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Childhood Autism Tool - Trivandrum (CAT-T) - Development and Validation
Babu George1, Madhavi Sukumaran Razeena Padmam2, Muttathu Krishnapanicker Chandrasekharan Nair3
1Developmental & Behavioral Pediatrics, KIMS Health, Thiruvananthapuram, Kerala, India. bgtvpm@gmail.com.
Indian Journal of Pediatrics
|July 29, 2025
Summary
A new 24-item tool, the Childhood Autism Tool-Trivandrum (CAT-T), was developed to diagnose Autism Spectrum Disorder (ASD) in young children in Kerala. This culturally appropriate measure demonstrates adequate validity and reliability for ASD diagnosis.
Area of Science:
- Child Psychology
- Neurodevelopmental Disorders
- Psychometric Measurement
Background:
- Autism Spectrum Disorder (ASD) diagnosis in young children requires culturally sensitive tools.
- Existing diagnostic measures may not be suitable for diverse populations, necessitating the development of region-specific instruments.
- Early and accurate diagnosis of ASD is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To develop and validate a culturally appropriate diagnostic tool for ASD in children aged 2-6 years in Kerala.
- To ensure the measure meets established psychometric standards for reliability and validity.
- To provide a reliable instrument for clinicians and researchers in the region.
Main Methods:
- A qualitative study involving 200 children aged 2-6 years in Kerala.
- Development of the Childhood Autism Tool-Trivandrum (CAT-T) following the COSMIN protocol.
- Validation against established scales (CARS, VSMS) and exploratory factor analysis for construct validity.
Main Results:
- A 24-item CAT-T was finalized after factor analysis.
- CAT-T demonstrated moderate convergent and divergent validity with CARS and VSMS, respectively.
- The tool exhibited excellent test-retest reliability (ICC=0.86), inter-rater reliability (ICC=0.89), and internal consistency (Cronbach's alpha=0.86).
Conclusions:
- The 24-item CAT-T is a valid and reliable measure for diagnosing ASD in young children in Kerala.
- The developed tool addresses the need for a culturally appropriate ASD diagnostic instrument in the region.
- CAT-T provides a robust psychometric profile, supporting its use in clinical and research settings.
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