Culturally Adapted Assessment Tool for Autism Spectrum Disorder and its Clinical Significance

Diagnosing of Autism Spectrum Disorder (ASD) using tools developed in the West is challenging in the Indian setting due to a huge diversity in sociocultural and economic backgrounds. Culturally adapted tools, such as the International Clinical Epidemiology Network (INCLEN) Diagnostic Tool for Autism Spectrum Disorder, have been developed in several Indian languages, yet, they do not accommodate all verbal abilities and education backgrounds. To address this disparity, we developed a home-based, audiovisual game app (Autest) suitable for ASD risk assessment in Indian children under 10 years of age. The game has five modules for each age group with specific peer interaction and play skill assessments. Each module follows a story from the Panchatantra, a popular Indian story series for children. Gameplay and behavior are tracked to assess risk. The effectiveness of Autest was rated by 30 psychologists with respect to current tools. Ratings suggested that the tool is effective and can reduce social inhibition and facilitate assessment due to the lack of a language barrier using emojis, cultural appropriateness, ease of administration, and simple scoring. This tool is particularly useful minimally verbal, at-risk children. Further usage and development of Autest can improve risk assessment and early intervention measures for children with ASD in India.