Preliminary reliability of South African adaptation and Northern Sotho translation of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up

Abstract

Background: There is a shortage of validated autism screening tests in the 11 official languages of South Africa. The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/FTM), a validated and well-known screening test, had already been adapted (in English) and translated into Northern Sotho for use in South Africa.Objectives: The aim was to collect pilot data to determine the preliminary reliability and feasibility of the two tests to confirm the equivalence of the adaptation and translation.Method: The study was conducted in a peri-urban community in South Africa. Twenty-one first-language Northern Sotho caregivers of children aged between 18 and 48 months were recruited by employing snowball sampling. The participants were asked to complete the Northern Sotho and the culturally adapted English M-CHAT-R/F, which were presented in random order.Results: The preliminary content validity and equivalence were evident, with no difference at the 5% interval of the Wilcoxon signed rank test. All 21 toddlers screened presented with a low risk for autism following the recommended execution of the Follow-Up section for the toddlers in the medium risk category. All participants completed the two screening tests, with none indicating unfamiliar words or constructs. A higher preference for the English adapted version was found but a need for the Northern Sotho screening test was also evidentConclusion: The Northern Sotho translation of the M-CHAT-R/F, as well as the adapted English version, appears feasible and is ready for comprehensive validation.

Reliability and Concurrent Validity of a Cultural Adaptation and Northern Sotho Translation of the M-CHAT-R/F

“…However, the distribution of the Northern Sotho child risk categories post-Follow-up were more similar to the The item-level analysis showed perfect agreement and near-perfect agreement between 17 items of the two M-CHAT-R/F versions. The equivalence between the two versions is similar to the pilot study results (Vorster et al, 2021). Only three of the 20 items (Items 5,11,and 12) showed slight variations between the Northern Sotho and the adapted English versions, with Item 11 displaying 90% agreement in the pilot study and 93.7% agreement in this study (Removed for blind peer review).…”

“…There is currently no culturally adapted, autism-specific screening instruments available in South Africa (Franz et al, 2017). Given the late identification of autism and the shortage of culturally appropriate and validated screening tests in South African languages, the M-CHAT-R/F was adapted, translated into Northern Sotho, and piloted in two previous studies (Vorster et al, 2021(Vorster et al, , 2022. Northern Sotho, one of the 11 official South African languages, is widely used in the greater Tshwane region, a densely populated urban and peri-urban area of South Africa, where the study was conducted.…”

Molecular autism research in Africa: a scoping review comparing publication outputs to Brazil, India, the UK, and the USA

“…However, many of the widely used tools have licensing restrictions and thus require permissions and payment in order to translate them into other languages which is problematic in low resource settings (Durkin et al ., 2015). Although there have been several preliminary studies assessing the use of diagnostic instruments in some SA languages, this process is still in its infancy (Chambers et al ., 2017; Malcolm-Smith et al ., 2013; Smith, Malcolm-Smith & de Vries, 2017; Vorster et al ., 2021). Furthermore, once appropriate diagnostic assessments have been established, considerable efforts will be required to adequately train professionals and effectively implement these tools (de Vries, 2016; Durkin et al ., 2015).…”

Screening Tools for Autism in Culturally and Linguistically Diverse Paediatric Populations: A Systematic Review

“…Within these studies, the Spanish studies made comments related to increasing sensitivity by using culturally appropriate examples and rewording some of the questions to increase clarity. Vorster (47) commented that in a South African population where the participants were presented with a Northern Soho (local language) and culturally adapted English version of this tool, there was higher acceptability and preference for the latter.…”