PSYCHOMETRIC VALIDATION OF THE URDU VERSION OF THE MODIFIED CHECKLIST FOR AUTISM IN TODDLERS (M-CHAT)

Abstract

The current study tried to carry out psychometrics validation of Urdu version of the Modified Checklist for Autism in Toddlers (M- CHAT) to construct a culturally balanced screening instrument in the early detection of autism in the Pakistani general populations. The study thus dealt with the significant absence of validated screening tools to detect autism in the Urdu-speaking community since all the existing screening tools could not be culturally and linguistically adapted in Pakistani milieu. The validation design used in the study is a cross-sectional design of 450 toddlers aged between 16-30 months, recruited in the sample at the pediatric clinics, child development centers, and community health facilities in Multan, Pakistan. The homegrown methodology entailed both forward and backward translation of the M-CHAT in the originating language, i.e., English to the target language i.e., Urdu, opinion of a panel of experts and pilot testing. The Urdu version of M-CHAT was administered to caregivers through the researcher’s collection of data, including clinical evaluation of caregivers with the aid of standard diagnostic criteria as a gold standard. The statistical analysis involved reliability using Cronbach’s alpha, construct validity via exploratory factor analysis and criterion validity by using sensitivity and specificity. The results showed an internal consistency (alpha 0.84) and reasonable test-retest reliability (r = 0.78). Urdu M-CHAT demonstrated good sensitivity (87%) and specificity (83%) in the detection of autism, the positive predictive value of 76 percent, and the negative predictive value of 91 percent. Factor analysis showed that the data could be partitioned into 3 factors that conformed to domains of core autism symptoms. The research findings stated that the Urdu M-CHAT was a valid and dependable screening scale in screening autism in Pakistani toddlers. The suggestions were the use of the approved tool in everyday pediatric practice, the education of health care professionals on early screening of autism, and the longitudinal study to determine the long-term duration of diagnosis and development outcome.