Effect of action observation training on the oral phase of swallowing in children with cerebral palsy: a pilot randomized controlled trial.

Swallowing disorder is prevalent in children with cerebral palsy (CP), and previous studies have shown that motor-based programs benefit children with CP by facilitating motor learning. We hypothesized that action observation training (AOT) could enhance motor learning and improve the oral phase of swallowing in children. In this two-group parallel double-blind randomized controlled trial, the intervention group received AOT and sensorimotor therapy, while the control group received a sham and sensorimotor therapy. The function of the oral phase of swallowing, as the primary outcome, was measured pre-intervention, post-intervention, and at one month of follow-up. Secondary outcomes included reported symptoms of feeding problems and the impact of the child's swallowing disorder on the main caregiver, which were measured pre-intervention and post-intervention. The result of the Mann-Whitney U test showed a significant difference between the two groups in the function of the oral phase of swallowing after the intervention. Additionally, the intervention had a large effect size. However, no significant difference was found in the parent-reported scores of the feeding/swallowing impact survey and symptoms of feeding problems between the two groups. In conclusion, this pilot study provides preliminary evidence of the clinical efficacy of AOT as a safe neurorehabilitation method to improve the oral phase of swallowing in children with CP. However more studies are needed in the future.

Translation and Psychometric Properties of the Persian Version of the Feeding/Swallowing Impact Survey in Iranian Mothers.

INTRODUCTION: Feeding is an interactive process between a child and a caregiver, and its early and chronic problems can affect the stress and quality of life of parents. Since the health and support of caregivers can affect the child's disability and performance, it is important to consider the impact of feeding and swallowing disorders on caregivers. Hence, the present study aimed to translate and investigate the validity and reliability of the Feeding/Swallowing Impact Survey (FS-IS) in Persian. METHODS: This methodological study consisted of two phases: translating the test to Persian (P-FS-IS) and evaluating psychometric properties including face and content validity (through experts' opinions and cognitive interviews), construct validity (by known-group validity and exploratory factor analysis), and reliability of the questionnaire (by internal consistency and test-retest reliability). The present study was performed on 97 Iranian mothers of children with cerebral palsy aged 2-18 years with swallowing impairments. RESULTS: Exploratory factor analysis rendered two factors with a cumulative variance of 59.71%. When evaluating known-group validity, the questionnaire scores were significantly different across the groups with different severity of the disorder (F(2, 94) = 57.1, p ≤ 0.001). P-FS-IS had a high internal consistency with Cronbach's alpha of 0.95, and there was an appropriate intra-class correlation coefficient of 0.97 for the total questionnaire. CONCLUSION: P-FS-IS has good validity and reliability and is a suitable questionnaire for assessing the impact of pediatric feeding and swallowing disorders on Persian language mothers. This scale can be used in research and clinical settings to evaluate and determine therapeutic goals.

Translation, Cultural Adaption, and Validation of the Persian Version of the Pediatric Eating Assessment Tool.

INTRODUCTION: The Pediatric Eating Assessment Tool (PediEAT) is a parent-report tool to assess feeding problems in children aged 6 months to 7 years. This study aimed to translate and adapt the PediEAT to Persian and determine its psychometric properties. METHODS: The PediEAT was translated and culturally adapted the following guidelines for health-related instruments. Face and content validity was assessed using an expert panel. This study also aimed to evaluate psychometric properties using a sample of 160 children without feeding problems and 43 children with diagnosed feeding problems. Known-groups validation was used to compare PediEAT scores between children with and without feeding problems. In criterion validity, pediatricians' opinions were used as a criterion. To calculate internal consistency, Cronbach's alpha was used. After 2 weeks, temporal stability was assessed with 40 parents who repeated the PediEAT. RESULTS: Face and content validity showed that all tool items had CVI and kappa coefficients higher than 0.8. Known-group validity showed that the total and subscale scores significantly differed between children with and without feeding problems (p < 0.001). Criterion validity showed that criterion measurements correlated with questionnaire measurements. All four subscales and the total scale showed acceptable internal consistency reliability (Cronbach's alpha > 0.74). Test-retest reliability was acceptable (ICC = 0.987, p < 0.001). CONCLUSIONS: The PediEAT-Persian version is a valid and reliable tool for assessing symptoms of problematic feeding in Persian children aged 6 months to 7 years.

Lexical-semantic processing of action verbs and non-action nouns in Persian speakers: Behavioral evidence from the semantic similarity judgment task.

The processing of sensory-motor aspect of word's meaning, and its difference between nouns and verbs, is the main topic of neurolinguistic research. The present study aimed to examine the lexical-semantic processing of Persian non-action nouns and action verbs. The possible effects of semantic correlates on noun/verb dissociation were evaluated without morphological confound. A total of 62 neurologically intact Persian speakers responded to a computerized semantic similarity judgment task, including 34 triplets of non-action nouns and 34 triplets of action verbs by pressing a key. Response Time (RT) and percentage error were considered as indirect measures of lexical-semantic encoding efficiency. We also assessed the latency of hand movement execution with no linguistic demand. The results showed that action verbs elicited more errors and had slower RT compared with object nouns. Mixed ANOVA revealed that the observed noun/verb distinction was not affected by demographic factors. These results provided evidence that the lexical-semantic encoding of Persian action verbs, compared to non-action nouns, requires more support from cognitive sources during the processing of the motor - related semantic feature. The possible accounts for the different processing of action verbs in terms of semantic view are suggested.

Depression, Anxiety, and Stress Relative to Swallowing Impairment in Persons with Multiple Sclerosis.

Dysphagia and symptoms of depression, anxiety and stress are common in persons with multiple sclerosis (MS). We posited a relationship between dysphagia and increased frequency of psychological symptoms. Therefore, the aim of the present study was to examine associations between symptoms of psychological difficulties, use of emotional suppression and cognitive reappraisal strategies, and dysphagia status in persons with MS. One hundred persons with MS were prospectively assessed in multiple domains of functioning: cognitive, psychological, and dysphagia-related. Participants underwent cognitive screening with the Mini Mental State Examination and completed two psychological inventories: The depression, anxiety and stress scale (DASS)-21 and the Emotion Regulation Questionnaire. Further, they completed the dysphagia in Multiple Sclerosis questionnaire. A speech-language pathologist evaluated persons suspected of having dysphagia with the Mann Assessment of Swallowing Ability. Dysphagia was present in 29 persons with MS, and the sample was split accordingly. The two groups differed at baseline with respect to Expanded Disability Status Scale scores. There were significant between-group differences for mental health symptoms and for use of emotional regulation strategies. Accordingly, multivariate logistic regressions showed that increased symptoms of psychological stress, decreased use of cognitive reappraisal strategies, and increased indicators of emotional suppression independently predicted the presence of dysphagia. There was a clear pattern towards poorer psychological well-being in persons with dysphagia compared to those without. Psychological difficulties may contribute to the manifestation or worsening of dysphagia and should be addressed in treatment planning and future investigations. Therapeutic interventions that promote improvement in mental state alongside swallowing function may be highly beneficial.

Validity and Reliability of a Language Development Scale for Persian-speaking Children Aged 2-6 Years.

BACKGROUND: Language disorders may affect receptive and/or expressive language skills. The use of a validated and reliable assessment tool is essential to assess these skills in children. The present study aimed to develop a valid and reliable language development instrument for Persian-speaking children aged 2-6 years. METHODS: The present cross-sectional study was conducted during 2016-2017 in three main Iranian cities, namely Mashhad, Tehran, and Isfahan. The target population was children between the ages of 2 and 6 in various kindergartens and schools. The Persian Language Development Scale (PLDS) was developed by incorporating linguistic characteristics of the Persian language and Iranian culture. Following a number of iterations, including a pilot study of 36 children, the final version of the PLDS tool was used to assess the receptive and expressive language skills of 460 children. The reliability and validity of the PLDS tool were examined. RESULTS: The content validity ratio (CRV) of the PLDS tool was 0.85. The tool could differentiate children by age, but not by sex. The test-retest reliability, with 10 days interval, showed a significant correlation between the coefficients of receptive (0.96) and expressive (0.93) scales. The intraclass correlation coefficient (ICC) for receptive and expressive scales was 0.93 and 0.98, respectively. The internal consistency, using the KR-21, for the receptive and expressive scales was 0.88 and 0.92, respectively. CONCLUSION: A language development scale has been developed to assess receptive and expressive language skills in Iranian children aged 2-6 years. The validity and reliability of the tool were confirmed.

Lexical Access in Persian Speaking Children With and Without Specific Language Impairment.

INTRODUCTION: Word retrieval problems are among the limitations observed in children with specific language impairment during the initial schooling years. These restrictions are predictive of reading problems and poor performance at school. Additionally, studies on lexical access in Persian speaking children are scarce. Therefore, this study aimed to investigate and compare naming accuracy and latency in children with and without specific language impairment. METHODS: Twenty 7-9-year-old children with specific language impairment and 20 age-matched peers were recruited as the study participants. They were requested to name the 128 black and white line-drawing pictures from a Persian picture naming set for children, as rapidly as possible. We compared the effects of psycholinguistic variables on naming latency in the explored children with and without specific language impairment. RESULTS: Linear mixed-effects modeling presented an interaction between the research groups and the psycholinguistic variables. Significant main effects were found for name agreement (P≤0.00) and the age of acquisition (P=0.05) in children with typical language development; significant effects for name agreement (P≤0.00) and log frequency (P≤0.00) were revealed in children with specific language impairment. CONCLUSION: The obtained models indicated that psycholinguistic factors could differently affect the naming latency in children with and without specific language impairment. Factors that may have accounted for the findings are discussed in this paper.