Table 1.

Translating and adapting: addressing four types of equivalence

Type of equivalence	Examples
Linguistic: Translation of test instructions, stimuli, and protocol forms from the original into the target language	Translation of the MSEL into Spanish (appropriate for Guatemala) was undertaken by the neurodevelopmental team with permission from Pearson, the company that owns the MSEL copyright.
	Local nurses were consulted when questions about specific regional language differences arose.
	The final version was back-translated by a third-party professional translator not involved in the initial translation.
	The back-translation was reviewed and approved by Pearson.
Functional: A translated test item should generate the same type of response as the original test item and, therefore, measure the same construct. That is, if a strict translation into the target language alters the meaning of the question or the concept being assessed and, therefore, results in a different pattern of responding, then changes to the language and wording may be necessary	For an item attempting to elicit the response “car,” the English question is, “What do we ride in?” The direct translation of the verb “to ride” in Spanish refers to mounting or riding a horse or other animal. Therefore, we changed the verb to the Spanish “to drive” and used the most common locally used equivalent Spanish verb for the local population “manejar,” so children would give the same response as English-speaking children.
	There were instances in which an English word translated to two different words with somewhat different meanings in Spanish. In these cases, we chose the word in Spanish that would result in a similar answer to the English question. For example, in English, the word “fire” can refer to flames and to something that is burning (e.g., a fire in the woods). In Spanish, “fuego” (fire) refers only to flames and “incendio” (fire) refers to something that is burning. There is a question that asks, “What should you do if you wake up in the middle of the night and there is a fire inside of your house?” If we used the word “fuego,” children would not think of a house on fire, but could interpret that flames come from the wood burning stove. Therefore, the word “incendio” was selected to preserve the meaning of the question.
	The word “letter” has two meanings in English, allowing for two different responses (i.e., a symbol of the alphabet and a written communication). In Spanish, there are two different words for each of those definitions, “letra” and “carta,” respectively. It was decided by consensus that “letra,” as in letter of the alphabet, better represented the item level of difficulty at this section of the assessment.
Cultural: An item or test question should be understood in a comparable manner, given local customs and experiences, between both the original and adapted versions	One item involved placing a spoon and a doll on the table and asking the child to hand the doll to the evaluator. Because toys are so much more unfamiliar in this population of children, in our pilot testing, children did not want to hand over the more novel, interesting toy (the doll). Therefore, we changed the item to include two equally appealing and novel objects: a doll and a duck.
	On an item assessing motor movement and reactivity in babies, the evaluator or the caregiver tries to stimulate the baby with noise, movement, and facial expressions in an attempt to elicit vigorous movement. In our pilot testing, no babies were reacting to these attempts apart from eye contact. We hypothesized that, culturally, caregivers in this area are often not actively engaging with their babies in animated ways; therefore, babies were unfamiliar with this type of stimulation. We, therefore, proceeded to adapt this item to observe for any vigorous movement observed throughout the entire assessment and not only during this item.
	An item assessing language understanding asks the child why it would not be safe to swim when there was not a lifeguard present. Because these types of water safety controls are not present in Guatemala, most children would not know what a lifeguard is or their purpose. In addition, the direct translation for “lifeguard” can also include “lifejacket” in Spanish. Therefore, we adapted the question to ask why it would not be safe to swim without an adult present.
Metric: Translated test items are equivalent in difficulty to the original test	On items requesting the child to repeat various sentences, we had to ensure that sentence length (as measured by syllables) was not changed in translation of the item, thereby making the item either more or less difficult. So, while we addressed content so that familiarity would not interfere with task difficulty (i.e., cultural equivalence), we also adjusted translations to achieve exact equivalence in length, ensuring metric equivalency. For example, “In the winter we go sliding down the hill on our sled” was changed to “En el verano bajo la montaña en bici,” which directly translates to “In the summer I go down the hill on a bike”.
	For a more difficult task of visual reception, the subject is asked to match a target word to one of three choices. Although we did not expect most children in the study to be able to read, matching unfamiliar letter patterns would be harder than matching familiar letter patterns. Therefore, we changed the stimulus words to Spanish target words that matched the original English words in length, vowel placement, and rhyming when present. For example, we replaced “coat, boat, goat, coat” with the Spanish “masa, tasa, casa, masa”.
	We sometimes chose a slang word over a direct translation to maintain metric equivalency. For example, the direct translation of “faucet” is “grifo,” which is not a commonly used word in Guatemala, making it less likely a Guatemalan child would be able to define it. Therefore, we used the slang term (“chorro”) rather than a direct translation for the question.

MSEL = Mullen Scales of Early Learning.