Translation and language validation of the Epworth sleepiness scale for children and adolescents (ESS-CHAD) into Brazilian Portuguese

Abstract

Objective: This study aimed to translate the Epworth sleepiness scale for children and adolescents (ESS-CHAD) into Brazilian Portuguese. Material and Methods: The translation and language validation processes were carried out through translation, back translation, technical review, assessment of verbal comprehension/clarity of the scale by experts (four pediatric neurologists). After they have reached a final version of the ESS-HAD a sample of asymptomatic children and adolescents that were participants in another sleep project were invited to read and complete the questionnaire to evaluate comprehension by the aimed population. Results: Two independent researchers made the forward translation and it has around 90% of concordance. Minor disagreements were related to the position of adjectives in the sentence. No major difficulties were reported by the 3 rd researcher that performed the back translation. After a consensus meeting with the four participants, we have reached a final version of the questionnaire. In the cognitive interviews, the scale was reportedly easy to understand to the 23 respondents. One adolescent suggested clarifying whether question 2 (likelihood of falling asleep watching TV or a video), referred to daytime or nighttime. The total ESS-CHAD score in this asymptomatic sample varied from 0-17, a mean score of 7.08±5.65. Discussion: The final version of the ESS-CHAD in Brazilian Portuguese was approved by the copyright owners and was well understandable by caregivers and adolescents. More studies are now necessary to use this questionnaire in a larger target population to verify its validity and internal consistency.

Daytime Sleepiness from Preschool Children’s and Parents’ Perspectives: Is There a Difference?

“…Due to some specificities, some adaptations had to be made to administer the questionnaire among children of different age groups. Created for the English-speaking population, the ESS-CHAD has been translated and proven for its reliability and validity in different languages [20,21,27].…”

“…There are various instruments available to assess excessive daytime sleepiness in different age groups of children. The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) is a highly valid, reliable and unidimensional tool for evaluating daytime sleepiness that has been translated and validated in several languages [19][20][21][22]. However, it has yet to be utilized in Croatian children.…”

Validation of the Malay version of Epworth sleepiness scale for children and adolescents (MESS-CHAD)

“…Furthermore, Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) could aid in delineating the clinical and polysomnography (PSG) characteristics of sleep disorders in children with excessive daytime sleepiness [ 19 ], as well as monitoring the treatment progress of sleep disorders by measuring excessive daytime sleepiness pre- and post-treatment, e.g., for nasal continuous positive airway pressure or mandibular advancement appliance therapy [ 20 ]. To date, Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) has been translated and validated into Persian [ 21 ], Turkish [ 22 ], and Brazilian Portugese [ 23 ].…”