Introduction: Increased diagnoses rates of autism and earlier identification pose new challenges to preschools and services delivering early intervention to children on the spectrum. A prerequisite for successful implementation of support is a high quality preschool learning environment. Here, we briefly describe the process of translating, culturally adapting and validating the contents of the Autism Program Environment Rating scale (APERS), originally designed for assessing the quality of the learning environment for children and adolescents with autism in the USA, to a European language and educational context.

Methods: In an authorized step-wise procedure, the 59 item scale was translated by a PhD level clinician fluent in English with expertise in autism and psychometrics. Subsequently, following internal feedback from the research team, adaptions addressing translation and cultural adaption of the scale were made. Then, five Swedish external preschool and early intervention experts were invited to provide feedback on the cultural appropriateness of the adapted scale. Lastly, nine additional independent external experts within the field of autism, preschool and early intervention were invited to rate the content validity of the adapted scale. Relevance of subdomains and domains was assessed as well as clarity and comprehensiveness for all of the scale’s items. Experts also rated the practical relevance, need, usefulness, and feasibility of the scale as a whole, and provided anecdotal formative feedback.

Results: All items, subdomains, and domains of the scale were estimated by the raters as showing sufficient content validity (Content validity index &#8805,.79). Several Swedish experts highlighted the need for such a scale, and the usefulness of the scale as a means to assess and then support preschool staff to improve learning environment for children with autism. However, some concerns were raised about the comprehensiveness of the scale and the challenges preschools will meet in improving their learning environment. 

Discussion There seems to be a need for a rating scale to assess and improve the learning environment for children with autism in preschool settings. Although the usefulness and content validity of the translated and adapted scale was established, little is still known about other psychometric properties of the scale, and more work needs to be done to assess its usefulness as a tool for systematic improvement of preschool program quality.