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

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/F(TM)), 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 evident CONCLUSION: 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.