ADI-R across cultures is valid, studies should evaluate not only the use of the ADI-R as a diagnostic tool, but also evaluate the equivalence of the tool within the culture (Magaña and Smith 2013). Studies of the ADI-R in Latino populations is rather limited, with many of these studies using the ADI-R to validate other tools, such as the M-CHAT (Albores-Gallo et al 2012) or the Autism Detection in Early Childhood (ADEC; Hedley et al 2010) in Latino populations. Even fewer have specifically investigated the properties of the ADI-R and its utility in assessing ASD in Latino populations.…”

“…Recent work on cultural adaptations of diagnostic and educational tools have found that cultural perceptions of disabilities and autism may vary greatly and these variations in perceptions may alter how the parent reports and understands their child’s development (Albores-Gallo et al 2012; Grinker et al 2015). For example, Latino families may perceive delayed language development to be within the norm and this in turn may influence when they seek out services for their child with ASD (Garcia et al 2000).…”

Racial, Ethnic, and Language Disparities in Early Childhood Developmental/Behavioral Evaluations

“…(84) For example, the initial norming group for the Modified Checklist for Autism in Toddlers (MCHAT) included only eight Spanish speakers, none of whom were deemed “high-risk.”(85) The Spanish MCHAT instrument was recently modified and validated for a larger population of children in Spain; (86) however, the Spanish – Western Hemisphere version of the M-CHAT has not been validated(87) and testing of a Mexican Spanish M-CHAT version reveals evidence for cultural differences in item responses. (88)…”

A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low‐ and middle‐income countries

“…The PEDS has also been used to detect DD in LMIC (Woolfenden et al, ), and has been translated for use in Tanzania (Kosht‐Fedyshin, ), India (Malhi & Singhi, ), Thailand (Theeranate & Chuengchitraks, ), and Indonesia (Gustawan & Machfudz, ). The M‐CHAT remains one of the most widely used screening tools for the detection of autism and has been translated for use in Mexico (Albores‐Gallo et al, ), Albania (Brennan, Fein, Como, Rathwell, & Chen, ), nine Arabic speaking countries (Seif Eldin et al, ), and Sri Lanka (Perera et al, ). However, in Sri Lanka, effort was made to examine the tool rather than just use it, and the M‐CHAT demonstrated unacceptably low specificity (Perera et al, ).…”