Turkish reliability and validity study of the dimensional assessment of repetitive behaviors (DARB)

Introduction: "Repetitive behaviours" or "restricted and repetitive behaviours" (RRB) is a term used to describe a group of unusual behaviours characterised by repetition, rigidity, non-contextuality and non-compliance. Studies on the epidemiology of restricted and repetitive behaviours have mostly focused on individuals diagnosed with Autism Spectrum Disorder (ASD), and data on their prevalence in the general population are very limited. Although the assessment of CTDs is of great importance in terms of diagnosis and intervention planning, the number of studies in which these symptoms are systematically evaluated is limited. In this context, it was planned to evaluate the Turkish validity and reliability of a scale such as the Dimensional Assessment of Repetitive and Restrictive Behaviours ('DARB'), which can also be used for other neurodevelopmental disorders. The aim of this study is to adapt a reliable and valid measurement tool that can be used in the processes of assessment, diagnosis and intervention planning of CTDs into the Turkish language. Method: This study was conducted in the outpatient clinic of Bolu Abant İzzet Baysal ÜTF İzzet Baysal EAH Child and Adolescent Mental Health and Diseases. Five groups including Attention Deficit/Hyperactivity Disorder (ADHD), Specific Learning Disability (SLD), Tic Disorders/Obsessive Compulsive Disorder (Tic-OCD), Autism Spectrum Disorder (ASD), Mental Retardation/Delay in Development (MR/DD) were included in the study. A total of 148 children and adolescents aged 3-18 years participated in the study. The Repetitive Behaviours Scale-Revised Turkish Version (TEDÖ-R-TV), Dunn Sensory Profile, Social Responsiveness Scale, Social Communication Scale, Childhood Autism Rating Scale, Adolescent Adult Sensory Profile scales were used to test the validity of DARB. Results: Cronbach's alpha coefficient calculated for DARB reliability was found to be 0.97 in our sample. Firstly, the suitability of the sample for factor analysis was evaluated with 98 items by Kaiser- Meyer- Olkin (KMO) sampling adequacy and Bartlett's test of sphericity. The KMO value was 0.783 and since this value was > 0.70, it was considered that the sample was sufficient for factor analysis. A scree plot was used to evaluate the number of components. The item-component correlation matrix supported that all items of DARB correlated ≥ ± 0.30 with at least one of the thirteen hypothesised components. Therefore, it was considered that there was no need to remove items from the scale. Confirmatory Factor Analysis (CFA) identified eight factors explaining 55.0% of the variance. The HTMT ratios calculated for the 8-factor structure of DARB support the discriminant validity of this structure. When compared with the scales used, it was thought that the original subscale scores of DARB could support the external validity of the original subscale scores. Conclusion: The DARB scale was found to be valid and reliable in Turkish and has the characteristics of a standardised measurement tool. It is thought that the DARB scale will make important contributions to studies and clinical applications in the field of pervasive developmental disorders. Key words: DARB, validity, reliability, restricted and repetitive behaviours, ASD, scale