Translation and adaptation for the cross-cultural validation of the Family Impact of Assistive Technology Scale for Augmentative and Alternative Communication (FIATS-AAC)

Lino, Carolina Cristina Alves; Carvalho, Elis Souza de; Lourenço, Gerusa Ferreira

doi:10.1590/1982-0216/202426613923

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ORIGINAL ARTICLES • Rev. CEFAC 26 (6) • 2024 • https://doi.org/10.1590/1982-0216/202426613923 copy

Translation and adaptation for the cross-cultural validation of the Family Impact of Assistive Technology Scale for Augmentative and Alternative Communication (FIATS-AAC)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose:

to present data from the theoretical validation and face validation of the Family Impact of Assistive Technology Scale for Augmentative and Alternative Communication for the Brazilian context.

Methods:

an initial translation, a reconciled translation, a content assessment by experts, a back-translation, and face validation. Researchers, bilingual translators, and judges specialized in alternative and augmented communication, participated in the study.

Results:

the analysis of the translations and back-translations showed high reliability in most items, with some discrepancies adjusted according to the experience of professionals in the area. The face validation included the participation of parents/caregivers of children/adolescents who use alternative and augmented communication, resulting in adjustments to the items that generated questions.

Conclusion:

the study concludes that the research objectives were achieved, contributing to the continuity of the validation process of the scale’s psychometric properties, thus, providing a tool that assesses the impact of using alternative communication resources from the family's perspective.

Keywords:
Communication Aids for Disabled; Evaluation of Research Programs and Tools; Validation Study

Participant	P1	P2	P3	P4	P5
Relationship	Mother	Mother	Mother	Mother	Father
Education attainment	Postgraduate degree	High school graduate	Bachelor’s degree	High school graduate	High school graduate
Occupation	Educator specialized in school inclusion	Stay-at-home mother	Accountant	Stay-at-home mother	Unemployed
Child	C1	C2	C3	C4	C5
Age	11 years and 7 months	9 years and 10 months	7 years and 4 months	12 years and 11 months	7 years and 11 months
Sex	Male	Male	Male	Male	Male
Education level	5^th grade	3^rd grade	1^st grade	7^th grade	2^nd grade
Diagnosis or disability condition (if any)	Cerebral palsy	Cerebral palsy and syndrome to be defined	ASD	ASD	ASD
Type of AAC system/ resource currently used	PODD with Snap™ + Core First® (iPad) and printed boards	PODD in the tablet and book	Snap Core First	PECS and Video Modeling	System of figures on printed boards
Time of use	Paper boards for 5 years and iPad for 1 year	1 year	1 year and 6 months	11 years	About 5 years

Original version	Back-translated version
PLEASE READ: This questionnaire will help us to learn a bit about you, your child, and your family life as it relates to your child’s face-to-face communication. Please complete the questionnaire by saying how much you agree with each statement. For instance, the first item says: ‘My child needs help from others when communicating.’ If you strongly agree with this statement because your child always needs help from others when communicating, circle ‘7’. If you strongly disagree because your child never needs help, then circle ‘1’. Circle one of the other numbers if you agree or disagree to a lesser amount. Please circle only one rating for each statement.	READ HERE: This questionnaire will help us learn a little about you, your child, and your family life when it comes to your child's face-to-face communication. Fill out the questionnaire saying how much you agree with each statement. For example, the first item states: "My child needs help from others to communicate". If you strongly agree with this statement because your child always needs help from others when communicating, circle "7". If you strongly disagree because your child never needs help, circle "1". Circle one of the other numbers if you agree or disagree in a lower value. Circle only one classification for each statement.
1- My child needs help from others when communicating.	1- My child needs help from others to communicate.
2- My child lets me know if something is wrong.	2- My child lets me know if something is wrong.
3- I need more support from family members when caring for my child.	3- I need more support from family members when caring for my child.
4- I find it easy to play with my child.	4- I find it easy to play with my child.
5- My child needs a lot of help to be understood.	5- My child needs a lot of help to be understood.
6- Being independent improves my child’s self-esteem.	6- Being independent improves my child's self-esteem.
7- My child tells me what she/he wants.	7- My child tells me what they want.
8- My child has a tough time starting a conversation with people.	8- My child finds it difficult to start a conversation with people.
9- If my child got lost, she/he could ask someone for directions.	9- If my child got lost, they would be able to ask someone for information.
10- Others share the caregiving responsibilities for my child.	10- Other people share the responsibility of caring for my child.
11- My child tells me about her/his day.	11- My child tells me about their day.
12- My child’s communication disability affects my ability to work outside the home.	12- My child's complex communication needs affect my ability to work outside the home.
13- It is hard for me to get anything else done when my child is at home.	13- It is difficult for me to do anything else when my child is at home.
14- My child likes to be independent.	14- My child enjoys being independent.
15- My child can phone for help in an emergency.	15- My child can call for help in an emergency.
16- I need help from professionals to care for my child.	16- I need professional help to take care of my child.
17- More than one person is required to help my child communicate.	17- More than one person is needed to help my child communicate.
18- My child knows how to take turns during conversations.	18- My child knows how to take turns asking and answering during conversations.
19- My child is learning to communicate independently.	19- My child is learning to communicate independently.
20- My family needs to give up many other luxuries so my child can have the devices she/he needs.	20- My family needs to forfeit many other luxuries so that my child can have the necessary devices.
21- My child communicates with other people on the phone.	21- My child communicates with other people on the phone.
22- All family members take turns supporting my child when going out into the neighborhood.	22- All members of the family take turns supporting my child when walking around the neighborhood.
23- My child is very sociable.	23- My child is very sociable.
24- My child communicates with family members.	24- My child communicates with family members.
25- I feel my child is safe if I leave her/him with another babysitter/caregiver.	25- I feel that my child is safe if I leave them with another nanny/caregiver.
26- My child communicates with people with whom she/he is less familiar.	26- My child communicates with people they are less familiar with.
27- I find it tiring to help my child communicate.	27- I find it tiring to help my child communicate.
28- My child’s communication disability affects family finances.	28- My child's complex communication needs affect the family's finances.
29- I do most of the caregiving for my child at home.	29- I am my child's primary caregiver at home.
30- We watch our finances because of my child’s communication disability.	30- We are careful with our finances due to my child's complex communication needs.
31- Other people understand my child.	31- Other people understand my child.
32- It is very demanding saying what my child wants to others.	32- It is very difficult to say what my child wants to others.
33- My child knows how to keep a conversation going.	33- My child knows how to hold a conversation.
34- Everyone in my family knows how to communicate with my child.	34- Everyone in my family knows how to communicate with my child.
35- My child plays with friends.	35- My child plays with friends.
36- Communication devices for my child make it difficult for my family to afford anything else.	36- My child's communication devices make it difficult for my family to buy anything else.
37- My child tells me when she/he is afraid.	37- My child tells me when they are scared.
38- My child’s independence is increasing.	38- My child's independence is increasing.
39- My child communicates her/his ideas.	39- My child communicates their ideas.
40- Much of my time during the day is spent helping my child to communicate.	40- Much of my time during the day is spent helping my child communicate.
41- My child participates in community activities.	41- My child participates in community activities.
42- My child tells me when she/he feels sick.	42- My child tells me when they feel sick.
43- My child needs my help to communicate with others.	43- My child needs my help when communicating with other people.
44- My child converses well with friends.	44- My child talks well with his friends.
45- It is hard work helping my child with homework.	45- It is hard work to help my child with their homework.
46- My child could never go out in the neighborhood on her/his own.	46- My child could never go out in the neighborhood alone.
47- My child prefers to communicate with me rather than other family members.	47- My child prefers communicating with me than with other family members.
48- My child socializes with others at mealtime.	48- My child socializes with other people at mealtimes.
49- My child’s teacher is satisfied with my child’s performance in school.	49- My child's teacher is satisfied with their performance at school.
50- Other family members need to help me care for my child.	50- Other family members need to help me care for my child.
51- My child must be with others to be content.	51- My child needs to be with other people to be happy.
52- I have difficulty managing my child’s behavior.	52- I have a hard time controlling my child's behavior.
53- My child can spend a long time doing one activity.	53- My child can spend a lot of time doing an activity.
54- My child can communicate with others.	54- My child can communicate with other people.
55- My child enjoys school.	55- My child enjoys school.
56- I need longer breaks from watching my child.	56- I need longer breaks when taking care of my child.
57- My child gets frustrated easily.	57- My child is easily frustrated.
58- I have little time to get chores done around the house.	58- I have little time to do housework.
59- My child behaves well around me.	59- My child behaves well around me.
60- I have trouble coping with the demands of caring for my child.	60- I have a hard time dealing with the demands of caring for my child.
61- My child participates in the classroom.	61- My child participates in the classroom.
62- My child likes to explore her/his surroundings.	62- My child likes to explore their surroundings.
63- My child acts appropriately towards other family members.	63- My child acts appropriately with other family members.
64- My child wants to be with me when I leave the room.	64- My child wants to be with me when I leave the room.
65- I would like to get more breaks from caring for my child.	65- I would like to have more free time when taking care of my child.
66- My child is performing well in school.	66- My child is performing well at school.
67- I would like to spend more time with my other family members.	67- I would like to spend more time with other family members.
68- My child gets bored easily.	68- My child gets bored easily.
69- My child can play games.	69- My child can play games.
70- My child is well behaved at school.	70- My child behaves well at school.
71- I must take my child with me when I go from one room to another.	71- I need to take my child with me when I leave one room for another.
72- I need to get more things done around the house.	72- I need to do most of the housework.
73- My child can be happy when I am not holding her/him.	73- My child can be happy when I am not holding them.
74- I am concerned about my child’s safety when she/he is left alone.	74- I worry about my child's safety when they are left alone.
75- My child participates in extra-curricular activities at school.	75- My child participates in extracurricular activities at school.
76- My child can use her/his hands to play.	76- My child can use their hands to play.
77- I need help to take care of my child.	77- I need help taking care of my child.
78- I am satisfied with my child’s achievement of personal goals at school.	78- I am satisfied with my child's achievements of personal goals at school.
79- My child feels self-confident.	79- My child feels self-confident.
80- A family member needs to be near my child during the day.	80- A family member needs to be around my child during the day.
81- I wish my child could give me a few minutes to myself each day.	81- I wish my child could give me a few personal minutes every day.
82- I am concerned about the way my child behaves.	82- I am concerned about the way my child behaves.
83- My child can control toys without help.	83- My child can control toys without help.
84- My child is proud of her/his schoolwork.	84- My child is proud of their schoolwork.
85- My child can be happy when left alone to play.	85- My child can feel happy when they are left alone to play.
86- My child needs me nearby to do many activities.	86- My child needs me around to do many activities.
87- My child disrupts her/his classmates.	87- My child disturbs their classmates.
88- I can manage my child on my own.	88- I can take care of my child on my own.
89- My child likes to be near me.	89- My child enjoys being near me.

Item	Original	Translation	Observations	Adjustment
16	I need help from professionals to care for my child.	Eu preciso da ajuda de profissionais para cuidar do meu filho.	Specify that they are for daily care	Eu preciso da ajuda de profissionais para os cuidados diários do meu filho.
22	All family members take turns supporting my child when going out into the neighborhood.	Todos os membros da família se revezam apoiando meu filho ao sair pela vizinhança.	They found the phrase “strange”, but they understood it	The item was not changed
41	My child participates in community activities.	Meu filho participa de atividades comunitárias.	Questions about what community activities are	Meu filho participa de atividades na comunidade.
72	I need to get more things done around the house.	Eu preciso fazer mais tarefas domésticas.	Questions about whether these tasks are related to caring for the child who uses the resource.	The item was not changed
80	A family member needs to be near my child during the day.	Um membro da família precisa estar perto do meu filho durante o dia.	Questions that were answered explaining the need for supervision or assistance	Um membro da família precisa estar perto do meu filho durante o dia, supervisionando-o ou o auxiliando.

Item	Original	Back-translation	Considerations
22	All family members take turns supporting my child when going out into the neighborhood.	All members of the family take turns supporting my child when walking around the neighborhood.	The term “walking” can be very specific. “Going out” involves a variety of activities outside the home/around the neighborhood.
65	I would like to get more breaks from caring for my child.	I would like to have more free time when taking care of my child.	“Breaks” implies the need for relief from childcare, while “free time” does not convey the same meaning.
72	I need to get more things done around the house.	I need to do most of the housework.	“I need to get more things done” implies that they don’t have enough time to get everything done. The reverse translation doesn’t convey this message.

Item	Original	New Portuguese version	2^nd back-translation
22	All family members take turns supporting my child when going out into the neighborhood.	Todos os membros da família se revezam apoiando meu filho ao sair pela vizinhança.	All members of the family take turns supporting my child when going out around the neighborhood.
65	I would like to get more breaks from caring for my child.	Eu gostaria de ter mais pausas ao cuidar de meu filho.	I would like to have more breaks when taking care of my child
72	I need to get more things done around the house.	Eu preciso fazer mais tarefas e cuidados com a casa.	I need to do more chores and house care

ABRAMO Associação Brasileira de Motricidade Orofacial Rua Uruguaiana, 516, Cep 13026-001 Campinas SP Brasil, Tel.: +55 19 3254-0342 - São Paulo - SP - Brazil
E-mail: revistacefac@cefac.br

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[1] Corresponding author: Carolina Cristina Alves Lino, Rodovia Engenheiro Thales de Lorena Peixoto Júnior, 242 - Encontro Valparaíso I, CEP: 13564-873 São Carlos - São Paulo, Brazil, E-mail: c.lino.carol@gmail.com