Adaptation of autism spectrum screening questionnaire (ASSQ) for use in Georgian school settings

Abstract

Purpose Even though 95% of children with neurodevelopmental disorders, including autism spectrum disorder (ASD), live in low- and middle-income countries, there is a dearth of studies from these countries, including the Republic of Georgia. Several ASD screening tools are available, but few are validated for use in Georgian or other smaller countries. This study aims to adapt and validate the autism spectrum screening questionnaire (ASSQ) for use in Georgia. Design/methodology/approach The ASSQ was administered for all third-grade students in 402 schools in the five main Georgian cities, n = 27,336. Prior to use, the 27-item ASSQ was translated, back-translated and adapted for use in Georgia. A total of 16,556 students (approximately 61%) were assessed by a parent and/or teacher. Optimal cutoff scores were estimated. Randomly chosen children who screened positive (n = 173) and negative (n = 127) were offered comprehensive assessment using standardized diagnostic procedures. Findings Data from 15,510 parents- and 13,517 teachers-administered ASSQ revealed statistically significant differences in median and cutoff scores between parents and teachers: 7 versus 4 and 9 versus 6, respectively. Cutoff score = 14, on either parent or teacher ASSQ, had sensitivity of 0.94, indicating that it can be used in school settings. Originality/value The Georgian adaptation of the ASSQ creates opportunity for further ASD research, while also providing a valid screening tool for clinicians. Data from Georgia will add to the growing understanding of the broader ASD phenotype.

Special considerations for assessing and caring for autism in girls and women

“…Current screening assessments may not be sensitive enough to detect the clinical presentations of autistic females as ASD traits vary by age and sex, and the standardization studies still tend to be dominated by autistic male samples in many countries [13,27]. Additionally, autistic girls and women with ID, are disproportionately excluded from research, especially in studies that require self-report such as mental health [28].…”

“…Additionally, autistic girls and women with ID, are disproportionately excluded from research, especially in studies that require self-report such as mental health [28]. For example, the Georgian adapted version of Autism Spectrum Screening Questionnaire (ASSQ) [29] lacked specificity in screening girls, with both parent-and teacher-report suggesting more work is needed to improve the screening ability of the Georgian version of ASSQs for use among girls [27]. Belcher et al [30] stress the importance of revising the Autism Spectrum Quotient (AQ) [31], as it emerged in their study that only two items out of 50 in AQ were gender unbiased.…”

Editorial: 25 years on

“…It was then validated, which successfully showed that the Indian version of ESCoT is appropriate for children aged 6–12. This could be very useful; the work is comparable to the Georgian adaptation of a related screening test: Zirakashvili et al (2022). (This paper has now attracted over 1,000 downloads.…”