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Journal of Intellectual Disability Research doi: 10.1111/jir.12128

208
volume 59 part 3 pp 208–214 march 2015

Factor validity and reliability of the Aberrant Behavior

Checklist-Community (ABC-C) in an Indian population
with intellectual disability
R. Lehotkay,1 T. Saraswathi Devi,2 M. V. R. Raju,3 P. K. Bada,3 S. Nuti,2 N. Kempf1 &
G. Galli Carminati1
1 Psychiatric Unit of Mental Development (UPDM), Department of Mental Health and Psychiatry, University Hospitals of
Geneva (HUG), University of Geneva, Geneva, Switzerland
2 Lebenshilfe for the Mentally Handicapped, Visakhapatnam, India
3 Department of Psychology and Para-psychology, Andhra University, Visakhapatnam, India

Abstract (RMSEA) was equal to 0.06, the comparative fit

index (CFI) was equal to 0.77, and the Tucker
Background In this study realised in collaboration
Lewis index (TLI) was equal to 0.77, which indi-
with the department of psychology and parapsychol-
cated that the model with five correlated factors had
ogy of Andhra University, validation of the Aberrant
a good fit. Coefficient alpha ranged from 0.85 to
Behavior Checklist-Community (ABC-C) in
0.92 across the five subscales. Spearman’s rank cor-
Telugu, the official language of Andhra Pradesh,
relation coefficients for inter-rater reliability tests
one of India’s 28 states, was carried out.
ranged from 0.65 to 0.75, and the correlations for
Methods To assess the factor validity and reliability
test–retest reliability ranged from 0.58 to 0.76. All
of this Telugu version, 120 participants with moder-
reliability coefficients were statistically significant
ate to profound intellectual disability (94 men and
(P < 0.01).
26 women, mean age 25.2, SD 7.1) were rated by
Conclusion The factor validity and reliability of
the staff of the Lebenshilfe Institution for Mentally
Telugu version of the ABC-C evidenced factor
Handicapped in Visakhapatnam, Andhra Pradesh,
validity and reliability comparable to the original
India. Rating data were analysed with a confirma-
English version and appears to be useful for assess-
tory factor analysis. The internal consistency was
ing behaviour disorders in Indian people with intel-
estimated by Cronbach’s alpha. To confirm the
lectual disabilities.
test–retest reliability, 50 participants were rated
twice with an interval of 4 weeks, and 50 were rated Keywords Aberrant Behavior Checklist-
by pairs of raters to assess inter-rater reliability. Community, intellectual disability, mental health,
Results Confirmatory factor analysis revealed that psychiatric disorders
the root mean square error of approximation

Correspondence: Dre Giuliana Galli Carminati, Psychiatric Unit of

Mental Development (UPDM), Department of Mental Health and Introduction
Psychiatry, University Hospitals of Geneva (HUG), Ch. du Petit
Bel Air 2, CH-1225 Chêne-Bourg, Switzerland (e-mail: For the last decade, great efforts have been made to
[email protected]). include persons with disabilities in all aspects of life

© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
 Journal of Intellectual Disability Research volume 59 part 3 march 2015
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R. Lehotkay et al. • Factor validity and reliability of the ABC-C in Telugu

in India because of The Persons with Disabilities Act essentially consistent with that of the institutional
(Ministry of Law, Justice and Company Affairs version (Marshburn & Aman 1992; Aman & Singh
1995), which establishes equal opportunities and 1994; Aman et al. 1995). Although the ABC-C was
protects the rights of this population. translated into many different languages, only two
In India, about 2% of the total population, or 23 studies have validated this scale in a non-English-
million people, have intellectual disabilities (ID) language country, Japan (Ono 1996) and China
(Srinivasan 2000). The Indian state of Andhra (Siegfrid 2000).
Pradesh encompasses 7.5% of the Indian popula- The ABC-C is completed in by an informant who
tion, and nearly 2 million people have an ID in this knows the subject well, such as a teacher, work
region. Thus, more attention should be paid to the supervisor, parent or other adult who has regular
population with ID in this state (Heru & Ryan contact with the subject. Each behavioural item is
2004; Radha & Kiran 2005). rated on a four-point scale from 0 (Not a problem)
People with ID are known to have behaviour dis- to 3 (The problem is severe in degree). Raters are
orders at higher rates than in the general population instructed to evaluate the residents’ behaviour for
(Lehotkay et al. 2009). These problems often the last month. This checklist is an easy-to-use
reduce a person’s ability to integrate into the com- instrument that reveals and determines the severity
munity and limit access to educational, leisure and of behaviour disorders in persons with ID. Beyond
occupational activities (Rojahn & Helsel 1991). the basic introduction to the ABC-C’s instructions
Thus, it is essential to evaluate the challenging and supplemental clarifications, this scale does not
behaviours. One of the greatest difficulties for edu- require much training. One advantage of standard-
cational staff working with these individuals involves ised instruments, such as the ABC-C, is that they
the management of disruptive behaviours, which are can be used in the evaluator’s native language,
often a source of stress for training teams, families which leads to consistent ratings on standardised
and the residents themselves. To date, however, no behavioural items; this helps to reduce misunder-
rating instruments for assessing behaviour disorders standing or misinterpretations from the evaluator.
are available in the Telugu language. As one of the most-used scales in the literature
Originally developed in New Zealand to effec- (Aman et al. 1985a,b; Aman & Singh 1994), the
tively assess persons with ID (Aman et al. 1985a), ABC-C has been translated and used in more than
the Aberrant Behavior Checklist (ABC) was 25 different languages, but not yet in Telugu. The
designed to quantify and qualify behaviour disorders goal of this present study is to translate and validate
in this population. The ABC is a 58-item rating the ABC-C in Telugu to make it available for the
scale derived by factor analysis, and its five sub- evaluation of behaviour disorders in people with ID
scales are labelled as follows: (i) Irritability, Agita- in the state of Andhra Pradesh in India. We hypoth-
tion, Crying (15 items); (ii) Lethargy, Social esised that the factor structure and the psychomet-
Withdrawal (16 items); (iii) Stereotypic Behaviour ric characteristics of the Telugu version would be
(7 items); (iv) Hyperactivity, Non-compliance (16 comparable to the original English version.
items); and (v) Inappropriate Speech (4 items). The
psychometric characteristics of the ABC, such as
internal consistency, test–retest reliability, inter-rater Method
reliability, and concurrent validity with other stand-
Participants
ardised instruments and direct observation, have
been reported to be generally good (Aman et al. The Lebenshilfe Institute was founded in 1980 in
1985b). The factor structure of the ABC was the area surrounding Visakhapatnam by Mrs T.
replicated in USA (Aman et al. 1987; Bihm & Saraswathi Devi, initially for 12 children with ID.
Poindexter 1991) and in Great Britain (Newton & This non-governmental organisation now provides
Sturmey 1988). A revised version, the ABC- support for 415 persons with ID of all ages from the
Community (ABC-C), was written to eliminate poorer segments of Indian society.
wording with institutional overtones, and the factor The participants in the present study were chil-
structure of this revised community version was dren, adolescents and adults with ID who receive

© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
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 Journal of Intellectual Disability Research volume 59 part 3 march 2015
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R. Lehotkay et al. • Factor validity and reliability of the ABC-C in Telugu

Table 1 Distribution of gender and intellectual disability (ID) level original version (Aman & Singh 1994). The aim of
of participants by age this translation/counter-translation method was to
obtain a version that was as close as possible to the
ID level original. The final Telugu version was considered
equivalent to the Aman & Singh (1994) original
Moderate Severe–profound version and was used in two experimental studies
carried out in the Lebenshilfe Institution
Age n Men Women Men Women (Kempf-Constantin et al. 2009; Varisco-Gassert
et al. 2009). The objective of these pilot studies was
17–20 38 15 6 12 5 to compare ABC-C data of the Lebenshilfe popula-
21–25 36 15 4 15 2 tion with ID with the normative data contained in
26–34 31 23 2 4 2 the ABC-C Manual (Aman & Singh 1994;
35–45 15 7 5 3 0
Kempf-Constantin et al. 2009), and with a
60 17 34 9
Total 120 77 43 similar population living in a Swiss institution
(Varisco-Gassert et al. 2009) as a pre-test for the
present validation.
support from the Lebenshilfe Institution in In the present study, participants were rated at
Visakhapatnam. The inclusion criterion was the the institution by a psychologist from Andhra Uni-
presence of a moderate, severe or profound ID versity with the help of a proxy who was an educa-
[F71–F73 according to International Statistical tor or a close family member. Fifty participants
Classification of Diseases and Related Health were rated by pairs of raters to confirm inter-rater
Problems, 10th Revision (ICD)] (World Health reliability, and another group of 50 participants
Organization 1994). The evaluation of ID was made were rated by the same person with an interval of
using the Developmental Screening Test (Bharath 4 weeks between ratings to determine test–retest
1998), the Vineland Social Maturity Scale (Malin reliability.
1992) and the National Institute for the Mentally
Handicapped Disability Impact Scale (Peshawaria
Statistical analysis
et al. 2000).
Of the 415 persons living in the Lebenshilfe Insti- The present analysis was performed in two stages.
tution, 120 (94 men and 26 women) met the inclu- First, to confirm the factor structure of the new
sion criteria. The ages of the men ranged from 17 to version in Telugu was comparable to the original
45 years (M = 25.2; SD = 6.5) and for the women, English version, and as we already know the factor
18 to 40 years (M = 25.1; SD = 7.2). The partici- structure of the ABC-C in English, we used con-
pant or legally authorised representative completed firmatory factor analysis (Gorsuch 1983). The five-
informed consent before participation in the study. factor model, as postulated by Aman et al. (1985a),
The age distribution and levels of ID are listed in was tested with a confirmatory factor analysis by
Table 1. using the software Mplus6. The model was esti-
mated using the unweighted least squares (ULS)
Procedure procedure, which does not assume a normal distri-
bution and is therefore considered the most suitable
The translation into Telugu of the English version method for analyses using dichotomous variables
of the ABC-C1 was made using the translation/back (Muthén 1993; Hatcher 1994). As the Chi-square is
translation method, meaning that the ABC-C was not applicable with the ULS method, we used fit
first translated into Telugu and this was then indices to assess the validity of the models. Three
retranslated into English to be compared with the pre-established criteria were used as indicators of
1
the goodness-of-fit of the data: (1) root mean square
The Aberrant Behavior Checklist and the Aberrant Behavior
Checklist-Community are copyrighted. The Aberrant Behavior
error of approximation (RMSEA) < 0.80, (2) com-
Checklist-Community was translated into Telugu with the permis- parative fit index (CFI) > 0.93, and (3) Tucker
sion of the authors. Lewis index (TLI) > 0.80.

© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
 Journal of Intellectual Disability Research volume 59 part 3 march 2015
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R. Lehotkay et al. • Factor validity and reliability of the ABC-C in Telugu

Table 2 Goodness of fit indices of the model with five correlated measure of internal consistency and provides an
factors estimate of the extent to which a subscale consist-
ently samples a given attribute. Cronbach’s alpha
Fit indices coefficients were calculated for each subscale of
ABC-C using the original factor assignment and
RMSEA 0.06 (0.06–0.07) were as follows: (i) Irritability = 0.89; (ii) Leth-
CFI 0.77 argy = 0.89; (iii) Stereotypic Behaviour = 0.89;
TLI 0.76 (iv) Hyperactivity = 0.92; (v) Inappropriate
speech = 0.85. The degree to which items measured
RMSEA, root mean square error of approximation; CFI, compara-
the same attributes was high and statistically
tive fit index; TLI, Tucker Lewis index.
significant.

Test–retest reliability
Second, internal consistency was estimated by
To assess test–retest reliability, a random group of
Cronbach’s alpha. Test–retest reliability and inter-
50 participants was rated twice with an interval of 4
rater reliability were tested using the Spearman’s
weeks between ratings. Spearman’s rank correlation
rank correlation coefficient for each factor. All sta-
coefficients for each subscale scores were as follows:
tistical analyses were performed using SPSS 15.
(i) Irritability = 0.58; (ii) Lethargy = 0.76; (iii)
Stereotypic Behaviour = 0.70; (iv) Hyperactiv-
ity = 0.69; (v) Inappropriate speech = 0.76. For all
Results subscales, the first and second ratings were highly
Confirmatory factor analysis correlated and statistically significant (P < 0.01).

Mplus6 suggested removal of item 44 (Easily dis-

tracted), as it was highly correlated with item 51 Inter-rater reliability
(Pays no attention when spoken to) (only four par- Inter-rater reliability was assessed by obtaining two
ticipants had different values on these two items). ratings for 50 randomly selected participants by
As the fit of the model using orthogonal five-factor pairs of raters. Spearman’s rank correlation coeffi-
model was unsatisfactory, we calculated the cients for each subscale score were as follows:
goodness-of-fit indices of the model with five corre- (i) Irritability = 0.73; (ii) Lethargy/Social With-
lated factors. This model yielded a RMSEA equal drawal = 0.65; (iii) Stereotypic Behaviour = 0.75;
to 0.06, which denoted a good fit, as did the CFI (iv) Hyperactivity = 0.67; and (v) Inappropriate
(0.77) and the TLI (0.76). These results are pre- speech = 0.73. These correlations were relatively
sented in Table 2. Table 3 shows the correlations high (Achenbach et al. 1987), and the correlation
between the five factors. Estimated factor IV coefficients were statistically significant for all sub-
(Hyperactivity, Non-compliance) and factor V scales (P < 0.01).
(Inappropriate Speech) appear to have a stronger
correlation with the other factors, but all factors are
statistically significant, confirming the hypothesis of
five orthogonal factors was unsatisfactory. The esti- Discussion
mated loadings of the model for all items are shown This study emerged from a joint collaboration
in Table 4. between the Lebenshilfe Institution and a Swiss
team to introduce evaluation tools that are com-
Reliability of Telugu version of the ABC-C monly used within institutions in Geneva to a dif-
ferent cultural setting. As the Indian and Swiss
Internal consistency
cultural contexts are very different, it was important
Determined by the average correlation among items to verify that the imported evaluation tools were
within subscales, Cronbach’s alpha coefficients is a useful for individuals with ID in India.

© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
 Journal of Intellectual Disability Research volume 59 part 3 march 2015
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R. Lehotkay et al. • Factor validity and reliability of the ABC-C in Telugu

Table 3 Correlations between factors

Irritability, Lethargy,
agitation, social Stereotypic Hyperactivity, Inappropriate
crying withdrawal behaviour non-compliance speech

Irritability, agitation, crying 1

Lethargy, social withdrawal 0.25* 1
Stereotypic behaviour 0.17* 0.18* 1
Hyperactivity, non-compliance 0.43* 0.41* 0.36* 1
Inappropriate speech 0.33* 0.35* 0.24* 0.60* 1

* P < 0.001.

The Swiss Psychiatric Unit of Mental Develop- comparable to others obtained for similar types of
ment has had extensive experience with the scales and to those reported by Aman et al. (1985b).
French translation of the ABC-C using explorative
studies (Galli Carminati et al. 2004). We previ-
ously compared data from the Lebenshilfe Institu-
Conclusion
tion to the normative data on the ABC-C
(Kempf-Constantin et al. 2009) and explored the The aim of this paper was to validate the Telugu
applicability of the ABC-C scale over time in a translation of the ABC-C. Our objective was to
different cultural context and compared the data make this tool available for examination of behav-
of a small group of residents in the Lebenshilfe iour disorders among a large population of persons
institution in India to a small group of residents with ID in India in the native Telugu language. The
in a Swiss institution (Varisco-Gassert et al. result of this study demonstrates the validity and
2009). This study further extends the applicability reliability of this assessment instrument for a
of this tool by showing that the ABC-C is a Telugu speaking population.
sensitive tool when used in an Indian population Confirmatory factor analysis revealed the five cor-
with ID. related factors model of the ABC-C in Telugu had
The confirmatory factor analysis revealed the a satisfactory fit. Consequently, our results showed
model of the Telugu version of the ABC-C with five that the Telugu version of the ABC-C was a sensi-
correlated factors had a satisfactory fit. tive tool when used in an Indian population with
Ranging from 0.85 to 0.92, the internal consist- moderate to profound ID, as the factor structure
ency coefficients of the Telugu version of the and reliability of this scale were comparable to the
ABC-C were generally very high and similar to original version of the ABC-C. However, it is
those reported by Aman et al. (1985b), indicating important to note that different cultural values may
good internal consistency. influence whether certain behaviours are perceived
Inter-rater comparisons resulted in Spearman as deviant. For example, Gopinath & Chaturvedi
rank correlations that had a mean of 0.71 across (1992) reported that Indian people are usually
subscales, which was statistically significant and much more troubled by inactivity, slowness or
reflected good inter-rater reliability. Although Spear- unemployment of people with mental illness than
man’s rank correlation coefficients for some sub- by the aggressive or psychotic features of illness.
scales for the test–retest reliability were slightly Nevertheless, the large majority of items loaded as
lower, the first and second ratings are highly corre- expected.
lated and show statistical significance (P < 0.01). In conclusion, the Telugu translation of the
These inter-rater and test–retest reliabilities are ABC-C showed acceptable psychometric character-
adequate for research purposes, and they were istics. We intend to conduct further validation with

© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
 Journal of Intellectual Disability Research volume 59 part 3 march 2015
213
R. Lehotkay et al. • Factor validity and reliability of the ABC-C in Telugu

Table 4 Factor loading for the five subscales of the Telugu version Table 4 Continued
of the Aberrant Behavior Checklist-Community (ABC-C)

Two-tailed
Two-tailed Estimate S.E. Est./S.E. P-value
Estimate S.E. Est./S.E. P-value
Y48 0.775 0.107 7.267 0.000
F1 BY Y49 0.783 0.113 6.929 0.000
Y1 1.000 0.000 999.000 999.000 Y50 0.794 0.140 5.653 0.000
Y2 1.200 0.305 3.941 0.000 Y51 1.002 0.086 11.638 0.000
Y3 0.969 0.293 3.309 0.001 Y52 0.593 0.117 5.061 0.000
Y4 1.479 0.287 5.150 0.000 Y53 0.734 0.120 6.106 0.000
Y5 1.022 0.293 3.495 0.000 F5 BY
Y6 1.354 0.287 4.715 0.000 Y54 1.000 0.000 999.000 999.000
Y7 1.483 0.294 5.037 0.000 Y55 1.074 0.108 9.905 0.000
Y8 1.427 0.294 4.858 0.000 Y56 0.913 0.126 7.269 0.000
Y9 1.057 0.212 4.985 0.000 Y57 0.839 0.129 6.523 0.000
Y10 1.267 0.243 5.213 0.000
Y11 1.522 0.298 5.114 0.000
Y12 1.084 0.326 3.326 0.001
Y13 1.462 0.260 5.619 0.000
Y14 1.327 0.294 4.507 0.000 a larger sample to confirm the applicability for use
Y15 1.499 0.305 4.917 0.000 at the Lebenshilfe Institution.
F2 BY
Y16 1.000 0.000 999.000 999.000
Y17 1.669 0.286 5.831 0.000
Y18 1.535 0.270 5.678 0.000 Acknowledgement
Y19 1.581 0.297 5.316 0.000
Y20 1.144 0.278 4.119 0.000 The authors would like to thank Professor Michael
Y21 1.596 0.300 5.326 0.000 G. Aman for his support and helpful comments to
Y22 0.998 0.219 4.548 0.000 this study, and Miss Elise Dupuis Lozeron for the
Y23 1.098 0.217 5.058 0.000 statistical analysis.
Y24 1.384 0.288 4.803 0.000
Y25 1.146 0.259 4.424 0.000
Y26 1.365 0.318 4.295 0.000
Y27 0.605 0.221 2.731 0.006 References
Y28 1.474 0.280 5.266 0.000
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F3 BY situational specificity. Psychological Bulletin 101, 213–32.
Y32 1.000 0.000 999.000 999.000 Aman M. G. & Singh N. N. (1994) Aberrant Behavior
Y33 1.459 0.405 3.601 0.000 Checklist-Community: Supplementary Manual. Slosson
Y34 1.014 0.337 3.012 0.003 Educational Publications, Inc., East Aurora, NY.
Y35 1.179 0.368 3.207 0.001
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Y37 1.660 0.360 4.609 0.000
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Y38 1.758 0.364 4.833 0.000
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Y46 0.748 0.116 6.443 0.000
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