Objective Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that increases in its degree of prevalence on a day-to-day basis . Due to the many problems that the disorder brings to the table for children, families, and society as a whole, its early screening, early diagnosis, and preparing early intervention for this group of children is of extreme relevance. Although many countries have put to use tools designed to screen ASD, Iran has not standardized any tool for this important job. One of the most reliable tools in recent years designed to screen traits of ASD in toddlers is the Early Screening for Autistic Traits (ESAT). Therefore, the aim of the present study is to investigate the validity and reliability of the ESAT-Persian Version (ESAT-PV) among toddlers.
Materials & Methods This research is a cross-sectional study that was conducted in order to standardize and validate the Persian version of ESAT. The population of the research included all children with ASD in the city of Isfahan. The sample included 72 toddlers selected using the convenience sampling method. After investigating and calculating the Content Validity Ratio (CVR) and Content Validity Index (CVI), like the developers of the main version of the questionnaire did, the mothers participating in the study were asked to answer ESAT-PV questions based on the characteristics of their own children at the age of 14 months. The construct validity was convergent and it was with the Modified Checklist for Autism in Toddlers (M-CHAT) and the Childhood Autism Rating Scale (CARS) and using the Spearman correlation coefficient . Criterion validity was tested by way of comparison of children with and without ASD. To determine the internal consistency of the scale, Cronbach's alpha coefficient was used, and to determine its test-retest reliability, the Intraclass Correlation Coefficient (ICC) was employed. The data were analyzed using SPSS-22.
Results The maximum and minimum of CVER were estimated to be 1 and 0.8, respectively, and CVI was 0.91. The correlation coefficient of Modified Checklist for Autism in Toddlers (M-CHAT) and ESAT-PV was 0.56 and that of Childhood Autism Rating Scale (CARS) and ESAT-PV was 0.61. In addition, there was a significant difference between the mean scores of ESAT-PV in the two groups of children with or without ASD (t=54.17 P=0.001). Cronbach's α coefficient was in the range of 0.73 to 0.77 for questions, and Cronbach's coefficient α for the total scale was 0.76. Intraclass Correlation Coefficient (ICC) was in the range of 0.93 to 0.77 for questions, and ICC for the total scale was 0.92.
Conclusion The results of the present study indicate that the ESAT-PV enjoys acceptable validity and reliability and can be applied as a clinical and research instrument for screening autism in toddlers. These results are important because through the investigating and approval psychometric properties of ESAT-PV, operation the concepts of early screening . Thereafter, interested researchers could use ESAT-PV in different groups for identification and screening of ADD . In addition, recommend to rehabilitation experts, psychologists and psychiatrists, with early screening characteristics of autism spectrum disorders in toddlers and acting for the development, implementation and evaluation of the results of early educational and rehabilitation interventions, and thus, be useful in reducing the cost of family and community.