Translating and validating the modified checklist for autism in toddlers (M-CHAT-R/F) into Malayalam for effective utilization of it in the clinical setting

Background: Early intervention strategies significantly improve developmental outcomes for children with autism spectrum disorders. In this background, this study was conducted to translate and validate Malayalam version of Modified Checklist for Autism in Toddlers (M-CHAT-R/F). Methods: This cross-sectional study was conducted in four steps. The original version of MCHAT-R/F was translated into Malayalam, and back translated by bilingual experts followed by pilot testing. Finally, the translated tool was administered to 100 children for evaluation of psychometric properties which included reliability and validity assessment. The statistical analysis was conducted using IBM SPSS version 25. Results: The internal consistency of the items as per parent confirmed stage of screening and flow chart interview stage of screening was 0.539 and 0.731 respectively. The level of agreement in categorizing the children according to the risk of ASD by two raters during first and second screening stage was 0.647 and 0.432 respectively. The test-retest reliability analysis showed that all the items had a moderate level of agreement between test and retest. All the items had an I-CVI more than 0.90. There was strong positive correlation between the score obtained during first stage (r: 0.562) and second stage (r: 0.529) with CARS score which indicates high convergent validity. Conclusions: The newly translated tool with high reliability and validity could enable in screening symptoms of autism among children belonging to lower age group, which would facilitate in providing appropriate intervention as early as possible.