• Childhood Nonverbal Communication Scale (CNCS) is
valid and reliable in the Turkish language.
• The Turkish version of the CNCS showed good
• CNCS can be used for screening 0–18 months old
children with suspected Autism Spectrum Disorder.
Introduction: Nonverbal communication (NC) skills develop dramatically
during the first year of life. Especially in children with Autism Spectrum
Disorder (ASD), inadequacies in these skills in the early period negatively
affect language development later. Therefore, early recognition of ASD
symptoms is the first step in the diagnosis. The test to screen ASD at the
earliest age is the Modified Checklist for Autism in Young Children/MCHAT
in Turkey. However, this test can be used for 18 months or later.
In the present study, we aimed to adapt the Childhood Nonverbal
Communication Scale (CNCS) to Turkish, which was developed in Iran
to evaluate NC skills in children from birth to 18 months and determine
Methods: This cross-sectional and methodological study was conducted
in three provinces and included 323 parents of children who are
normally hearing and 3–18 months old. Sociodemographic form, Ankara
Development Screening Inventory, CNCS-Turkish form, and LittleEARS
Auditory Questionnaire were applied.
Results: CNCS Turkish form consisting of 37 questions shows a twofactor
structure. The reliability coefficient of the 37-item scale is highly
reliable (KR-20=0.937). It also had good convergent validity based on
a significant correlation between total scores and LittleEARS results
(r=0.804, P<0.001). According to the normative curve plotted by the
CNCS total score for age, NC skills progressed with a steep slope from 3
to 12 months and then progressed gradually until 18 months.
Conclusion: Childhood Nonverbal Communication Scale (CNCS) is a
promising tool showing good validity and reliability in Turkish.
Keywords: Autism spectrum disorder, Childhood Nonverbal
Communication Scale, screening, Turkish, validity and reliability