Sleep Disturbance Scale for Children: Translation, cultural adaptation, and validation

Ferreira, Vanessa Ruotolo; Carvalho, Luciane B.C.; Ruotolo, Fabiana; de Morais, José Fausto; Prado, Lucila B.F.; Prado, Gilmar F.

doi:10.1016/j.sleep.2008.03.018

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Volume 10, Issue 4 , Pages 457-463, April 2009

Sleep Disturbance Scale for Children: Translation, cultural adaptation, and validation☆

Vanessa Ruotolo Ferreira
- Federal University of Sao Paulo, Department of Medicine and Department of Neurology, Brazil
Luciane B.C. Carvalho
- Federal University of Sao Paulo, Department of Medicine and Department of Neurology, Brazil
Fabiana Ruotolo
- Federal University of Sao Paulo, Department of Medicine and Department of Neurology, Brazil
José Fausto de Morais
- Federal University of Sao Paulo, Department of Medicine, Brazil
Lucila B.F. Prado
- Federal University of Sao Paulo, Department of Medicine and Department of Neurology, Brazil
Gilmar F. Prado
- Federal University of Sao Paulo, Department of Medicine and Department of Neurology, Brazil
- Corresponding author. Rua Claudio Rossi, 394, São Paulo, SP, CEP 01547-000, Brazil. Tel./fax: +55 11 50816629.

Received 27 November 2007; received in revised form 5 March 2008; accepted 24 March 2008.

Abstract

Introduction

The Sleep Disturbance Scale for Children (SDSC) is a 26-item instrument for evaluating sleep among children aged 3–18 years. It differentiates among conditions such as disorders of initiating and maintaining sleep, sleep breathing disorders, disorders of arousal, sleep–wake transition disorders, excessive somnolence, and sleep hyperhydrosis. The aim of this study was to translate, culturally adapt, and validate it for Brazilian Portuguese.

Method

The study was carried out in two phases: (1) forward translation, back translation, pretesting, and calculation of sample size; (2) validation: reliability (Chronbach’s alpha), convergent analysis (Pearson correlation), and discriminatory validity (comparing the scores of the test with the results of polysomnography). One hundred children, aged 3–18 years, accompanied by their parents and/or guardians participated in the phases. PSG studies have been done to calculate the sample size and validation.

Results

The scale instructions and items were adapted regarding semantic, experiential, conceptual, and cultural equivalence validation. The scale structure related to visual communication was also adapted to Brazilian population preference and habits, and this resulted in a chart with clear instructions and easy recognition of the statements and possible responses. Reliability analysis showed values greater than 0.55. There has been reasonable convergent validity. Discriminatory validity using the PSG study for positive sleep-disordered breathing (SDB) was 8.9, attesting discriminatory validity only for SDB. The three questions of the scale can screen SDB.

Conclusion

The SDSC was translated, adapted and validated for Brazilian Portuguese, and it presented internal consistency and convergent and discriminatory validity. It can be used in population-based studies in order to screen for sleep-disordered breathing in children.

Keywords: Sleep, Children, Questionnaire, Validation, Sleep Disturbance Scale for Children, Cultural adaptation