Screening for Intellectual Disabilities and/or Autism Amongst Older Children and Young Adults: a Systematic Review of Tools for Use in Africa

There are many well-developed screening tools for both intellectual disabilities and autism, but they may not be culturally appropriate for use within Africa. Our specific aims were to complete a systematic review to (1) describe and critically appraise short screening tools for the detection of intellectual disabilities and autism for older children and young adults, (2) consider the psychometric properties of these tools, and (3) judge the cultural appropriateness of these tools for use within Africa. Six screening tools for intellectual disabilities and twelve for autism were identified and appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. We identified two screening tools which appeared appropriate for validation for use within African nations

Validation of the social communication questionnaire amongst Nigerian adolescents

Few autism spectrum disorder (ASD) screening tools have been developed and validated in Africa. This study aimed to examine the psychometric properties of the Social Communication Questionnaire (SCQ) when used with Nigerian adolescents. Parents and caregivers of two hundred and five adolescents completed the SCQ Lifetime form while the adolescents were assessed for ASD using the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS‐2). Factor structure and convergent and discriminative validity were examined, along with the sensitivity and specificity of the SCQ in identifying participants with an autism spectrum disorder. The confirmatory factor analysis (CFA) was used to examine the factor structure, while logistic regression and Pearson's correlation coefficient were used to examine the validities. The SCQ had good internal consistency, discriminative, and convergent validity. A cut‐off score of 10 revealed sensitivity = 0.81 and specificity = 0.88 for the identification of autism spectrum disorder. AUC was 0.83, p < 0.001, 95% CI [0.77, 0.90]. The results of this study provide evidence to support the retention of the original four factors of the SCQ. The SCQ has good psychometric properties when used with Nigerian adolescents

Using the consensus group method to select the best screening tools for autism and intellectual disability for use with Nigerian adolescents

Diagnosing autism or ID using a gold‐standard tool can be time‐consuming, costly, and requires training, which is generally limited in Nigeria, and the rest of Africa. Screening, on the other hand, can be quick and effective, with minimal training depending on the tool (Iragorri & Spackman, Public Health Reviews, 2018;39(1):17), thus making the availability of short screeners a necessity in Nigeria, and the rest of Africa. We identified four screening tools through a previously completed systematic review (Nwokolo et al., Review Journal of Autism and Developmental Disorders, 2022;1–23.), two (SCQ and AQ‐10) for autism and two (SCIL and CAIDS‐Q) for ID, which appeared appropriate for validation for use within African nations. The Nominal Group Technique was used with a purposive group of professionals, parents, and laypersons to select and adapt the existing screening tools for autism and ID for use with older children and adolescents in Nigeria. The group examined the screening tools for cultural relevance, face and content validity. Following the discussions, items were either (1) accepted in the original form or (2) more culturally appropriate examples chosen if at least 75% of participants agreed. The group selected the SCQ for autism and the SCIL for ID. The minimum agreement on all autism and ID measures items was 84%, and this indicated the measures had face and content validity for use within Nigeria. Following the recommendations and consensus of the group, the SCQ and the SCIL 14–17 were agreed on as measures to be validated with the Nigerian adolescents, with only a small number of adjustments needed to allow for different use of language, customs and environment in the Nigerian context