Help Autism Rating Scale (HARS) Chart: A Validated and Reliable Tool for Autism Screening in Bangladesh

Abstract

Background: In Bangladesh, several tools like Autism Behavior Checklist (ABC), Modified Checklist for Autism in Toddlers (M-CHAT), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule (ADOS) are widely used for either screening or diagnosis of autism. Recently, Help Autism Rating Scale (HARS), has been locally developed in 2012 but not widely used. Objective: To evaluate the diagnostic reliability and validity of Help Autism Rating Scale (HARS) for screening or diagnosis of autism. Materials & Methods: This analytical study was conducted on 300 children having autism spectrum disorders (ASDs) recruited from Department of Paediatric Neurology, Dhaka Medical College Hospital, Department of Paediatric Neuroscince, Dhaka Shishu (Children) Hospital, and Institute of Paediatric Neurodisorder and Autism (IPNA) of Bangabandhu Medical University (BMU), Dhaka, Bangladesh, in between July and December of 2022. Item level scores of HARS were collected and analyzed. For internal consistency, Cronbach's α coefficient was calculated. Convergent and divergent validity was calculated. The factor structure of HARS was demonstrated by principal components analysis. Results: The adequate face and content validity, HARS demonstrated good internal consistency (Cronbach's α=0.962) and item-total correlation 0.790. The convergent validity between the HARS and the Gesell Developmental Schedules (GDS), as calculated with Pearson's product-moment correlation coefficient was 0.741 (P=0.01). Divergent validity calculated by correlating HARS scores to ADD-H Comprehensive Teacher Rating Scale (ACTeRS) showed non-significant association (r= 0.18; P=0.4) demonstrating that HARS discriminates autism from other childhood psychiatric disorders like ADHD. A 5-factor structure explained 63.34% of variance. Conclusion: The HARS has strong psychometric properties and is now readily available for clinical and research work in Bangladesh.

BJME: Vol.-17, Issue-02, July, 2026: 69-75