Level 2 Screening for Autism Spectrum Disorder in Young Children: Cross-Cultural Adaptation and Validation of the Behaviour Development Screening for Toddlers (BeDevel) in China.
The Chinese BeDevel spots ASD in toddlers as well as the original English version, so you can screen Mandarin-speaking families with confidence.
01Research in Context
What this study did
The team translated the Behaviour Development Screening for Toddlers (BeDevel) into Chinese. They gave the 5-minute checklist to the kids months in Beijing clinics.
Half of the children already had an ASD diagnosis, half were typically developing, and a small group had other delays. Parents filled out the form while clinicians gave a full gold-standard assessment blind to the screen results.
What they found
The Chinese BeDevel caught 85-96 % of the toddlers who truly had ASD. It also correctly ruled out 89-94 % of the kids who did not have ASD.
Those accuracy numbers stayed high whether the child was 16 months or 3 years old. Test-retest and inter-rater reliability were both above 0.90, which is excellent.
How this fits with other research
Maïano et al. (2011) and Wilson et al. (2023) did the same kind of cultural re-write. They took Western-made tools, translated them, and proved the new versions still work. Kaiyan et al. now adds toddler ASD screening to that list.
Matson et al. (2004) saw that teacher ADHD scales held up better than parent scales in kids with ID. Kaiyan’s parent-report BeDevel did hold up, probably because ASD traits are more stable than ADHD symptoms and the toddler age removes classroom noise.
Sisson et al. (1993) found weak agreement between self- and caregiver reports for depression in teens with ID. Here, agreement was strong, showing that when the trait is clear-cut and the reporter knows the child well, a single caregiver screen can be enough.
Why it matters
If you serve Mandarin-speaking families, you now have a quick, free, Level-2 screen you can trust. Hand the parent the 20-item BeDevel while they wait; a score in the red zone gives you evidence to fast-track a full evaluation and start Early Intervention months earlier.
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02At a glance
03Original abstract
BACKGROUND: Early screening tools for autism spectrum disorders (ASDs) have made great strides in recent years. The BeDevel is a comprehensive and precise screening instrument that addresses many of the shortcomings found in other screening instruments, including limited cultural adaptability and insufficient sensitivity. Therefore, we further analyzed its cultural adaptability and validity. METHODS: We worked with the original development team to translate and back-translate the BeDevel into Chinese. With the guidance of a committee, we made semantic and cultural modifications to the BeDevel to assess its cross-cultural adaptability. We gathered validation data from 542 participants (9-11 months, n = 24; 12-17 months, n = 61; 18-23 months, n = 136; 24-35 months, n = 217; 36-42 months, n = 104). The study included 191 individuals with ASD, 103 with DD and 248 with TD. Individual items and total scores were analyzed for internal consistency, agreement with clinical diagnosis (yielding optimal cut off numbers of Item, sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV]) and consistency with existing diagnostic instruments. RESULTS: The mean Cronbach's α coefficients of the Chinese version of BeDevel-I/P were all above 0.8 (ranging from 0.872 to 0.93), with correlation coefficients greater than 0.05 (r = 0.061 to 0.834). Metrics of diagnostic accuracy across age groups were as follows: κ coefficient, 0.064-0.722; sensitivity, 0.853-0.962; specificity, 0.429-1.000; PPV, 0.758-1.000; and NPV, 0.700-0.974. κ values for interinstrument consistency ranged from 0.432 to 0.973 and exceeded 60% for all instruments compared. CONCLUSIONS: The Chinese version of the BeDevel has demonstrated high reliability and effectiveness in screening for autism. Therefore, we recommend this validated C-BeDevel for Level 2 ASD screening in both clinical and maternal and child health settings.
Journal of intellectual disability research : JIDR, 2026 · doi:10.1111/jir.70064