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Published on: March 14, 2018
Cross-Cultural Adaptation and Validation of the Simplified Chinese Version of the Communication and Symbolic Behavior
Weiqin Wang1, Lingyan Chen2, Zhongling Liu1
1Child Health Care Medical Division, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, China.
Purpose:
This study aimed to adapt and validate the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC) for infants aged 6-24 months in mainland China (Simplified Chinese version), ensuring its effectiveness in identifying communication delays and neurodevelopmental risks.
Method:
A cross-sectional validation study was conducted with 296 infants (Mage = 15 months; interquartile range: 11-19 months) recruited from Shanghai Children's Hospital. The CSBS-DP-ITC underwent systematic cross-cultural adaptation (forward translation, synthesis of translations, back-translation, expert committee review, pretesting, and final documentation review). Reliability was assessed using internal consistency (Cronbach's α, McDonald's ω), split-half reliability, and test-retest reliability (Spearman ρ; n = 130). Validity was evaluated using exploratory/confirmatory factor analysis (EFA/CFA), convergent/discriminant validity, and criterion validity against the Gesell Developmental Schedules (GDS)-Chinese version and known-groups validity.
Results:
The scale demonstrated excellent overall internal consistency (α = .92, ω = .93) and split-half reliability (.91). Test-retest reliability was strong at ≤ 90 days (ρ = .94-.96), but it declined over longer intervals. EFA and CFA confirmed the three-factor structure (social, speech, and symbolic; χ2/df = 2.88, Comparative Fit Index/Tucker-Lewis Index = 0.95, root-mean-square error of approximation = 0.080), although the discriminant validity between the social and symbolic composites was suboptimal (r = .88). Criterion validity with the GDS was moderate for the speech-language domain (κ = .50). Known-groups analysis showed significantly lower CSBS-DP-ITC scores in infants with developmental delay (p < .001). Notable ceiling effects (emotion/eye gaze, communication) and floor effects (words) were observed.
Conclusions:
The Simplified Chinese CSBS-DP-ITC exhibited robust reliability and acceptable validity for screening early communication skills among mainland Chinese infants. Generalizability may be constrained by urban, highly educated samples, and future studies should include rural populations.
Supplemental Material:
https://doi.org/10.23641/asha.32048631.
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