Designing and psychometric analysis of a Comprehensive Functional Assessment Instrument for 2 to 5 Years Old children With Autism Spectrum Disorder

Abstract

Based on searches in Farsi and English in available databases, we have not found a comprehensive tool that can classify these patients, this disease includes a wide range of disabilities and functional and sensory deficiencies that So far, it has not been categorized by any comprehensive tool, the empty space of an effective tool is strongly visible, clinicians in dealing with patients with autism spectrum experience a confusion and immersion in a flood of symptoms that each category of symptoms needs a different treatment approach. If successful in classifying the symptoms of this disease, the diagnosis and treatment of these patients will be easier. Methodology: For conceptualization, first the texts related to the functional classification of children with autism spectrum disorder and the concept of functional classification in children were searched . After extracting the titles and various functional aspects, the results of the study conducted by Bolte et al. as an important basic study were compared with the items obtained from different studies, and considering that according to the opinion of the panel of experts, all of the functional aspects raised in other studies,were included in their study and even more, so it became the basis of our research. During various meetings and with the presence of the research team, the initial version was compiled. The content validity of each tool was evaluated both qualitatively and quantitatively (by calculating two indexes (Content Validity Ratio (CVR) and Content Validity Index (CVI)). Face validity was evaluated qualitatively with the participation of members of each group and by 15 people from Expert experts were quantitatively examined and the impact score of each item of the tool was determined. To check the reliability of the questionnaire, Cronbach's α coefficient and ICC correlation coefficient index were used. The feasibility of the final tool was examined by 20 evaluators from each group in a pilot manner. Findings: The results of content validity ratio (CVR) indicated that out of 231 questions designed in the tool, only 70 questions were equal or greater than Lawshe's table number (0.51). This article shows that out of a total of 231 questions, only 70 questions were used as necessary and important questions in this tool. Therefore, in the initial stage, 161 questions were removed from the proposed questions, and for the remaining 70 questions, the review of other stages of content validity evaluation was done. The results of the content validity index (CVI) indicated that out of the 70 questions that were transferred to the CVI stage after the revision in the CVR stage, all the questions except questions 6, 29 and 59 had a CVI score higher than 0.79 and Therefore, they were recognized as suitable. The CVI score of questions 28, and 58 was 0.78, which were between 0.70 and 0.79, which meant that they needed correction and revision, and the necessary correction was done on these three questions. The results of the agreement index between evaluators (K) indicated that all 70 questions had a score higher than 0.74, which indicates the level of agreement at an excellent level. Therefore, at this stage, all 70 questions remained in the designed tool. The intraclass correlation coefficient (ICC) for the revised questionnaire (70 questions) was calculated as 0.968 (P < 0.001), which indicates the high reliability of the questionnaire.