Fikirte GirmaNardos Teklemariam2026-02-212026-02-212025-02-01https://etd.aau.edu.et/handle/123456789/7677Background: Autism Spectrum Disorder (ASD) is a neuro-developmental disorder characterized by difficulties with socio-communicative functioning and restricted and repetitive behaviors. There is limited data available regarding the prevalence of ASD in low and middle-income countries (LMICs), one of the reasons for the limitation being the scarcity of translated, validated, and culturally adapted screening and diagnostic tools. The Global Open Access Screening and Diagnostic Tool for Autism (OSSDx) is an autism screening and diagnostic tool that is currently under development. It is a tool being developed for a target population of children aged 2-9 years, living in Africa. Objective: The study aimed to culturally adapt the OSSDx into the Amharic language and pilot it in selected private hospitals and facilities. Methods: The original OSSDx was translated and culturally adapted into the Amharic language through expert consultation. The adapted OSSDx tool was then piloted on 6 experts and 17 caregivers/parents of children with ASD diagnosis and suspected developmental disorders at the selected private hospitals and facilities using mixed mixed methods design. The quantitative data were collected using a yes/no checklist, which was completed by both the parents/caregivers and experts. Cognitive interviews were also conducted with all the participants to gather more information regarding the clarity, cultural relevance, and acceptability of the adapted tool. Result: The findings from this pilot study show that the adapted OSSDx demonstrates an acceptable face and content validity. Although some items were noted as difficult to understand, the quantitative feedback from parents/caregivers showed a high level of agreement on the tool’s relevance and clarity. While evaluations from experts also highlighted a need for improvements, they have observed adequate construct coverage. Cognitive interviews further endorsed these findings. Overall, the adapted version of the OSSDx was considered applicable with a few revisions suggested before a large-scale implementation. Page | 7 Implication: The adapted Amharic OSSDx can assist in screening at-risk children earlier and help in establishing a clearer referral pathway for diagnosisenA Thesis Submitted to the Department of psychiatrySchool of medicineCollege of health SciencesThesis