⁠ Translation and Malay Cross-Cultural Adaptation of ASD and ADHD Domains in A-TAC for Use in Malaysia: A Preliminary Reliability Study

Abstract

Introduction: Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are prevalent neurodevelopmental disorders. Early diagnosis is essential for timely intervention. The Autism-Tics, ADHD, and other Comorbidities inventory (A-TAC) is widely used for screening, but its applicability for Malay-speaking populations in Malaysia has not been established. This study aimed to translate, culturally adapt, and pilot selected A-TAC domains into Bahasa Malaysia. Methods: A forward-backward translation process was employed to adapt the A-TAC Lite (17 ASD items, 19 ADHD items). Content validity was assessed by eight experts (clinical psychologists, psychiatrists, a speech therapist and an occupational therapist). A pilot test was conducted with 20 Malaysian parents of children diagnosed with ASD or ADHD. Content Validity Ratio (CVR) and Index (CVI) were calculated. Internal consistency of both domains was measured using Cronbach’s alpha. Results: Experts suggested minor revisions to improve clarity and cultural relevance. CVR values ranged from 0.75 to 1.00, with all items meeting retention criteria. Most items achieved Item-CVI values >0.80. Scale-level CVI/Ave across domains (relevancy, clarity, simplicity, ambiguity) ranged from 0.96 to 0.98. The adapted tool, A-TAC Lite MY, demonstrated strong internal consistency (Cronbach’s alpha = 0.89 for ASD, 0.95 for ADHD). Conclusion: The Bahasa Malaysia version of the A-TAC Lite appears to be linguistically and culturally appropriate for screening ASD and ADHD symptoms in Malaysia children. While content validity was established, further psychometric testing, including reliability and construct validity assessments, is needed to fully validate the tool for use in clinical, research and educational settings.