Tradução, adaptação transcultural e validação da MSPA: uma nova ferramenta para avaliação do TDAH e do TEA na infância

Abstract

A growing number of research is now supported by Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), which emphasizes the need of identifying, treating and investigating individuals with comorbid Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) by scientific and clinical community involved in infant mental health. The use of standardized instruments is vastly employed in clinical setting and makes symptom assessment more practical, comprehensive, and objective. Currently, there is not a instrument available in Brazil that characterize both disorders, while the use of more than one instrument to fill this gap turns assessment longer and more expensive. In this context, this study aims to translate, cross-culturally adapt and validate the Multidimensional Scale for Pervasive Developmental Disorder (PDD) and Attention Deficit/Hyperactivity Disorder (ADHD) Brazilian version (MSPA-BR). This is a semistructured interview that depicts the main symptoms associated to ASD (formerly known as PDD) and ADHD, as well as associated clinical features (e.g. sleep, learning, motor skills, etc.). Translation and adaptation processes followed strict and pre-established methodology involving two independent translations, a synthesis, two independent back-translations, a new synthesis and final observations on content and comprehension. Following, we proceeded with a agreement analysis between the new Brazilian version and the baseline English version. Afterwards, reliability and construct and criterion validity analyses were conducted. Agreement between Brazilian and English versions showed good indexes through Spearmans rho and Bland-Altman analysis. Exploratory Factor Analysis (EFA) produced factor loadings in accordance to what would be expected. Sleep cycle variable loaded under ADHD factor, while isolated special skill did not load in any factor. Criterion validity was investigated through correlation indexes among MSPA-BR factors and variables and correspondent scales or behavioral measures. Significant and higher correlations were found between MSPA-BR factors and scales, in spite of behavioral measures. Cronbachs was adequate for all analyses, either by factor of full scale, considering the initial model proposed by original authors and the structured suggested by EFA. Agreement for inter-rater and test-retest had indices disturbed by sample sizes, though percentages of absolute agreement yielded good results. We resolve that MSPA was adequately translated and adapted. Its psychometric properties suggest that MSPA-BR does assess main and side clinical signs associated to ASD and ADHD in a reliable and stable manner. This study offers to Brazilian population an instrument to characterize ASD and ADHD among children.