Efficacy of training with the Arabic "differential processing training program "on temporal processing skills in dyslexic children with auditory processing disorder: A randomized clinical trial.

BACKGROUND: There is a lot of debate regarding auditory processing disorders, especially treatment, as there is no gold standard to date. Learning and literacy challenges can result from impaired auditory processing abilities, specifically temporal processing skills, compromising a child's academic and social accomplishment. OBJECTIVE: To determine the effect of auditory processing training using the adapted translated version of the "Differential Processing Training Program" on auditory and cognitive functions in Egyptian Arabic-speaking dyslexic children with auditory processing disorder in comparison to training with the established Arabic computer-based auditory training program. METHODS: A randomized controlled trial was conducted on 52 dyslexic children with an auditory processing disorder. Using block randomization, the children were divided into two groups: a case group called the DPTP group and a control group called the CBAT group. Objective assessments were used to assess both groups' auditory skills. The DPTP group received training using the "Differential Processing Training Program," while CBAT received training in a computer-based auditory training program. Both groups were re-evaluated post-therapy using the same protocol. RESULTS: All assessed parameters demonstrated statistical improvement in both groups when pre-therapy and post-therapy scores were compared. Furthermore, the DPTP group exhibited superior performance in the AFTR when percent change was compared between the studied groups. CONCLUSIONS: Temporal processing skills showed a favorable response to therapy. Comparable results of the Arabic version of the "Differential Processing Training Program" and the Arabic computer-based training program Hence, the Arabic version of the "Differential Processing Training Program" is a reliable and valid training program for the tested population.

Early assessment of aspiration risk in acute stroke by fiberoptic endoscopy in critically ill patients.

BACKGROUND: Fiberoptic endoscopic evaluation of swallowing (FEES) has been recommended to assess aspiration in stroke. This study aimed to determine the diagnostic and prognostic roles of FEES in the early assessment of aspiration, intensive care unit (ICU) stay and mortality in acute stroke patients. METHODS: Fifty-two patients with acute stroke admitted to the Alexandria Main University Hospital were included. Complete examinations and assessment of aspiration using the 8-point penetration-aspiration scale (PAS) with FEES protocol were performed. RESULTS: The patients were classified into three groups: normal with no or low risk of aspiration (n=15, 27.3%; PAS level 1), low to moderate risk (n=8, 14.5%; PAS level 2-4), and high risk (n=32, 58.2%; PAS ≥5). There was high incidence of aspiration pneumonia, prolonged ICU stay, and mortality in both moderate- and high-risk groups (P=0.001, P<0.001, and P<0.001, respectively). The PAS score predicted aspiration pneumonia (hospital-acquired pneumonia) with sensitivity and specificity of 80.0% and 76.0%, respectively (negative predictive value [NPV], 76.0; positive predictive value [PPV], 80.0; 95% confidence interval [CI], 0.706-0.940) and mortality with sensitivity and specificity of 88.46% and 68.97% (NPV, 87.0; PPV, 71.9; 95% CI, 0.749-0.951). The PAS score could predict the length of ICU stay with sensitivity and specificity of 70.21% and 87.50, respectively (NPV, 33.3; PPV, 97.1; 95% CI, 0.605-0.906). CONCLUSIONS: The standard FEES protocol using PAS score is a useful tool to assess aspiration in acute stroke patients and could be used to predict length of ICU stay and mortality.

Validation and Cultural Adaptation of an Arabic Version of Pediatric Eating Assessment Tool (Pedi-EAT-10Arabic).

Pediatric eating assessment tool (Pedi-EAT-10Arabic) is a validated and reliable caregiver administered outcome instrument designed for detection of children at high risk of penetration/aspiration. The objective of this study is to translate and validate the Arabic version of Pedi-EAT-10 and to correlate its results with pharyngeal residue and aspiration on fiber optic endoscopic examination of swallowing (FEES). A cross-sectional study including 202 children selected randomly from those attending the swallowing clinic in phoniatrics unit, Otorhinolaryngology department (ORL) at main university hospital between February 2019 and October 2020 complaining of dysphagia. For test-retest reliability, one hundred caregivers refilled the Pedi-EAT-10Arabic after a 2-week period following their first visit. Validity was established by comparing the scores of dysphagia patients to healthy controls. Internal consistency of Pedi-EAT-10Arabic was high (Cronbach's alpha 0.986). Intra class correlation showed excellent test-retest reliability (r = 0.968). The median Pedi-EAT 10Arabic score was significantly higher in dysphagia group compared to healthy controls. (Median 27 IQR 21-34 for cases compared to median zero IQR 0-2 points for healthy controls, P less than 0.001). A strong correlation was found between Pedi-EAT 10Arabic scores and PAS scores with Spearman's correlation coefficient r = 0.803 and P < 0.001. The ROC for evaluating the discriminatory capacity of Pedi-EAT 10 for aspiration showed an AUC of 0.92 (95% CI of 0.89 to 0.96). Conclusion: Pedi-EAT 10Arabic was found to be a valid and reliable screening tool for further instrumental assessment of risk of dysphagia in pediatric population.