Reliability and validity of the Arabic version of the brief version of the Questionnaire of Olfactory Disorders.

Background: An accessible self-assessment questionnaire is needed to evaluate quality of life in olfactory dysfunction. The need to address this gap led to the development of the brief version of the Questionnaire of Olfactory Disorders (brief QOD), which holds particular value in the context of telemedicine. Objectives: The aim of this study is to examine the reliability and validity of the Arabic brief QOD. Methods: This study included 307 patients suffering from olfactory dysfunction as well as a control group filled a questionnaire including demographic information, the olfaction Visual Analog Scale (VAS), the Sino-nasal Outcome Test 22 (SNOT-22) questionnaire, and the Arabic version of the brief QOD. The Arabic brief QOD's reliability was assessed using Cronbach's α to measure internal consistency. To evaluate test-retest reliability, the intraclass correlation coefficient (ICC) was employed. The discriminative ability: score differences between the two groups were analyzed. The validity Arabic brief QOD was evaluated by comparing it to the olfaction VAS. Results: The Cronbach's α coefficients were 0.757 for Questionnaire of Olfactory Disorders-Parosmia (QOD-P), 0.832 Questionnaire of Olfactory Disorders-quality of life (QOD-QoL), and 0.817 Questionnaire of Olfactory Disorders-visual analog scale (QOD-VAS). The reliability of the overall brief QOD was 0.93. The ICC exceeded the acceptable threshold of 0.7, indicating strong test-retest reliability. The highest correlation was observed between the SNOT-22 and QOD total scores (r = 0.552 and p < .001) as well as between SNOT-22 and QOD VAS (r = 0.512 and p < .001). Conclusion: Excellent validity and reliability have been shown for the Arabic brief QOD as a self-assessment tool assessing quality of life among olfactory dysfunction patients. Level of evidence: NA.

Persistent Shortness of Breath in Post-COVID-19 Patients: Inducible Laryngeal Obstruction Can Be a Cause.

BACKGROUND: Inducible laryngeal obstruction (ILO) is the adduction of the true vocal folds during inspiration or, less frequently, expiration. Its etiology is unknown. PURPOSE: This study aimed to identify ILO as a possible cause of shortness of breath (SOB) in post-COVID-19 patients. METHODS: A retrospective study was conducted on 59 post-COVID-19 adults complaining of SOB. We collected the cases' clinical and chest imaging data, including demographic data, pulmonary function test (PFT), CT chest, and laryngeal endoscopic examination. A visual score was used to assign the severity of the glottic obstruction. The grades of this score ranged from 0 (complete patency) to 3 (almost complete closure). RESULTS: ILO was detected in 8 out of 59 cases (13.5%). Two cases out of eight had glottic closure grade 1, while five cases had glottic closure grade 2, and one had glottic closure grade 3. There was a positive correlation between ILO grades (the severity of glottic closure) and PFT results (the degree of upper airway restriction). PFTs in ILO have a specific pattern. It was typical for the expiratory loop to be normal and the inspiratory loop to be flattened. CONCLUSION: ILO is a possible cause of SOB in post-COVID-19 adult cases. It should be considered during evaluation and management.

Validation and cross-cultural adaptation of the Arabic version of the self-reported mini olfactory questionnaire (Self-MOQ).

Background: A simple self-assessment screening questionnaire for olfactory dysfunction is direly needed in Rhinology practice, and this questionnaire should be accessible to affected individuals. The self-reported mini olfactory questionnaire (Self-MOQ), constructed to fill this gap, could be an important tool, especially in the era of telemedicine. Objectives: The aim of this study was to assess the validity and reliability of the Arabic version of the self-reported mini olfactory questionnaire (Self-MOQ) in patients with olfactory dysfunction. Methodology: This cross-sectional study included all adult patients who visited a rhinology clinic between January and June 2023 with a complaint of olfactory dysfunction and a control group. The participants completed a questionnaire that included items on demographics, risk factors of olfactory dysfunction, the olfaction VAS, SNOT-22, and Arabic Self-MOQ. The Self-MOQ was forward- and back-translated by qualified professional translators familiar with American English and Arabic.The reliability of the Arabic Self-MOQ was evaluated using Cronbach's α. The test-retest reliability was assessed by estimating the intraclass correlation coefficient (ICC) for the total Arabic Self-MOQ score and the individual items. The discriminative ability was examined by comparing the scores of the case and control groups. The construct validity was assessed by comparing the Arabic Self-MOQ to the olfaction VAS. Results: The study sample included 307 respondents (196 cases and 111 controls; 34 undertook the retest). The Cronbach's α coefficients were 0.92 (total Self-MOQ) and considered excellent. The ICC for the total Self-MOQ score was 0.87 (95% CI: 0.757, 0.933; p < .001), which indicated good test-retest reliability. Strong correlations were observed between the Self-MOQ items and VAS scores (r = 0.732, p < .001), (r = 0.689, p < .001). Conclusion: The current investigation showed the Arabic version of the Self-MOQ to be a reliable tool for olfactory dysfunction screening.

Validity and Reliability of the Arabic Version of the Glottal Function Index in Dysphonic Patients.

OBJECTIVES/HYPOTHESIS: The Glottal Function Index (GFI) is a four-item self-administered survey suitable for the evaluation and treatment of patients with glottal dysfunction. To date, it has been translated into Lithuanian, Persian, and Hebrew. This study is intended to translate and cross-culturally adapt the GFI for use in Arabic-speaking patients with dysphonia. STUDY DESIGN: This work is a cross-sectional study involving the administration of the GFI to participants with dysphonia (cases) and patients without dysphonia (controls). The validation process included reliability and validity assessments. METHODS: The GFI was translated using forward and backward translation methods from English into Arabic. The questionnaire's reliability was assessed using Cronbach's alpha and test-retest reliability (intraclass correlation coefficient, ICC). The Mann-Whitney test evaluated validity by comparing cases and controls. Finally, the Kruskal-Wallis test examined differences in the GFI across various pathologies. RESULTS: The GFI demonstrated favorable internal consistency (Cronbach's alpha = 0.848) and excellent test-retest reliability (ICC = 0.993). Significant differences in the A-GFI score between the cases and controls were also observed (P < 0.001), supporting the instrument's validity. However, no statistically significant differences were found in A-GFI across different diagnoses (P = 0.712). CONCLUSIONS: The A-GFI is a valid and reliable screening tool for clinicians to assess dysphonia and voice impairment in patients in Arabic-speaking countries. The tool is easy to administer in daily clinical practice given its brevity and self-administration.

Translation and Validation of an Arabic Version of the Voice Disability Coping Questionnaire.

OBJECTIVES/HYPOTHESES: Voice disorders can significantly affect the quality of life. This study aimed to translate, culturally adapt, and validate an Arabic version of the voice disability coping questionnaire (A-VDCQ) for use in Arabic-speaking populations with dysphonia. STUDY DESIGN: This was a cross-sectional study involving the translation and cultural adaptation of the VDCQ into Arabic. The validation process included reliability and validity assessments. Participants were categorized into cases (individuals with dysphonia) and controls (individuals without dysphonia) to compare coping strategies between the two groups. METHODS: ccccccccThe 15-item VDCQ was translated from English into Arabic using the forward and backward translation methods. The questionnaire's reliability was assessed using Cronbach's alpha and test-retest reliability (intraclass correlation coefficient, ICC). Validity was evaluated by comparing cases and controls using the Mann-Whitney test. Differences in coping strategies across different diagnoses were examined using the Kruskal-Wallis test. RESULTS: The A-VDCQ demonstrated satisfactory internal consistency (Cronbach's alpha = 0.769) and excellent test-retest reliability (ICC = 0.993). Significant differences in coping strategies between the cases and controls were also observed (P < 0.001), supporting the instrument's validity. Notably, item 4, which is related to information seeking, had the highest impact score among the cases. However, no statistically significant differences were found in coping strategies across different diagnoses (P = 0.249). CONCLUSIONS: The A-VDCQ demonstrated robust psychometric properties for assessing coping strategies in individuals with voice disorders and such strategies' potential implications for clinical practice and research.

Validity and Reliability of the Arabic Thyroidectomy-Related Voice and Symptom Questionnaire (A-TVSQ) for Assessing Post-Thyroidectomy Patients.

OBJECTIVE: Post-thyroidectomy patients commonly experience voice changes, swallowing symptoms, and neck discomfort, a condition known as post-thyroidectomy syndrome. The Thyroidectomy-Related Voice and Symptom Questionnaire (TVSQ) is a validated tool showing strong correlations with established tools with a potential predictive value for post-thyroidectomy voice outcomes. Our study aims to translate and validate the TVSQ into Arabic. METHODS: This validation study was conducted at King Abdulaziz University Hospital and King Khalid University Hospital in Riyadh, Saudi Arabia. Forward and backward translations ensured the conceptual equivalence of the Arabic TVSQ (A-TVSQ) and were reviewed by an expert panel. A pilot test assessed the A-TVSQ's face validity and clarity, leading to necessary cultural adjustments. The final A-TVSQ was preoperatively and postoperatively administered to thyroidectomy patients to evaluate its test-retest reliability. RESULTS: Data were collected from 116 participants (53 cases [45.6%] and 63 controls [54.3%]). The internal consistency analysis showed strong intercorrelation among the A-TVSQ items, with Cronbach's alpha coefficients (0.951) indicating excellent estimated internal consistency within both domains. Test-retest reliability showed a moderate level of reliability with an intraclass correlation coefficient of 0.696. A-TVSQ item discrimination analysis showed significant associations between the total and domain scores pre- and post-thyroidectomy. External validity analysis showed significant changes in A-TVSQ voice change (P < 0.010) and neck discomfort (P = 0.011) domains and total scores (P < 0.010) between before and 2 weeks after thyroidectomy. However, no significant changes were observed between 2 and 4 weeks after thyroidectomy. CONCLUSIONS: The translated and validated A-TVSQ showed excellent internal consistency and moderate test-retest reliability, comparable to the original version. Voice change significantly worsened after thyroidectomy, highlighting the need for continued monitoring and management strategies for this complication.

Voice Problems Among School Teachers employing the Tele-teaching Modality.

OBJECTIVES: To assess the prevalence of voice problems among teachers in Riyadh during tele-teaching and examine the relationship between the Voice Handicap Index 10 (VHI10) scores and a variety of risk factors believed to be related to voice problems. We also assessed awareness of voice hygiene and therapy among teachers. STUDY DESIGN: An observational cross-sectional study conducted using a multistage random sampling method among Riyadh school teachers who taught by tele-teaching for a minimum of one year. METHODS: A self-assessment questionnaire which included demographic information about teachers, factors related to their teaching backgrounds, tele-teaching settings, effects of tele-teaching on the voice, medical and social histories, reports of voice and reflux symptoms, VHI10, and general knowledge about voice hygiene. This was distributed to school teachers using an SMS link through the Ministry of Education's IT department. RESULTS: A total 495 were included in the study after exclusions. The prevalence of teachers who had significant voice problems during tele-teaching (VHI10>11) was 21.6%. Multiple risk factors significantly increased the risk of voice problems during tele-teaching. These factors included being female, teacher age, the presence of background noise from both teachers and students, loud voices, using an open camera during the teaching, stress and anxiety, allergies, respiratory disease, reflux, hearing problems, and a family history of voice problems. Only 4.6% of respondents were familiar with voice hygiene and voice therapy, but 65% believe that it is important for teachers to be knowledgeable about them. CONCLUSIONS: Due to the lower prevalence of voice disorders among tele-teaching compared to traditional teaching methods, tele-teaching may be a viable option for teachers who have voice problems. There are still several factors influencing voice problems among tele-teachers. To attenuate potential risks, it is crucial that teachers are aware of the concepts of voice hygiene and voice therapy.

Validation and Cultural Adaptation of the Arabic Version of the Aging Voice Index.

BACKGROUND: The aging voice index (AVI) is a 23-item self-administered, patient-reported outcome measure. It was developed in the English language to assess the impact of voice disorders on the elderly population. OBJECTIVES: This study aimed to develop an Arabic version of the AVI (A-AVI), test its reliability and validity, and assess its psychometric aspects in Arabic-speaking elderly persons with voice disorders. STUDY DESIGN/METHODS: This was an observational, cross-sectional study involving elderly patients aged ≥60 years. Eighty-two patients with voice disorders were included in the dysphonia group and 77 patients without voice disorders were included in the vocally healthy group. The translated A-AVI and Arabic voice handicap index 10 (A-VHI10) were distributed to the study groups. The A-AVI was tested for its reliability (test-retest reliability and internal consistency) and validity (content, construct, and concurrent with A-VHI10). RESULTS: The A-AVI showed excellent test-retest reliability and internal consistency (intraclass correlation coefficient = 0.987 and Cronbach's alpha = 0.954, respectively). There was a significant difference in A-AVI scores between the elderly in the dysphonia and vocally healthy groups (P < 0.001). In addition, a significant correlation was demonstrated between A-AVI and A-VHI10 (r = 0.89). Unilateral vocal fold immobility and inflammatory laryngeal disorders were most frequently reported by the dysphonia group (28%). CONCLUSIONS: A-AVI has excellent validity and reliability in Arab-speaking elderly patients with voice disorders. It can be considered in the assessment of the effect of voice disorders on the quality of life of the elderly.

Cochlear implantation versus auditory brainstem implantation in children with auditory nerve deficiencies.

BACKGROUND: Cochlear nerve deficiency is one of the known causes of congenital sensorineural hearing loss. Management of hearing loss in children with cochlear nerve deficiency poses a multidimensional challenge. The absent or hypoplastic cochlear nerve may prevent electrical stimulation from reaching the brainstem and the auditory cortex. A deficient cochlear nerve can be associated with other inner ear malformations, which may diminish the success of cochlear implantation in those children. Promising results in adults after auditory brainstem implantation led to the expansion of candidacy to include the pediatric populations who were contraindicated for CIs. OBJECTIVE: To review the outcomes of cochlear implantation versus that of auditory brainstem implantation in children with various conditions of the auditory nerve. METHODS: This retrospective chart review study comprised two pediatric groups. The first group consisted of seven ABI recipients with cochlear nerve aplasia and the second group consisted of another seven children with cochlear nerve deficiencies who underwent CI surgery. The participants' auditory skills and speech outcomes were assessed using different tests selected from the Evaluation of Auditory Responses to Speech (EARS) test battery. RESULTS: There were some individual variations in outcomes depending on the status of the auditory nerve. The mean CAP score of the ABI group was 2.87, while the mean SIR score was 0.62. On the other hand, the mean CAP score of the CI group was 1.29, while the mean SIR score was 0.42. CONCLUSION: Our results are in good agreement with the reported auditory perception and speech and language development outcomes of pediatric auditory brainstem implantation. We added to the growing body of literature on the importance of verifying and identifying the status of the cochlear nerve in the decision-making process of the surgical management of those pediatric groups.

Arabic Version of short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12).

OBJECTIVES: To translate and validate the short form of the speech, spatial, and qualities of hearing scale (SSQ12). This will help in the assessment of hearing disability in the daily life of hearing-impaired populations, as well as the improvement of their quality of life. METHODS: This cross-sectional study was conducted at the King Abdullah Ear Specialist Center, Riyadh, Saudi Arabia, between April and June 2021. The study included 102 hearing-impaired participants as the patient group and 84 normal-hearing participants as the control group. The English SSQ12 was translated according to the International Quality of Life Assessment method. Internal consistency and reliability of the Arabic SSQ12 were then assessed using Cronbach's alpha (α) and test-retest reliability. Discriminant validity was also assessed by comparing the patients' scores with the control participants. RESULTS: The overall internal consistency of the Arabic SSQ12 was excellent (α=0.9), with good test-retest reliability (intraclass correlation coefficient [ICC]=0.8). There was a significant difference between the Arabic SSQ12 scores of the patient and control groups (p<0.0001). CONCLUSION: The Arabic version of the SSQ12 appears to be a valid and reliable tool that can be used to assess the communication ability of hearing-impaired patients in audiology clinics.

Validation of LittlEARS® Early Speech Production Questionnaire in Arabic-speaking children with normal hearing.

OBJECTIVES: To validate an Arabic version of the LittlEARS® Early Speech Production Questionnaire (LEESPQ), which assesses the early development of speech and language in infants between 0 and 18 months, in Arabic-speaking children with normal hearing in Saudi Arabia. METHODS: This is a cross-sectional study conducted in the city of Riyadh, Saudi Arabia between September and December 2020. Parents completed the LEESPQ regarding their child's speech production development. To assess the ability of normal hearing children aged 0-18 months in developing speech and language production, a norm curve has been generated based on the standardized values that were calculated from the Arabic normal-hearing data set. RESULTS: A total of 198 questionnaires were analyzed. The total score on the LEESPQ correlated with age, gender, and bilingualism. A norm curve for early speech production in children with normal hearing was created. CONCLUSION: The Arabic version of LEESPQ appears to be a valid questionnaire that can be used in the assessment of early language and speech development of Arabic-speaking children with normal hearing in the age range of 0-18 months. The Arabic version of the LEESPQ might also be a useful tool to detect developmental delays and hearing disorders in young children.

Validation and clinical application of the Arabic rhinoplasty outcomes evaluation questionnaire.

OBJECTIVES: To carry out translation, cross-cultural adaptation, and validation of the rhinoplasty outcome evaluation (ROE) into Arabic. METHODS: This non-randomized, prospective study included 50 patients from the Otorhinolaryngology Department, King Saud University, Riyadh, Saudi Arabia who underwent primary rhinoplasty from January to October 2020 and a control group of 89 healthy individuals. The reliability of the Arabic (ROE) was tested using Cronbach's alpha. The test-retest reliability was assessed by estimating the intra-class correlation coefficient for the total Arabic (ROE) score and individual items. Discriminant validity was used to examine the validity of the Arabic (ROE) by comparing the scores of the patients and the control group. The Friedman test was used to measure differences in Arabic (ROE) ratings within the study patients' group, including preoperative, and 2 weeks, and 3 months postoperative ratings. RESULTS: The internal consistency and reliability of the Arabic (ROE) were good. There was a significant difference in ratings between rhinoplasty patients and the control group regarding both the individual questions and total scores. Significant improvement was observed in the patient group ratings at 2 weeks and 3 months postoperatively compared to the preoperative rating (p<0.0001). CONCLUSIONS: The Arabic version of the (ROE) showed good reliability and validity and can be used in the assessment of rhinoplasty outcomes in the Arabic population.

Características do padrão de refluxo na posição ortostática versus posição supina em pacientes com refluxo laringofaríngeo

Resumo Introdução: Muitos problemas relacionados à laringe têm sido atribuídos ao refluxo laringofaríngeo, inclusive disfonia, pigarro frequente, tosse crônica e sensação de "globus" faríngeo. No entanto, ainda há controvérsias quanto ao diagnóstico e à apresentação clínica dessa condição clínica. Objetivo: Descrever as características do refluxo laringofaríngeo de diferentes posições, em pacientes diagnosticados por meio de pHmetria orofaríngea. Método: Foi feita uma revisão retrospectiva de prontuários de 161 pacientes com refluxo laringofaríngeo diagnosticado por pHmetria orofaríngea de 24 horas. Os indivíduos do estudo foram categorizados em grupos com refluxo laringofaríngeo na posição ortostática e refluxo laringofaríngeo na posição supina com base nos resultados do pH. Os dois grupos foram comparados quanto à apresentação clínica e às características do pH. Resultados: Foram encontradas taxas significativamente mais altas de refluxo laringofaríngeo na posição ortostática em comparação à posição supina (p < 0,0001). Os resultados do índice de sintomas de refluxo foram significativamente maiores no grupo com refluxo laringofaríngeo na posição ortostática em comparação com o grupo com refluxo laringofaríngeo na posição supina. O uso do escore de Ryan composto (composite Ryan score) para a pHmetria orofaríngea de 24 horas foi significantemente maior no grupo com refluxo laringofaríngeo ortostático em relação ao grupo supino (p < 0,0001). Nenhuma diferença significante foi encontrada entre os grupos refluxo laringofaríngeo na posição ortostática e posição supina em relação à frequência da apresentação clínica ou classificações do índice de desvantagem vocal. Conclusão: O refluxo laringofaríngeo foi mais prevalente na posição ortostática entre os grupos de estudo. As características relacionadas ao refluxo, inclusive parâmetros de pH, foram mais evidentes no refluxo laringofaríngeo na posição ortostática.

Characteristics of upright versus supine reflux pattern in patients with laryngopharyngeal reflux.

INTRODUCTION: Many laryngeal-related problems have been attributed to laryngopharyngeal reflux including dysphonia, frequent throat clearing, chronic cough, and globus sensation. However, there is still controversy regarding diagnosis and clinical presentation of this disorder. OBJECTIVE: The main objective of this study is to describe laryngopharyngeal reflux characteristics of different reflux position patterns in laryngopharyngeal reflux patients diagnosed with oropharyngeal pH monitoring. METHODS: A retrospective chart review was conducted for 161 laryngopharyngeal reflux patients diagnosed with 24h oro-pharyngeal pH monitoring. Study subjects were categorized into upright and supine laryngopharyngeal reflux groups based on the pH results. The two groups were compared regarding the clinical presentation and pH characteristics. RESULTS: Significant higher rates of upright laryngopharyngeal reflux position than supine laryngopharyngeal reflux position (P<0.0001) were reported among the study group. Reflux symptoms index results were significantly higher in the upright larybgopharyngeal reflux group compared to the supine laryngopharyngeal reflux group. 24h oropharyngeal pH measurements composite Ryan score was significantly higher in the upright group compared to the supine group (P<0.0001). No significant difference was found between the upright and supine laryngopharyngeal reflux groups regarding the frequency of clinical presentation or voice handicap index ratings. CONCLUSION: Laryngopharyngeal reflux was found to be more prevalent occurring in the upright position among the study group. Reflux-related characteristics including pH parameters were more evident in the upright laryngopharyngeal reflux position.

Audiologic Outcome of Cochlear Implantation in Children With Cochlear Nerve Deficiency.

OBJECTIVE/HYPOTHESIS: The aim of this study was to investigate cochlear implantation (CI) outcome in children with nerve deficiency. STUDY DESIGN: Retrospective chart review. METHODS: A total of seven children with prelingual profound deficiency (hypoplasia or aplasia) were included. A control group of 10 CI children with no cochlear nerve anomalies was also included. In addition to implant stimulation levels, children's performance on pure-tone audiometry, speech reception measure, and auditory and speech skills ratings were compared across groups. Additionally, pre- and postoperative audiologic results were evaluated for the group with nerve deficiency. RESULTS: In general, children with nerve deficiency performed poorer than those without nerve deficiency on all tested measures. Stimulation levels were considerably higher and more variable than the control group. Results further showed that performance was dependent on the diameter of the internal auditory canal. CONCLUSION: Overall, cochlear implantation outcome in children with auditory nerve deficiency is poorer and extremely more variable than those without nerve deficiency. However, three of the patients had a noticeable improvement in auditory performance postimplantation suggesting that CI is a viable option in this population but expected benefit can be dependent on the status of the cochlear nerve.

Validation and inter-rater reliability testing of the Arabic version of speech intelligibility rating among children with cochlear implant.

OBJECTIVES: To validate and assess the reliability of the new version of an Arabic speech intelligibility rating among di erent raters. METHODS: This cross-sectional analysis was carried out between December 2018 and January 2019. Thirty cochlear-implant (CI) children (study group) and 30 subjects (control group) were enrolled. Study candidates' speech skills were evaluated using the translated Arabic SIR by parents and original SIR by professions such as speech-language pathologists (SLPs). Inter-rater agreement, test-retest reliability, pre- and post-intervention score (responsiveness test), patient versus control score comparison (discriminant validity), and cross-validation of Arabic SIR have all been assessed. RESULTS: There was a good sense of agreement between the post-operative SIR parents' assessments and the professional SLPs' assessments (r=0.920, p less than 0.001). The mean of study subjects pre- and post-implantation score of Arabic SIR showed a statistically significant difference (p less than 0.001). CONCLUSION: The Arabic SIR demonstrated excellent reliability with strong consistency. It showed its clinical ability in distinguishing healthy subjects from patients along with follow up of speech development skills over time. The Arabic SIR can be used by parents to evaluate post-CI progress of their children.

Inter-rater Reliability and Validity of the Arabic Version of Categories of Auditory Performance-II (CAP-II) Among Children With Cochlear Implant.

BACKGROUND: Categories of Auditory Performance II (CAP-II) is an established audiological test that consists of a rating scale that can be used for prospective assessment of the auditory performance of cochlear implant (CI) recipients. OBJECTIVE: To create and validate an Arabic version of Categories of Auditory Performance scale II (CAP-II), and to evaluate its reliability. METHODS: In this cross-sectional study, 30 post-CI children (patients' group) along with 30 control subjects were included. The translated Arabic CAP-II scale has been used by speech-language pathologists and parents to evaluate the study subjects' auditory abilities. The interrater reliability, test-retest reliability, pre and postintervention score (responsiveness test), case versus control score comparison (discriminate validity), and cross-validation of the new Arabic version of CAP-II have been assessed. RESULTS: The Arabic CAP-II demonstrated high test-retest and inter-rater reliability. There was a positive correlation between the Arabic CAP-II and Meaningful auditory integration scale. The Arabic CAP-II scores were higher in the patients' group compared with control subjects. CONCLUSION: The Arabic CAP-II showed high inter-rater reliability with excellent concurrent and discriminate validity. The Arabic version of CAP-II seems to be a valid and reliable tool in assessing different auditory performance in Arabic speaking children with hearing impairment.

The Arabic translation, cultural adaptation, and validation of the pediatric voice-related quality of life survey.

OBJECTIVE: The aim of this study was to develop an Arabic version of the pediatric voice-related quality of life (PVRQOL) and test its validity and reliability. SUBJECTS: and methods: Fifty-one children with voice problems were included in the study along with 60 control children without any voice disorders. The translated Arabic PVRQOL and the Arabic pediatric voice handicap index (PVHI) have been distributed to the study subjects. The Arabic PVRQOL was tested for its internal consistency, test-retest reliability, and clinical validity. RESULTS: the Arabic PVRQOL showed strong internal consistency and excellent test-retest reliability (Cronbach α = 0.9 and ICC = 0.92 respectively). There was a significant difference between the patients and control group regarding Arabic PVRQOL scores (P < 0.0001). Also, significant correlation was demonstrated between the Arabic PVRQOL and Arabic PVHI. CONCLUSION: The Arabic version of PVRQOL maintained its validity and reliability and may be considered in the assessment of voice disorders for Arabic speaking children.

Auditory and language skills development after cochlear implantation in children with multiple disabilities.

BACKGROUND: Cochlear implantation (CI) in children with additional disabilities can be a fundamental and supportive intervention. Although, there may be some positive impacts of CI on children with multiple disabilities such as better outcomes of communication skills, development, and quality of life, the families of those children complain from the post-implant habilitation efforts that considered as a burden. OBJECTIVE: To investigate the outcomes of CI children with different co-disabilities through using the Meaningful Auditory Integration Scale (MAIS) and the Meaningful Use of Speech Scale (MUSS) as outcome measurement tools. METHODS: The study sample comprised 25 hearing-impaired children with co-disability who received cochlear implantation. Age and gender-matched control group of 25 cochlear-implanted children without any other disability has been also included. The participants' auditory skills and speech outcomes were assessed using MAIS and MUSS tests. RESULTS: There was a statistically significant difference in the different outcomes measure between the two groups. However, the outcomes of some multiple disabilities subgroups were comparable to the control group. Around 40% of the participants with co-disabilities experienced advancement in their methods of communication from behavior to oral mode. CONCLUSION: Cochlear-implanted children with multiple disabilities showed variable degrees of auditory and speech outcomes. The degree of benefits depends on the type of the co-disability. Long-term follow-up is recommended for those children.