Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial

BACKGROUND

Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders.

OBJECTIVE

This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention.

METHODS

A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants).

RESULTS

The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received.

CONCLUSIONS

The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/54426.

Effect of premature infant oral motor intervention [PIOMI] combined with music therapy on feeding progression of preterm infants: a randomized control trial

Prematurity may produce long-term complications in the physical and cognitive development of infants. There is a need for interventions that can improve feeding and reduce the length of NICU stay and separation time between the infant and mother. This study aimed to explore the clinical effect of premature infant oral motor intervention [PIOMI] combined with music therapy [MT] on feeding progression in premature infants.Premature infants with gestational ages between 26 and 30 weeks were included in the study. Fifty-two participants were randomly divided into intervention and control groups. All infants received PIOMI, and the intervention group received additional MT. The participants of the two groups were compared based on weight gain, feeding progression, Preterm Oral Feeding Readiness Scale [POFRAS], milk volume, and length of hospitalization. The data were analyzed using independent sample t-tests, covariance tests, and repeated measure ANOVA used to compare three group means.The intervention group reached independent oral feeding 8 days earlier [P = .018] than the control group. Length of hospitalization was 6 days shorter [P = .224] for the intervention group, and the mean volume of milk on the 10th day was 215.38 ± 56.4 in the intervention group and 155.69 ± 68.9 in the control group, respectively [P = .001]. The mean score of the POFRAS scale on the 10th day was 28.65 ± 3.0 in the intervention groups and 20.96 ± 3.3 in the control groups, retrospectively [P = .001]. There was no difference in weight gain between the two groups [P = .522].Conclusion: PIOMI combined with MT was effective for the feeding progression of premature infants, and infants who received both these interventions were discharged sooner than control infants. Thus, MT should be considered part of feeding interventions for preterm infants with gestational ages between 26 and 30 weeks.Trial registration: Clinical trial registration number: IRCT20210502051155N1 on 18/9/2021 What is Known -- What is New: • There is numerous study about the eff ect of music therapy or oral motor interventi on. However, premature Infants havenot been yet studied to determine whether music therapy and oral motor interventi ons may synergize to aid their feedingprogression.

Phonological development in first language Laki-speaking children aged 3 to 5 years: A pilot study

PURPOSE

To date there are no studies of speech sound acquisition in Laki, a language spoken in western regions of Iran. Thus, we set out a pilot study to investigate the speech development of 56 first language Laki-speaking children (aged 3-5 years).

METHOD

Single words were elicited through a picture naming test specifically developed for this study. After recording and transcribing of speech samples, percentage of consonants correct (PCC), percentage of vowels correct (PVC), and proportion of whole word proximity (PWP) were documented in four age groups (36-41, 42-47, 48-53, and 54-59 months) and both genders. Children's phonetic inventories and consonant and vowel accuracy were also described.

RESULT

All the sounds were considered as emerging by 53 months of age. For speech sound accuracy, all the speech sounds except /ɢ, z, ŋ, ʒ/ were mastered by 5 years. The effect of age on PCC values was significant. Also, age groups showed significant differences for PWP but were not significant for PVC. Boys and girls did not differ for PCC, PVC, and PWP values.

CONCLUSION

From a theoretical perspective, findings contribute to theories about phonological acquisition in general and will enable crosslinguistic comparisons. From an applied standpoint, language-specific characteristics are identified, which are much needed for clinical practice with Laki-speaking children.

Developing a Serial Search Task to Evaluate Procedural Memory and Investigating the Relationship Between Procedural Memory and Grammar in Farsi-speaking Children: A Preliminary Study

Objective: Procedural memory is a key component of long-term memory that can be assessed in different modalities, such as verbal and motor. Learning through procedural memory occurs in three stages: initial learning, consolidation, and retention. Several tasks evaluate procedural memory, but none have concurrently studied procedural learning in various modalities and learning stages. Besides, according to the declarative-procedural model, there may be an association between the performance of individuals in procedural learning and their state of the grammar of a language. Therefore, this study aimed to design a Serial Search Task (SST) for the simultaneous evaluation of procedural memory in motor and verbal modalities during three stages of learning and determine its reliability. Moreover, the relationship between procedural memory and grammar skills was examined. Materials & Methods: This study is methodological research in the first stage and descriptive analytics in the second stage. First, based on the literature review and the opinions of three speech-language pathologists, some words with appropriate psycholinguistic features were chosen from the Persian picture naming set. Then, corresponding pictures were determined. The task was designed using Java programming language. The face validity of the task was evaluated, then after revisions, the reliability was determined. Face validity was assessed in 10 normal children, and the test-retest reliability was evaluated in 15 normal children aged 7-9 years; all of them were chosen using the convenience sampling method. In the second stage, to assess the relationship between grammatical skills and the SST, 20 normal children aged 7-9 years were selected by a mixed sampling method. Every child had exposed to a verbal modality in three stages: initial learning, consolidation (24 hours later), and retention (one week later). Then the same stages were performed in the motor modality. Each child's language skills were determined using the test of language development-primary (TOLD-P3), and the relationship between the two skills was determined. Statistical methods included the Pearson and Spearman correlation coefficients and repeated measures analysis of variance. Results: The correlation values between two performances in the initial learning stage for the reaction time variable in verbal (r=0.84, P<0.001) and motor (r=0.80, P˂0.001) modalities and the variable of response accuracy in verbal (r=0.81, P=0.011) and motor (r=0.77, P=0.026) modalities were obtained. In the consolidation and retention stages, the correlation values for the reaction time variable in verbal (r=0.737, P=0.002) and motor (r=0.743, P=0.001) modalities and the variable of response accuracy in verbal (r=0.624, P=0.013) and motor (r=0.916, P<0.001) modalities were obtained. The relationship between grammar and procedural learning in the verbal modality was significant in the consolidation stage (P=0.045, CI:0.016-0.797, r=0.491). Conclusion: SST is a reliable task to assess different stages of procedural memory in both verbal and motor modalities. Therefore, this task can be used to evaluate procedural memory in normal children aged 7-9 years. The current study's findings confirmed the predictions made by the declarative-procedural model during the consolidation stage in the verbal modality.

Non-word repetition in Persian learning toddlers with typical development

In the current research, non-word repetition (NWR) skills of Persian learning toddlers and its association with phonological accuracy and language measures, such as percentage consonant correct (PCC), mean length utterance (MLU), and expressive vocabulary was evaluated. First, the Persian task of NWR, comprising 15 non-words, was developed and validated. Forty-four typically developing Persian learning toddlers aged from 24 to 30 months were recruited in this project. Word and NWR responses were elicited during play. MLU was investigated using serial picture description. Furthermore, the Persian version of MacArthur-Bates communicative development inventories was completed by participants' parents. The association between NWR, word repetition, MLU, and vocabulary indices was measured. Excellent values were obtained for test-retest reliability, PCC of NWR (ICC = .94, 95% CI, .78-.94, p < .001) and PCC of word repetition (ICC = .96, 95%CI, .83-.96, p < .001). The values of PCC for NWR and PCC of word repetition were 80.32 ± 13.44 and 83.51 ± 9.91, respectively. The Wilcoxon ranked test showed that participants had better performance in word repetition than NWR (z = -.275, p = .02). Significant associations were found between NWR, word repetition, MLU, number of different words, number of total words, and the expressive vocabulary size. Sex, socioeconomic status, and age did not affect NWR in this study. The findings of the current research demonstrated that the Persian task of NWR is a valid and reliable test to measure the NWR and the scores of participants were substantially associated with phonological accuracy, MLU, and vocabulary measures.

Speech sound acquisition in Azeri Turkish-speaking children in Iran

BACKGROUND

Currently no data exist on the acquisition of speech sounds in Azeri Turkish-speaking children in Iran. This investigation was conducted to describe phonological development in Azeri Turkish-speaking children.

METHODS

A total of 120 typically developing Azeri Turkish-speaking children within the age range of 3;0 to 4;11 years were recruited. They were asked to name pictures in the Azeri Turkish Speech Test and their productions were analyzed to determine consonant acquisition, Percentage of Consonants Correct (PCC), Percentage of Vowels Correct (PVC), and Whole Word Proximity (WWP) according to sex and age. In addition, PCC values in terms of consonant position in the syllable (syllable-initial and syllable-final), and manner of articulation were calculated.

RESULTS

For consonant acquisition, they mastered all consonants except [d, d͡z, t͡s, ʒ, v, ɟ] by 4;11 years of age. PCC values increased with increasing age (H(3)= 67.212, p <0.001). In terms of manner of articulation, PCC showed that nasals were most accurately produced and trill sound least accurate. The effect of sex on PCC values was not significant U (N_males =60, N_females =60)= 1686.5, z = -0.600, p=.54). WWP values were also found to increase in older children H(3)=46.94, p<.001). Similarly, the effect of sex on WWP values was not significant U (N_males =60, N_females =60)= 1782.5, z = -0.09, p=.92).

CONCLUSIONS

Children acquiring speech sounds in the Azeri Turkish language show some similar tendencies to children acquiring other languages but are also different. Findings of the present research describe phonological development in Azeri Turkish-speaking children, which has not been documented before.

Psychometric Properties of the Persian Word Pairs Task to Evaluate Declarative Memory

Introduction

According to the declarative/procedural (DP) model, the semantic aspect of language depends on the brain structures responsible for declarative memory. The word pairs task is a common tool to evaluate declarative memory. The current study aimed to design a valid and reliable task to evaluate declarative memory in Persian-speaking children at the learning and retention stages and investigate its relationship with the semantic aspect of language.

Methods

A panel of experts agreed on the content validity of the proposed task. The reliability of the task was determined using internal consistency and test-retest reliability. A total of 31 typically developing children aged 7-9 years participated in this study.

Results

The content validity of all the 42-word pairs was calculated as one. The test-retest reliability showed a correlation coefficient of 0.825 (P<0.001). The task showed acceptable internal consistency (Cronbach's alpha 0.880). The results of correlation analysis showed no significant relationship between declarative memory and semantic aspect. However, the regression analysis showed that the retention stage can explain 24.2% of the variations in the semantic aspect.

Conclusion

It seems that the word pairs task has good validity and reliability to evaluate declarative memory. The task applied to evaluate the semantic aspect can be one of the potential causes of the lack of a relationship between the semantic aspect and declarative memory. The participants' scores in the retention stage can be predicted concerning their performance at the semantic aspect.

Highlights

The proposed task has several advantages as follows:Good validity and reliability to evaluate different stages of declarative memory, including learning, immediate recall, delayed recall, delayed recognition, and retention.Children's performance improves with age at different stages of the task.Subjects' performance in the retention stage of declarative memory was the only component predicting the score of the semantic aspect.

Plain Language Summary

One of the components of long-term memory is declarative memory. This memory includes the semantic memory in which information about vocabulary is stored. In this research, the word pairs task was designed to evaluate declarative memory in children aged 7 to 9 years and its validity and reliability were investigated. The final task consists of 42 unrelated word pairs that are presented to children in several stages, and it examines the ability of children to communicate between pairs of unrelated words in terms of meaning (e.g., book-teeth). The better the children's performance in this task is, it indicates the better performance of these children's declarative memory. The task has good validity and reliability and can be used to evaluate children's declarative memory and to determine changes after introducing declarative memory improvement techniques.

Phonological acquisition in 3- to 5-year-old Kurdish-Speaking children in Iran

BACKGROUND

given the lack of sufficient information and research about phonological acquisition in the Kurdish language, the aim of this study was to examine phonological acquisition in typically developing Kurdish-speaking children. Three analyses were performed: (1) the age of customary, acquisition and mastery production of Kurdish consonants; (2) phonological accuracy and the age of phonological pattern suppression; and (3) effect of age and sex on speech sound acquisition.

METHODS

this research assessed 120 monolingual Kurdish-speaking children aged 3;0 to 5;0 years. The participants were selected randomly from the health center of Bukan city, Iran. Acquisition of 29 Kurdish consonants was assessed using the Kurdish Speech Test.

FINDINGS

results found that Kurdish-speaking children had acquired all the vowels before 3;0 and all the consonants in the three positions of initial, medial and final up to 4;6 years old, with the exception of /ʤ/ in initial position, /ɣ/ in medial position and /ʒ/, /z/, /ɡ/, /ɣ/ in final position. Consonant production in initial position was more accurate than in medial and final positions. The accuracy of Kurdish vowels and consonants improves with increasing age as phonological patterns decrease. There was no significant sex difference within the age groups; however, overall, a statistically significant difference was noted for fricative production and for production of word final consonants in the older groups with females outperforming males.

CONCLUSIONS

the present study is the first investigation of speech sound acquisition in Kurdish-speaking children. Knowledge of typical speech sound acquisition provides a basis for speech-language pathologists working with Kurdish-speaking children to differentiate children with typical development from those with speech delays and speech sound disorders.

Development of a speech production test in Azeri Turkish speaking children

Due to the lack of appropriate tests for the assessment of speech sounds of Azeri Turkish speaking children, the present study aimed to develop and validate a single word test. A total of 150 typically developing children were recruited in the study (30 children for investigating the name agreement and 120 children to establish construct validity). In the first step, a test with 31 items was developed in terms of suggested criteria in the literature including word frequency, word length, syllabic structure, familiarity, and picturability of words. Then, we asked the expert panel's opinion for the test items. The value of the content validity ratio for each target word was 1.00 except for one item. To administer the test, we asked the participants to name images. Name agreement of the items was determined through administrating the test. The percentages for the indices of name agreement were 87.68 and 0.17, respectively. The findings of the item-by-item test-retest and inter-rater reliability showed satisfactory values in terms of consonants in the initial and final positions. Also, the value of the internal consistency was calculated to be kr = 0.78 (p < 0.001). The psychometric properties of this scale with 31 items proved that it is appropriate for quantifying the speech sound production in Azeri Turkish typically developing children.

Executive functions in Persian-speaking preschool children with speech sound disorders and comparison with their typically developing peers

This study aimed to compare working memory, inhibitory control, and cognitive flexibility, the core components of executive functions, among two prevalent subtypes of preschool children with speech sound disorder, i.e., phonological delay (n = 16) and consistent phonological disorder (n = 15), and a group of typically developing children (n = 18). The correlation between executive function components and the accuracy of speech sound production were also investigated. Nonword repetition task and syllable repetition task were used to evaluate the phonological loop of working memory. Backward digit span was administered to examine the central executive of working memory. Cognitive flexibility was assessed using the second selection of the flexible item selection task and inhibitory control using Stroop-like and Go/No-Go tasks. The percentage consonants correct was applied to calculate the accuracy of speech sound production. Results of a one-way multivariate analysis of covariance revealed statistically significant differences between groups in the combined dependent variables after controlling for age (F(14, 80) = 17.289, p < .001, Pillai's trace = 1.503, partial ηƞ² = .752). Typically developing children outperformed in all measurements of executive functions than both speech sound disorder subgroups. Moreover, children with phonological delay performed better in nonword repetition and corrected responses of Stroop-like than consistent phonological disorder group. All executive function measurements also correlated with speech sound production. The results of the present study highlight the importance of including domain-general cognitive skills in current assessment protocols for children with phonological delay and consistent phonological disorders.

Comparison of Definitional skills in school-age children with cochlear implants and normal hearing peers

Objective

The auditory experience is important because makes a major contribution to the development of speech, language, cognitive, and social skills. Knowledge of the lexicon has been increased throughout life. Input factors and linguistic and metalinguistic knowledge are effective factors in the acquisition of definitional skills. This study was done to investigate definitional skills in cochlear-implanted (CI) children and their typically developing (TD) peers.

Materials & methods

A total of 46 third-grade primary school children (16 with cochlear implants and 30 their TD peers) were recruited. The verbal definitional task included 14 common high-frequency nouns and 11 common high-frequency verbs. All definitions were scored for both content (semantic) and grammatical forms. Statistical analysis was conducted to compare the definitional skills between the two groups.

Results

There were significant differences between CI children and their TD peers for word definition skills in both categories of content and form (p<0.001). The results showed the mean scores of content and

form aspects of word definition in the TD group were approximately twice higher than the CI ones (M±SD=133±28 and M±SD= 78±23, respectively).

Conclusion

Children with CI may have trouble with definitional skills. It seems that the lower scores of CI children in definitional skills were due to a lack of auditory experience. Considering interventions on definitional skills in CI children is suggested.

Phonological development in Persian-speaking children: A cross-sectional study

PURPOSE

The Persian language is a member of the Western Iranian branch of the Indo-Iranian family within the Indo-European language family. Here, we aimed to study phonological development in Persian-speaking children.

METHOD

The speech samples were collected from 387 children, aged 3-6 years old, using two picture-naming tasks: Persian Articulation and Phonology tests, which were used to study phonetic and phonemic inventories, phoneme accuracy, and the age of error patterns suppression.

RESULT

Vowels are acquired at three or earlier. Acquisition of all consonants in the initial position precedes that of the final position. Older children had higher values in phoneme accuracy compared with those of the younger children. Although no significant effects of gender on phonological development were found, girls had higher accuracy scores compared with boys. Final devoicing and cluster reduction were the last error patterns which were suppressed by 6.0.

CONCLUSION

The results showed that the accuracy of children's productions grew with age and the number of error patterns decreased. It seems that there are some similarities between phonological developments in different languages; however, it is still important to study language specific tendencies to be used in clinical settings and speech sound development research.

Development and measurement of psychometric properties of the Persian test of speech consistency in children with typical development

The current research pursues the study of developing the Persian test of speech consistency and investigating speech consistency in normally developing children in Iran. After developing the Persian test of speech consistency, the obtained speech samples of 317 participants (163 girls and 154 boys) were analyzed. This test of consistency includes 27 items. Experts' consensus over the characteristics of the Persian test of speech consistency was above 85%. Different age groups had statistically significant differences for the mean scores of the variable responses (p < .001), consistent correct (p < .001), and consistent incorrect responses (p = .007) in the Persian test of speech consistency. Also, there was a high value for the inter-rater reliability (ICC = .88, p < .001) as well as the moderate value for the test-retest reliability (ICC = .89, p < .001). The Persian test of speech consistency is regarded as a reliable and valid scale for measuring the speech consistency in Persian-speaking children. Future studies are proposed to investigate the speech consistency in Persian-speaking children with various kinds of speech sound disorders.

Development of Communicative Functions in Normal Persian-speaking Children from 12 to 18 Months of Age: A Longitudinal Study

Objective: Communication can affect the personal and social life of people. According to International Classification of Functioning, Disability and Health (ICF), communication is one of the most important components of social participation and can have different functions such as behavior regulation (regulating the behavior of others to achieve a particular goal), social interaction (drawing attention of others to the self) and joint attention (attracting the attention of others to an event or particular object). Having knowledge of the development of communicative functions is so important in assessment, diagnosis, prognosis, and early intervention. Despite the importance and effect of communicative functions in language and communication development, no study has been conducted yet that examines the communicative function development of normal Persian-speaking toddlers. The purpose of this study was to investigate the development of communicative functions in normal Persian-speaking children from 12 to 18 months of age, regardless of communicative expressions (such as gestures, vocalization, and words). Materials & Methods: This is a longitudinal observational study. The communicative function of 11 monolingual Persian-speaking 12-month-old children (7 boys and 4 girls) living in Tehran, Iran was investigated for 7 months. Sampling was done by using purposive and snowball non-probability sampling methods. All children had healthy medical history and normal growth, were from a family with a moderate socioeconomic status, and their parents had at least a high school diploma. The participants’ developmental status was assessed by Ages and Stages Questionnaire. A demographic form with acceptable content validity was also used to determine their demographic characteristics. For 7 months (once a month, each session for one hour), the examiner filmed the child-mother interaction during a semi-structured play with a set of toys at the child’s home. Afterwards, the recorded videos were coded according by the researcher and then entered into the SPSS V. 22 software. Descriptive statistics including mean and standard deviation were used to describe the data. The Shapiro-Wilk test was used to determine the normality of data distribution, and repeated measures ANOVA (within-subject comparison) was used to analyze the data. Two raters were taught about the coding and rating of the communicative functions. To verify the validity of the data coding, 20% of the recorded samples were given to them to code communicative functions. The coding validity was determined by calculating the Intra-class Correlation Coefficient (ICC). Results: The mean frequency of behavior regulation and social interaction was constant from 12 to 18 months of age (P<0.05), while the mean frequency of joint attention was constant from 12 to 15 months of age (P<0.05) and then significantly increased at months 16 (P= 0.019), 17 (P= 0.023) and 18 (P= 0.003) compared to the 12th month. The ICC value as the criterion for coding validity was reported 90%. Conclusion: The mean frequency of joint attention increased significantly from 12 to 18 months of age, while it was constant for behavior regulation and social interaction. Our findings are consistent with the ICF’s social participation, stating that a child uses a particular type of communicative function to increase its participation in the society.

The quantitative ultrasound study of tongue shape and movement in normal Persian speaking children

OBJECTIVES

Ultrasound research on speech production in normal speakers has long used quantitative measurements in different languages. However, no studies in this area have been conducted in the Persian language. This study investigated Persian speaking children scores on two single curve measures of tongue shape, based on midsagittal tongue shape data from ultrasound imaging.

METHODS

This is a cross-sectional study conducted on four 7-8 years old Persian speaking children. The data for analysis was collected using an ultrasound machine in 2018-2019. The stimuli included a range of consonants including/p/,/t/,/f/,/k/and/s/in consonant-vowel sequences, with the vowels/a/and/i/. The measures do not require head stabilization. Statistical analyses were done using Linear mixed models in lmer software package of R version 3.6.2. The results were performed by Chi-squared and Tukey post hoc tests in R.

RESULTS

In all of the consonants, the mean of two single curve measures in the context of/i/was greater than the context of/a/. However, there was no significant effect of the vowel context on one measure for the/k/. Also, these measures were significantly different in each of the Persian consonants and they showed consistent patterns across all of the participants (P<0.001).

CONCLUSION

It seems the single curve measures are the valid value of tongue dorsum excursion for Persian speaking children. This study showed that measures of single curves are reliable for distinguish between consonants in vowel contexts and created robust results on lingual coarticulation of the consonants without the use of head stabilization.

Speech characteristics of childhood apraxia of speech: A survey research

PURPOSE

There has not been any valid method for the clinical diagnosis of Childhood Apraxia of Speech (CAS) up to now, and the golden standard for diagnosis is the expert's opinion. The current research was conducted to obtain criteria used by the Iranian Speech-Language Pathologists (SLPs) to establish speech characteristics and co-occurring problems of CAS based on their knowledge and clinical experience.

METHODS

This research used a questionnaire-based survey design for data collection. The questionnaire was filled out by 260 anonymous participants, both physically and online.

RESULTS

The nine top speech characteristics reported with 75.6% agreement as the core symptoms of CAS included: inconsistency (86.9%), consonant sequencing problems (75%), low intelligibility (75%), groping (72.7%), slow diadochokinetic (DDK) (72.3%), articulatory configuration problems (66.2%), difficulty with multisyllabic words (62.7%), suprasegmental disturbances (56.2%) and metathesis (53.5%). The consent of the Iranian practicing SLPs was consistent with the American Speech-Language-Hearing Association (ASHA) diagnostic criteria, Strand's 10-point checklist, and Ozanne's cluster model. More than half of the respondents have been identified with fine motor deficit and language impairment as the most common co-occurring problems of CAS.

CONCLUSIONS

The results of this study are in accordance with the findings of previous practicing SLPs' surveys in different languages. Carrying out researches on the speech characteristics of Persian-speaking children suspected of CAS and compare with the results of clinicians' surveys will help us to find a reliable standard for differential diagnosis of Persian-speaking children in Iran.

Assessment of Speech Sound Production by Story-retelling in Persian Speaking Children: Introducing a New Instrument

Background

Speech and language pathologists should include connected speech assessment as part of their evaluation for children with speech sound disorders. The purpose of the present study was to design and validate an instrument for assessment of articulation by story-retelling for Persian children.

Methods

261 typically developing children, aged 4-5 years old in Iran, Tehran, in 2016-2017, were recruited in the current study. First, two stories were designed. Next, the expert panel reviewed those two stories and selected one story for assessment. The strengths of the test for discriminating between the two age groups (48-54 months and 55-60 months) and between boys and girls were investigated for construct validity. Test-retest was performed for 15 children. Also, inter-rater reliability was evaluated via calculating the correlation between the two examiners' scores. Statistical Package for Social Sciences (SPSS), version 24, was used for statistical analysis. The significance level was set at (P<0.05).

Results

There was 80% or more agreement in experts' response to questions regarding content validity. All of the reliability values were higher than 0.85. No significant difference was observed between boys and girls (P=0.77), but there was a significant difference between the two age groups (P<0.001). There was a significant correlation between this test and phonetic test of the Persian version of diagnostic articulation and phonology (r=0.62, P=0.002).

Conclusion

The Persian story for the assessment of speech sound production is a reliable and valid instrument that can be used to evaluate the articulation of Persian children.

Validation of the Persian version of the LittlEARS® auditory questionnaire for assessment of auditory development in children with normal hearing

OBJECTIVES

To adapt the LittlEARS^® Auditory Questionnaire into Persian and evaluate the psychometric properties of the Persian version of the questionnaire for children with normal hearing.

METHODS

A "back-translation" method was used to translate and adapt the LittlEARS Auditory Questionnaire into Persian. The translated version was first evaluated by means of an expert-appraisal method. After having improved the Persian version of LittlEARs with the results obtained from that evaluation, various psychometric analyses were carried out to determine the validity and reliability. A group of 240 Persian speaking parents of children below 24 months of age with normal hearing completed the LittlEARS^® Auditory Questionnaire. Various psychometric analyses (scale analysis and item analysis) were conducted.

RESULTS

In the current study, the following scale and item characteristics were investigated: Corrected item-total correlations ranged from 0.14 to 0.74; Cronbach's alpha coefficient value was 0.960; the split-half reliability r was 0.734; predictive accuracy Guttman's lambda was 0.965; the correlation between the overall score and age of the children was 0.808 (p < 0.001). The regression curve, which reflects the age-dependence of auditory behavior, was produced. The regression analysis that was conducted to obtain normative data showed that 80% of the variance in the total scores could be explained by age.

CONCLUSION

The data obtained from psychometric analysis support the use of the Persian version of the LittlEARS Auditory Questionnaire as a reliable and valid tool to assess the development of auditory behavior in Persian speaking children who are 24 months old or younger.

Kurdish Speech Test: A validation study for children aged 3-5 years

OBJECTIVES

Speech disorder in children is the most common disorder reported by speech and language pathologists in all languages and its evaluation and diagnosis requires valid and reliable tools. This study aimed to develop a Kurdish Speech Test for children aged 3-5 years and to determine its psychometric properties.

METHODS

The validation included 120 monolingual Kurdish-speaking children aged 3-5 years in the city of Bukan, Iran. Content validity was determined according to expert opinions of Kurdish speech and language pathologists and linguists. Test-retest (one-week interval) and scoring-rescoring by two independent examiners were conducted to determine intra- and inter-rater reliability. The tests ability to discriminate between four age groups (36-60 months) was investigated for construct validity. Differences related to gender were assessed.

RESULTS

Intra- and inter-rater reliability showed no significant difference between the first and second week of administration (p < 0.001) and scoring-rescoring by two independent raters confirmed the reliability of the Kurdish Speech Test (P < 0.001). Discriminating properties, reflecting construct validity showed higher scores with increasing age. No gender differences were found.

CONCLUSION

The Kurdish Speech Test is a reliable and valid instrument for evaluation of articulation in three-to-five-year-old children. Results suggest that the test is appropriate for clinical assessment of children with speech sound disorders.

Single word test for the assessment of speech sound production in Persian speaking children: Development, validity and reliability

OBJECTIVES

Single word tests are used frequently to determine clients' speech sound errors. These tools are user-friendly and popular for speech and language pathologists. The aim of this study was to design and validate a single word test for the assessment of speech sound production for Persian speaking children.

METHODS

The present study included two phases. In phase I, test material was developed. Psychometric properties were evaluated in phase II. In the next phase, 525 typically developing Persian-speaking children with the age range of 3-5 years old were studied. Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) was used for statistical analysis of this study. The significance level was set at (p < 0.05). Pilot study was performed by administrating the test on 25 typically developing children, construct validity: by administrating the test on 400 typically developing children and the comparison of performance of the children in 4 age groups (discriminative validity regarding age and by administration of this test and phonetic subtest of Persian version of diagnostic evaluation of articulation and phonology on 100 children (convergent validity)). Inter-rater reliability was performed by transcription and scoring of samples of 25 children and calculation of Intra Correlation Coefficient (ICC) was calculated. Test-retest was completed by administrating the test two times on 30 children with two weeks intervals. Internal consistency was achieved by the calculation of the correlation of the items of test.

RESULTS

The final version of the test includes 70 target words for assessment of the consonants in three positions, vowels in medial position and consonant clusters (CVCC). There was 80% or more than it for the percentage agreement between experts for the content validity. There wasn't any significant difference between experts' responses about items of the test. 4 pictures were revised based on children's responses for the pilot study. All of the reliability values (test-re test, internal consistency and inter-rater reliability) were higher than 0.85. There was a significant difference between the four age groups for the mean value of Persian single word test for speech sound production (p < 0.0001). There was a high correlation between the score of this instrument and the scores of participants in the Phonetic sub-test of the Persian version of Diagnostic evaluation of articulation and phonology(r = 0.934, p < 0.0001).

CONCLUSION

It seems that the Persian Speech sound Production Test is a reliable and valid tool that can be used to measure speech sound errors for Persian speaking children.

The Effect of Non-Nutritive Sucking and Maternal Milk Odor on the Independent Oral Feeding in Preterm Infants

OBJECTIVES

Given the positive effects of stimulation with breast milk odor and non-nutritive sucking (NNS) on preterm feeding skills, we examined the effect of NNS and milk odor, on the time of achieving independent oral feeding in preterm infants.

MATERIALS & METHODS

This study was conducted at two Neonatal Intensive Care Units of Tehran, Iran in 2016. Overall, 32 neonates with gestational ages of 28-32 wk were enrolled in two groups; NNS with and without olfactory stimuli (breast milk odor). The simulations were performed in both groups during the first five minutes of gavage, three times per day, and over ten consecutive days. Weight gain, time of achieving oral feeding and chronological age at discharge were as measures of the effectiveness of the interventions. The results of the interventions were analyzed and compared using SPSS.18.

RESULTS

NNS with breast milk odor resulted to a lower post-menstrual age at the first oral feeding, independent oral feeding and discharge from the hospital, but had no effects on their daily weight gain and weight at the time of discharge.

CONCLUSION

These results show the effectiveness of combining milk odor and NNS as two important stimuli in achieving oral feeding and earlier discharge from the hospital.