Eastern Kentucky University Encompass Online Theses and Dissertations Student Scholarship January 2012 Preliminary Validation Of The hiC ldhood Autism Rating Scale - Second Edition Questionnaire For Parents Or Caregivers (cars2-Qpc) And The Gilliam Autism Rating Scale (gars-2) With A Chinese-Speaking Population Nannan Li Eastern Kentucky University Follow this and additional works at: https://encompass.eku.edu/etd Part of the Psychology Commons Recommended Citation Li, Nannan, "Preliminary Validation Of The hiC ldhood Autism Rating Scale - Second Edition Questionnaire For Parents Or Caregivers (cars2-Qpc) And The iG lliam Autism Rating Scale (gars-2) With A Chinese-Speaking Population" (2012). Online Theses and Dissertations. 69. https://encompass.eku.edu/etd/69 This Open Access Thesis is brought to you for free and open access by the Student Scholarship at Encompass. It has been accepted for inclusion in Online Theses and Dissertations by an authorized administrator of Encompass. For more information, please contact [email protected]. PRELIMINARY VALIDATION OF THE CHILDHOOD AUTISM RATING SCALE – SECOND EDITION QUESTIONNAIRE FOR PARENTS OR CAREGIVERS (CARS2-QPC) AND THE GILLIAM AUTISM RATING SCALE (GARS-2) WITH A CHINESE-SPEAKING POPULATION By NANNAN LI Doctor of Medicine in Psychology Xinxiang Medical University Xinxiang, Henan 2005 Submitted to the Faculty of the Graduate School of Eastern Kentucky University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE May, 2012 Copyright © Nannan Li Graduate Student, 2012 All rights reserved ii ACKNOWLEDGEMENTS I would like to sincerely thank Dr. Myra Beth Bundy for her guidance, wisdom, and encouragement. I feel honored to have had such a wonderful mentor. I would also like to thank the members of my thesis advising committee, Dr. Richard Osbaldiston, and Dr. Dustin Wygant for their support and expertise throughout this thesis project. Furthermore, I would like to thank Dr. Don Beal for his help, guidance, and support during this project. I would also like to thank my husband Fei Ma who have helped me to recruit participants for this study and continually supported me. I would like to express my thanks to the participants, who volunteered their time and efforts and made this study possible. Finally, I am very appreciative of my parents and family for always encouraging and supporting me in the pursuit of my education and goals. iii ABSTRACT Autism is a neurobiological disorder that is diagnosed through careful behavioral assessment in early childhood. Appropriate measurement of autism is essential for determining appropriate intervention strategies. Whereas, there are only a limited autism measures available for use in China. For this reason, valid and reliable measures of autism for use with Chinese speaking individuals are of critical importance. The purpose of the present study is to begin the process of developing two measures of autism for use with Chinese speaking individuals. The development of the measures of autism with Chinese speaking population was started by translating the Questionnaire for Parents or Caregivers of Childhood Autism Rating Scale – Second Edition (CARS2-QPC) and the Gilliam Autism Rating Scale– Second Edition (GARS-2) into Chinese. The translated versions then were given to a group of 20 Chinese Immigrants. The individual scores were examined to see the relationship between the English version and the Chinese version. The individual scores on the Chinese version and the English version of the CARS2-QPC and the GARS-2 correlated highly and significantly. Therefore, this study provided initial support for these Chinese versions of the CARS2-QPC and the GARS-2. Limitations and recommendations for future research were also discussed. iv TABLE OF CONTENTS CHAPTER PAGE 1. INTRODUCTION -------------------------------------------------------------------------------- 1 The Symptoms and Nature of Autism -------------------------------------------------------- 1 Social interaction---------------------------------------------------------------------------- 2 Communication------------------------------------------------------------------------------ 3 Repetitive behavior ------------------------------------------------------------------------- 4 Other symptoms ----------------------------------------------------------------------------- 5 The Prevalence of Autism Spectrum Disorders in Society -------------------------------- 6 Autism in China---------------------------------------------------------------------------------- 6 Cross-Cultural Development of Tests -------------------------------------------------------- 8 Applying an already existing instrument ------------------------------------------------ 8 Adapting an already existing instrument------------------------------------------------- 8 Assembling a new instrument ------------------------------------------------------------- 9 Influence of ICD-10 ------------------------------------------------------------------------ 9 Approach selected for this study---------------------------------------------------------- 9 Concept of Test Development ----------------------------------------------------------------10 v Rating Scales Used In This Study -------------------------------------------------------------------- 11 Questionnaire for Parents or Caregivers of Childhood Autism Rating Scale – Second Edition (CARS2-QPC) ----------------------------------------------------------11 Gilliam Autism Rating Scale–Second Edition (GARS-2)----------------------------15 Rating Scales Used In China------------------------------------------------------------------17 Research Questions, Expectations, and Hypothesis of the Investigation ---------------18 2. METHODS----------------------------------------------------------------------------------------20 Participants --------------------------------------------------------------------------------------20 Materials -----------------------------------------------------------------------------------------20 Questionnaire for Parents or Caregivers of Childhood Autism Rating Scale – Second Edition (CARS2-QPC) ----------------------------------------------------------22 Gilliam Autism Rating Scale–Second Edition (GARS-2)----------------------------22 Procedure ----------------------------------------------------------------------------------------23 3. RESULTS -----------------------------------------------------------------------------------------25 Characteristic of Participants------------------------------------------------------------------25 Similarity of Original and Back-translated versions---------------------------------------26 Correlational Analysis -------------------------------------------------------------------------27 Descriptive statistics -----------------------------------------------------------------------27 vi Correlational analysis----------------------------------------------------------------------29 Reliability Analysis-----------------------------------------------------------------------------33 4. DISCUSSION ------------------------------------------------------------------------------------34 Discussion of Participants ---------------------------------------------------------------------34 Discussion of the Correlation Analysis------------------------------------------------------36 Discussion of the Coefficient Alpha ---------------------------------------------------------37 Limitations and Perspective for Future Research ------------------------------------------37 Limitations ----------------------------------------------------------------------------------37 Suggestions for Future Study-------------------------------------------------------------39 Strengths of the present study ------------------------------------------------------------40 5. SUMMARY---------------------------------------------------------------------------------------42 REFERENCES --------------------------------------------------------------------------------------44 APPENDIX A. Informed Consent Form -------------------------------------------------------------------51 B. Demographic Information Form ---------------------------------------------------------53 C. Debriefing Form ----------------------------------------------------------------------------55 D. The original English Questionnaire for Parents or Caregivers of Childhood Autism Rating Scale – Second Edition (CARS2-QPC) ------------------------------58 vii E. The original English Gilliam Autism Rating Scale–Second Edition (GARS-2) --65 F. The back-translated English Questionnaire for Parents or Caregivers of Childhood Autism Rating Scale – Second Edition (CARS2-QPC) ------------------------------74 G. The back-translated English Gilliam Autism Rating Scale–Second Edition (GARS-2)------------------------------------------------------------------------------------81 H. The Chinese Questionnaire for Parents or Caregivers of Childhood Autism Rating Scale – Second Edition (CARS2-QPC)-------------------------------------------------92 I. The Chinese Gilliam Autism Rating Scale–Second Edition (GARS-2)-------------99 J. GARS-2 and CARS2-QPC rating scale comparison in English between original and back-translation --------------------------------------------------------------------- 110 K. Revised GARS-2 and CARS2-QPC rating scale items comparison in English between original and back-translation ------------------------------------------------ 117 VITA ------------------------------------------------------------------------------------------------