Adaptation and validation of the strengths and weaknesses of ADHD symptoms and normal behavior scale (SWAN) among 5 - 12 year old children in Colombo District

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder and is characterized by persistent age-inappropriate core symptoms of inattention, hyperactivity, and impulsiveness that could result impairment in one’s major life activities and wellbeing. Hence, early identification, and prompt treatment are essential. Screening tools are commonly used by clinicians and researchers to assess ADHD, however lack of culturally adapted and validated screening tools in Sri Lankan context hinders the early identification of ADHD in children. TheStrengths and Weaknesses of ADHD symptoms and Normal behavior (SWAN) rating scale assesses the symptoms of ADHD and has 18 items with a 7-point rating. The aim of this study was to adapt and translate the SWAN scale to Sinhala language by establishing content and consensual validity and measure the construct, criterion validity along with assessing the reliability. This is a cross-sectional and correlational study. The psychometric properties of the SWAN Sinhala scale were established using a community sample of 220 parents of school children who were between 5 and 12 years old in Colombo district and a clinicalsample of 50 parents of children that were diagnosed with ADHD at Lady Ridgway Hospital (LRH), Colombo. The reliability of the SWAN scale was measured using the community sample and the achieved internal consistency reliability Cronbach’s alpha value plus the test-retest reliability stability were 0.96, and 0.96, indicating as excellent. The clinical utility of the Sinhala SWAN scale was examined by executing criterion validity through resulting good concurrent validity. Further, convergent validity in the community sample was agreeable and the obtained Principal Component Analysis factor loadings and structures were adequate. In conclusion, the SWAN Sinhala version retains sound psychometric properties as of the original SWAN and will be a valuable instrument to screen ADHD among 5 to 12 year old children in Sri Lankan context.