Translation, adaptation, and validation of the Malay Preschool Screening Instrument for Targeting Educational Risk (MyPra-SIFTER): a teacher-administered hearing screening tool for preschool children in Malaysia

Early detection of hearing loss is essential to minimize academic and social delays in preschoolers. In Malaysia, the number of teacher-administered screening tools is limited. This study aimed to translate, adapt and validate the Preschool Screening Instrument for Targeting Educational Risk (Preschool SIFTER) into Malay for use by teachers. Face validity was assessed by 10 preschool teachers, with all items achieving ≥90% agreement. A total of 109 children aged 3–6 years were evaluated by 21 teachers using the Malay Preschool SIFTER (MyPra-SIFTER). Internal consistency was strong (Cronbach’s α = 0.95), and test–retest reliability, assessed with 23 students, was high (ICC = 0.95). Criterion validity was examined by comparing communication and social behavior classifications (‘Pass’ or ‘At-risk’) with DPOAE screening outcomes (‘Pass’ or ‘Refer’) for 78 children. Both the communication and social behavior domains demonstrated a sensitivity of 33.3%, with specificity of 98.2% and 96.5%, respectively. Significant differences in mean domain scores were found between DPOAE pass and refer groups (p < 0.05). The MyPra-SIFTER demonstrated strong reliability and high specificity, indicating its usefulness in identifying children unlikely to have hearing-related difficulties, while its lower sensitivity highlights the need for use alongside audiological screening.