Risk identification for Autism Spectrum Disorder in preschool children: design and validation of a screening instrument

Abstract

Introduction: Autism Spectrum Disorder (ASD), which has a multifactorial etiology, is primarily diagnosed through clinical evaluation. It is well established that early identification significantly contributes to a more favorable prognosis. The educational environment is conducive to screening for signs of ASD in preschool children; however, there is a lack of specific instruments designed for this purpose. Objective: To examine the content validity evidence of an instrument aimed at identifying signs indicative of ASD in the educational context. Method: The development of the instrument followed the guidelines of the Standards for Educational and Psychological Testing (American Educational Research Association, 2014) and of Pasquali (1998). The process involved three stages: (1) item development and submission to a panel of 15 experts in ASD, consisting of 10 occupational therapists and five speech-language pathologists; (2) assessment of item clarity by 10 preschool teachers; and (3) analysis of the revised version by two experts and six preschool teachers. Results: The literature review supported the development of the initial version of the instrument. In the expert panel analysis, the Content Validity Index (CVI and CVI-I) indicated high agreement among the specialists, although adjustments were necessary, resulting in a second version. The evaluation by preschool teachers revealed the need for further modifications to some items, which led to the development of a third version. Finally, the analysis of the third version by two experts and the group of teachers indicated additional revisions, resulting in the fourth version of the instrument. Conclusion: The instrument developed demonstrated evidence of content validity, and it is recommended that the next stages of validation be pursued.