Cultural adaptation and updating of the ICAST-R child abuse and neglect instrument for Denmark.

We describe the validation, cultural adaptation, and updating of The International Society for the Prevention of Child Abuse and Neglect, Child Abuse Screening Tool, Retrospective version (ICAST-R) for use in a Danish context. Thorough Danish questionnaires on child abuse and neglect exist, but some are proprietary, and their development precedes widespread use of social media. As forms of abuse evolve, including online sharing of abuse material, updated tools are needed, and we are not aware of any recent, comprehensive and validated questionnaires that are culturally adapted for Danish. The free ICAST-R measure has been translated into at least 20 languages and is widely used in the field. To develop a Danish version, the questionnaire has been back-and-forth-translated and has undergone cognitive testing and focus group interviews by eight individuals within the target age range and seven experts by experience with abuse and neglect. Further adaptation was done through focus group interviews with professionals from research and practice. Categorisation of severity of abuse was done through a Delphi process, and acceptability of the adapted measure was assessed in an online survey distributed to 450 Danish adults. The ICAST-R has also been reviewed in focus group interviews with 11 professionals working with child abuse and neglect, representing practitioners, researchers and non-governmental organisations. The final Danish measure incorporates additional questions focused on online sexual abuse, free-text options for other experiences of abuse, and items describing acts of abuse with subcultural attributions of meaning. The neglect section is substantially altered, and the section on sexual child abuse has been restructured into non-contact sexual abuse, non-contact technology-facilitated sexual abuse, and moderate and severe contact sexual abuse. For sexual abuse, the structure was changed so that sexual experiences were recorded and subsequent questions explored consent and age at the event. For all events, a number of questions exploring disclosure was added.