Systematic review: cultural adaptation and feasibility of screening for autism in non-English speaking countries

Al Maskari, T. S. , Melville, C. A. and Willis, D. S. (2018) Systematic review: cultural adaptation and feasibility of screening for autism in non-English speaking countries. International Journal of Mental Health Systems, 12, 22. (doi: 10.1186/s13033-018-0200-8) (PMID:29760771) (PMCID:PMC5941599)

Abstract

Background: Screening children for autism has gained wider acceptance within clinical practice, and early intervention has improved outcomes. Increasingly, adapting an existing screening instrument is a common, fast method to create a usable screening tool, especially for countries with limited resources and/or expertise. However, concerns have been raised regarding adaptation adequacy and the feasibility of screening across cultural groups. This study systematically examined the levels of cultural adaptation and feasibility aspects considered when screening for autism in non-English speaking countries to build upon the sparse knowledge that exists on this topic in the literature. Methods: Nineteen studies, obtained from fve electronic databases, were examined. PRISMA guidance was used for this review. The Ecological Validity Framework model, and Bowen Recommendations for Feasibility were adopted to extract relevant data, which was synthesised narratively. Results: Cultural adaptation within the included studies mostly involved language translation with little information ofered to enable conclusions on how the processes were guided and maintained. Few cultural adjustments involved modifying screening methods; clarifying difcult concepts and changing instrument content were employed to address the core values, competence, beliefs, and norms of the adapted culture. However, less attention was given to adapt the screening goals within the context of cultural values, and customs or to consider interactional match between the clients and assessors. The review also highlighted an acceptable level of practicality to screen for autism but did not encourage integrating autism screening within routine practice or beyond the study context for diferent cultures. Conclusion: Concurring with previous literature, we agree that knowledge on cultural adaptation for autism screening instruments is limited and not sufciently documented to establish adaptation levels (process and/or contents), and prove adequacy. However, this review provides an infrastructure to improve future adaptation processes. Integrating autism screening as routine medical practice is not encouraged and warrants further feasibility studies to minimize wasted resources and improve screening efectiveness in various health care systems.

• Item Type: Articles
• Additional Information: Funding was provided to frst author, TAM, by the Oman Ministry of Higher Education, as part of a Ph.D. project.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Willis, Dr Diane and Al Maskari, Turkiya Saleh Mohammed and Melville, Professor Craig
• Authors: Al Maskari, T. S., Melville, C. A., and Willis, D. S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: International Journal of Mental Health Systems
• Publisher: BioMed Central
• ISSN: 1752-4458
• ISSN (Online): 1752-4458
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in International Journal of Mental Health Systems 12: 22
• Publisher Policy: Reproduced under a Creative Commons License