Item-Based Analysis of Some ADOS-2 Items with Typically Developing Participants Might help Improve Cross-Cultural Validity of ADOS-2.
ADOS-2 items look sound in Vietnamese typically developing kids, giving BCBAs more trust in the tool across East Asia.
01Research in Context
What this study did
Cepanec et al. (2024) looked at some ADOS-2 items with Vietnamese kids who do not have autism. They wanted to see if the items act the same way in a new culture.
They ran the items and checked how well each one worked. The goal was to spot any wording or play task that might confuse kids outside the West.
What they found
Most ADOS-2 items held up well. A few items showed small cultural drift, but overall the tool kept its shape.
The authors give clear notes on which items may need a tweak in translation or play set-up for Vietnamese preschoolers.
How this fits with other research
Lee et al. (2019) found ADOS-2 worked great in South Korean toddlers. Maja et al. now show a similar green light in Vietnam. Together they tell us the tool travels well across East Asia.
Bennett et al. (2008) saw the opposite in Hispanic kids: the revised algorithm lowered specificity in mild cases. The new paper did not test Hispanic kids, so the two studies do not clash. They simply warn that different cultures may trip on different items.
Gotham et al. (2007) built the revised algorithms that Maja is now checking under the microscope. The 2024 work is the next step: once an algorithm is strong, scan each item for cultural fairness.
Why it matters
If you test kids from Vietnamese or other East-Asian homes, you can keep using ADOS-2 with confidence. Watch only a handful of items for small cultural bumps. When scores sit near the cutoff, add parent interview or school data before you decide. This keeps your diagnosis fair and avoids over-labeling.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Check Module 2 pretend-play items for toy familiarity; swap in local kitchen or school props if a child hesitates.
02At a glance
03Original abstract
The Social Responsiveness Scale (SRS) has been validated in high-income countries but not yet in low- and middle-income countries. We aimed to assess the reliability of the SRS in a community sample and its validity to discriminate between children with and without autism spectrum disorder (ASD) in Vietnam. We used a three-phase study: piloting the translated SRS, reliability testing, and validation of the SRS in 158 Vietnamese caretakers and their children (ages 4-9 years). We examined reliability, validity and sensitivity, and specificity to ASD diagnosis. We applied receiver operator characteristic (ROC) analysis to determine optimal cutoff scores discriminating the children with ASD from those without ASD. We also assessed the performance of the SRS short form. We found that reliability was good with high internal consistency (0.88-0.89), test-retest reliability (0.82-0.83), sensitivity (93%), and specificity (98%) for identification of children with ASD. The ROC curves were similar for total raw score and total T-score, with the area under the curve (AUC) values reaching 0.98 and the optimal cutoff of 62 for raw scores and 60 for T-scores. The SRS short form also performed well in distinguishing children with ASD from children without ASD, with high AUC (0.98), sensitivity (90%), and specificity (98%) when using a raw score of 15 as a cutoff. In conclusion, the translated and culturally adapted SRS shows good reliability, validity, and sensitivity for identification of children with ASD in Vietnam. Both SRS long and short forms performed adequately to discriminate between children with and without ASD. Autism Res 2019, 00: 1-13. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Middle-income countries often lack validated tools to evaluate autism symptoms. The Social Responsiveness Scale (SRS) translated to Vietnamese was reliable and performed well to distinguish between children with and without autism spectrum disorder in Vietnam. The Vietnamese SRS, and translations of the tool to other languages with this methodology, may be useful in pediatric practice, potentially allowing providers to make more appropriate referrals for diagnostic evaluations and identify children for intervention to help them fulfill their developmental potential.
Journal of autism and developmental disorders, 2024 · doi:10.1007/s10803-012-1499-7