Cultural adaptation and validation of the Argentine Children's Orientation and Amnesia Test

Abstract

The Children's Orientation and Amnesia Test (COAT) is a widely used tool for assessing post-traumatic amnesia (PTA) in children, yet no validated Spanish version exists. This study aimed to translate, culturally adapt, and linguistically validate the COAT into Argentine Spanish following the International Society of Pharmacoeconomic and Outcomes Research (ISPOR) guidelines. A Delphi panel of 10 experts evaluated item clarity, relevance, coherence, and comprehensiveness, while a pilot test with 14 healthy children (7 males, 7 females; mean age 7.9 years, SD 3.5) assessed comprehensibility and acceptance. The translation process revealed minor challenges in adapting culturally specific references, which were addressed through expert consensus. The pilot test confirmed that most items were well understood, though some children had minor difficulties with number sequences. No discomfort was reported during administration, supporting the tool's feasibility and acceptance. The Argentine version of the COAT represents a validated, culturally appropriate instrument for assessing PTA in children with traumatic brain injury. Its adaptation ensures conceptual equivalence while accounting for linguistic and cultural nuances. This study provides a crucial first step in making a standardized PTA assessment available for Spanish-speaking populations, facilitating its clinical use and future research. However, further psychometric validation in clinical populations is required to confirm its applicability in diverse healthcare settings.