Validity and Reliability of Family Time and Routines Index in the Families of Children With Autism

Objective Autism spectrum disorders are among the most prevalent developmental disorders. Diagnostic criteria for these disorders consist of the two general categories of symptoms, including deficiencies in communication and social interactions, and limited, repetitive and stereotypic patterns in behavior, interests, and activities. Routines are well-established  and the regular patterns of occupations and activities that provide structure and stability for everyday life and add meaning to it can affect health. The disabling nature of autism and its numerous associated problems unable families to develop effective and meaningful routines; consequently, the integrity and solidarity of family are lost and family is disturbed. A proper tool is required to evaluate everyday routine in the families of children with autism. The present study investigated the validity and reliability of the Family Time and Routines Index (FTRI) in the Iranian families of children with autism.
Materials & Methods This was a non-experimental methodological study. The statistical population of the study consisted of all children with autism in Tehran City, Iran. Among them, 100 parents of children with autism referring to autism centers and private clinics in Tehran were selected by the convenience sampling method; they were entered into the study, according to the inclusion criteria. Inclusion criteria were the diagnosis of autism by a child psychiatrist, based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), the age of 3-11 years, and the absence of blindness, deafness, epilepsy, and other disabilities in the child. Moreover, the subjects with no desire to cooperate or uncompleted the questionnaires were excluded from the study. The required data were collected using demographic information questionnaire and FTRI completed by parents. After obtaining the permission of the designer of the questionnaire for translation and the investigation of its psychometric properties, the questionnaire was translated according to the International Quality of Life Assessment (IQOLA) project. The face validity and content validity of the questionnaire were evaluated using experts and parents’ opinions; then, a preliminary test was conducted in which the questionnaire was completed by 10 parents of children with autism to determine the appropriate time to complete the questionnaire. Consequently, 100 parents of children with autism completed the demographic information questionnaire and FTRI. Furthermore, to determine the test-retest reliability, after 2 weeks, 33 parents of children with autism re-completed the questionnaire. To examine the face validity, item impact score was calculated. To assess the content validity, Content Validity Ratio (CVR) and Content Validity Index (CVI) was used. Internal Consistency Coefficient (ICC) was used for assessing the test-retest reliability of the scale. Moreover, the internal consistency of the whole questionnaire and its subscales was assessed by Cronbach's alpha coefficient.
Results Item impact score for all items of the questionnaire was over 1.5. The CVR for each item of the questionnaire was between 0.8 and 1 and for the whole questionnaire was equal to 0.87. The CVI for the items of the questionnaire was between 0.83 and 1 and for the whole questionnaire was equal to 0.97. Additionally, the intraclass correlation coefficient for the total score was equal to 0.96 and Cronbach's alpha coefficient was calculated as 0.88. Moreover, the lowest Cronbach's alpha coefficient related to the subscale of child routines (0.70) and the highest related to the subscale relative's connection routines (0.86).
Conclusion The obtained results indicated that FTRI has acceptable validity and reliability in the Iranian samples and can be a useful research and clinical tool for assessing the family routines.