Is traditional back translation enough? Comparison of translation methodology for an ASD screening tool.
Back-translation alone warps Spanish autism screeners—add cultural adaptation or risk invalid scores.
01Research in Context
What this study did
DuBay et al. (2022) tested two ways to turn an English autism screener into Spanish. One team used plain back-translation. The other added cultural tweaks so items matched life in Spanish-speaking homes.
They then gave both versions to caregivers and checked if the two forms still measured the same thing.
What they found
The two Spanish forms did not act alike. Caregivers answered the same core questions differently depending on which version they saw.
In short, classic back-translation alone broke the test. Cultural adaptation was required to keep the meaning intact.
How this fits with other research
Fitzpatrick et al. (2017) and de Kuijper et al. (2014) both got good Spanish results, but they already baked cultural edits into their process. Michaela’s work shows what happens when you skip that step.
Heo et al. (2008) and Sun et al. (2014) also found solid psychometrics after adapting items for Korean and Mandarin families. The pattern is clear: straight word-for-word translation is not enough.
Taylor et al. (2017) took the extra step with isiZulu red-flag items and saw clean group differences, again proving cultural fit matters.
Why it matters
If you use a Spanish autism screener, ask the publisher if they only back-translated. If the answer is yes, treat scores with caution and look for a culturally-adapted edition. When you adapt a tool yourself, pilot both versions with local parents and compare item-level data before you lock the final form. A few extra weeks of cultural tweaking can save months of mis-screening later.
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02At a glance
03Original abstract
Early identification of autism spectrum disorders (ASD) in non-English speaking children often relies on translation of English ASD screening measures. Most measures employ a forward-back translation approach, despite data suggesting that this method may result in poor psychometric properties. Some studies in non-ASD fields have suggested that a rigorous method of translation with cultural adaptation may yield better psychometric properties, but no studies in the ASD field have compared the two approaches directly. This investigation compares these two translation methodologies to determine if they produce psychometrically similar or dissimilar measures. Three hundred and eighty US-based Spanish-speaking caregivers of children 8-16 months old were randomly assigned to complete either a forward-back Spanish translation or a rigorous translation with cultural adaptation of a parent-report ASD screening tool. Measurement invariance analyses determined that the two translations were psychometrically dissimilar. Additional qualitative explanatory methods using cognitive interviews examined textual differences and participant preferences between non-invariant items. LAY SUMMARY: Autism screening questionnaires created in English need to be translated into other languages so non-English speaking parents can fill them out accurately. Traditionally, researchers have not considered cultural differences when they translate these questionnaires. When we compared a direct translation to a translation with cultural adaptations, the two questionnaires were statistically different. Parents interpreted and responded to the same questions differently, depending on which version they filled out.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1016/j.rasd.2019.02.005