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Validity and Reliability Analysis of Chinese Parent Version of the Autism Spectrum Rating Scales
The national screening, diagnosis and treatment of ASD are started recently in China. Up to now, very few screening and diagnostic instruments were available for the Chinese general population; In particular, before the screening to measure the validity and reliability of instruments is necessary under the Chinese culture environment. One years ago, an important initiative funded by the Ministry of Health was launched to boost autism awareness and clinical and research expertise. As part of this recent program, a national epidemiological survey of ASD among the school-aged population of China was designed. In order to conduct the screening phase of this survey involving 8 provinces (n=120,000), we needed an instrument, properly validated for the Chinese population. After reviewing several instruments, we decide to employ the Autism Spectrum Rating Scale (ASRS) for the epidemiological survey. We report here on the part of our study that aimed at the reliability and validity of the ASRS in a Chinese pilot sample.
Objectives:
The primary aim of this study was to investigate the validity and reliability of Chinese parent version of the Autism Spectrum Rating Scale (ASRS), before it is applied in Chinese population.
Methods: 1625 community based subjects aged 6-12 years old, including 830 boys (51.1% ) from four sites (Shanghai, Guangzhou, Changsha, and Harbin city) in China and 211 clinic-based participants (aged 6-18, and 87.7% are male) were assessed. All clinic cases were diagnosed with pervasive development disorder under the criteria of DSM-IV, and 10% of which were confirmed by a parental interview using the Autism Diagnostic Interview-Revised (ADI-R). All the parents of recruited subjects administered the Chinese version of ASRS questionnaire, and the Chinese version of the Social Responsiveness Scale Questionnaire (SRS). Test-retest reliability (pair- wised student’s t-tests), construct validity using Confirmative factor analysis (CFA) and Pearson correlation, concurrent validity (Pearson correlation) , and discriminate validity (Student’s t-tests) for Chinese version parent ASRS were analyzed by using relevant statistical methods. Age, gender and sites effect on the subscales scores and T-scores were analyzed by using multiple linear regressions. Between-group difference (effect size and 95%CI) was reported. SPSS statistical package was used, P<0.05 was deemed as statistical significant level.
Results: Boys in community-based sample had significant higher scoring in Social Communication (SC), Unusual Behavior (UB), Self-Regulation (SR) and standardized total score (T-score) by 2-3 points than that in girls, Ps<0.001. The internal consistency (Cronbach’s alpha) were 0.585–0.929, and test-retest reliability (interclass correlations, 0.542–0.749, p>0.05). CFA showed fairly good model fitting , concurrent validity was 0.732 compared with SRS scores. Clinical sample showed significantly higher T-scores and the three subscale scores compared with community-based samples. With mean difference of 0.4SD for SC, 0.4SD for UB, 0.3SD for T-score between male and female in clinical case.
Conclusions:
The Chinese parent version of ASRS is a reliable and valid tool for screening autistic symptoms in the Chinese general population.