Screening Questionnaire for Early Signs of Autism Spectrum Disorder: evidence of validity and internal consistency

ABSTRACT Objective Assess the evidence of validity and the internal consistency of the Questionnaire for Screening Early Signs of Autism Spectrum Disorder (QR-TEA). Methods Four healthcare professionals with more than five years of clinical experience in treating children diagnosed with ASD analyzed the content. A sample of 133 parents/guardians of children aged 24-36 months from all over Brazil participated in the internal structure and internal consistency study. Participants answered the questionnaire through interviews with healthcare professionals. An exploratory factor analysis technique verified the factor structure. Additionally, to assess the instrument’s internal consistency, the composite reliability was calculated. Results i-IVC = 1.00 was found for most items; Kappa between 0.51 and 0.94; p < 0.05; CCI = 0.90; p < 0.05. Exploratory factor analysis pointed to a two-factor solution for QR-TEA. Composite reliability was adequate (above 0.70) for both factors. The factor structure replicability measure suggested that the two factors are replicable in future studies (H > 0.80). Conclusions The data indicate initial evidence of validity and adequate internal consistency. The findings also support the psychometric adequacy of the QR-TEA in line with the DSM-5 two-factor model. It is recommended to conduct further studies to assess other evidence of validity and to verify the sensibility and specificity.

摘要：研究目的 评估自闭症谱系障碍早期症状筛查问卷（QR-TEA）的效度证据与内部一致性。研究方法 招募4名拥有5年以上儿童自闭症谱系障碍（Autism Spectrum Disorder, ASD）临床诊疗经验的医护人员对问卷内容进行效度评审；同时招募来自巴西全境的133名24至36个月龄儿童的家长或监护人参与问卷内部结构与内部一致性验证研究，所有参与者均通过医护人员访谈完成问卷填写。本研究采用探索性因子分析技术验证问卷的因子结构，并通过计算组合信度评估该工具的内部一致性。研究结果 多数条目的项目内部一致性系数（i-IVC）为1.00；Kappa值介于0.51至0.94之间（p < 0.05）；组合信度系数（CCI）为0.90（p < 0.05）。探索性因子分析结果显示，QR-TEA符合双因子结构模型；两个因子的组合信度均达标（高于0.70）；因子结构可复制性测量结果表明，该双因子结构在未来研究中具备良好可复制性（H > 0.80）。研究结论 本研究数据为QR-TEA提供了初步的效度证据与充足的内部一致性，研究结果同时支持QR-TEA符合《精神障碍诊断与统计手册第五版》（Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5）的双因子模型，具备优异的心理测量学特性。建议后续开展进一步研究以评估该问卷的其他效度证据，并验证其敏感性与特异性。