Ages and stages questionnaires: adaptation to an Arabic speaking population and cultural sensitivity

Background: Early detection of developmental delay is essential to initiate early intervention. The Ages and Stages Questionnaires (ASQ) correlate well with physician's assessment and have high predictive value. No such tool exists in Arabic.

Aims: Translate and test the applicability and reliability of Arabic translated Ages and Stages Questionnaires (A-ASQ) in an Arabic speaking population.

Methods: 733 healthy children were assessed. ASQ-II for 10 age groups (4-60 months) were translated to Arabic, back translations and cultural adaptation were performed. Test-retest reliability and internal consistency were evaluated using Pearson Correlation Coefficient (CC) and Cronbach's alpha (Cα). Mean scores per domain were compared to US normative scores using t-test.

Results: A-ASQ, after culturally relevant adaptations, was easily administered for 4-36 months age groups but not for 4-5 year old due to numerous cultural differences in the later. For the 4-36 month age groups Pearson CC ranged from 0.345 to 0.833. The internal consistency coefficients Cα scores ranged from 0.111 to 0.816. Significant differences were found in the mean domain scores of all age groups between Lebanese and US normative sample (p-value <0.001) with some exceptions in gross motor, fine motor and personal social domains.

Conclusion: A-ASQ was easily translated and administered with acceptable internal consistency and reliability in the younger age groups. It proved to be culturally sensitive, which should be taken into consideration when adapting such tool to non-western populations.