Repurposing EORTC QLQ-H&N43 and NCCN Distress Thermometer and Problem List: Adaptation and Validation in Kannada

To translate, validate and test the reliability of Kannada version of "EORTC QLQ-H&N43" and "NCCN Distress Thermometer and Problem list" version 2.2022. The English version of "EORTC QLQ H&N43" and "NCCN Distress thermometer and Problem List" version 2.2022 tools were translated into Kannada language according to standard guideline. The translated version was validated by EORTC and by using content validity index (CVI). Further, the reliability of validated tools was established via test-retest and internal consistency method whereas construct was determined via spearman rank correlation. The Cronbach alpha value > 0.7 and correlation coefficients (ρ) < 0.05 was considered as significant. The Kannada version of "EORTC QLQ-H&N43" was validated by EORTC as well as by experts whereas  NCCN distress tool was validated only by experts with average CVI score of 1 and 0.97 respectively. Out of total 80 patients, 50% were head and neck cancer (HNC) patients and 50% belonged to other cancer types. Kannada version of EORTC QLQ-H&N43 and NCCN distress tool was found to be reliable among HNC and general cancer patients respectively with the Cronbach alpha value between 0.819-1 and 0.71-1 for all the domains. Further, only 7.72% of EORTC QLQ-H&N43 and 13.33% of NCCN distress tool construct were significantly correlated with construct of EORTC QLQ-C30 (p < 0.05). The Kannada version of QoL and distress instrument was found to be valid and reliable to use among HNC and/ general cancer patients respectively. Thus, this method of translation, validation and reliability testing can be used as a novel practice in healthcare.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-023-04366-0.

A Glossary of Distress Expressions Among Kannada-Speaking Urban Hindu Women

People's lived experiences of distress are complex, personal, and vary widely across cultures. So, too, do the terms and expressions people use to describe distress. This variation presents an engaging challenge for those doing intercultural work in transcultural psychiatry, global mental health, and psychological anthropology. This article details the findings of a study of common distress terminology among 63 Kannada-speaking Hindu women living in Mysuru, the second largest city in the state of Karnataka, South India. Very little existing scholarship focuses on cultural adaptation for speakers of Dravidian languages like Kannada; this study aims to fill this gap and support greater representation of this linguistic family in research on mental health, idioms of distress, and distress terminology. Between 2018 and 2019, we conducted a 3-phase study consisting of interviews, data reduction, and focus group discussions. The goal was to produce a non-exhaustive list of common Kannada distress terms that could be used in future research and practice to translate and culturally adapt mental health symptom scales or other global mental health tools.

Adaptation and Validation of Overall Assessment of the Speaker's Experience of Stuttering for Adults in Kannada (OASES-A-K)

INTRODUCTION

Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter.

METHOD

The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment.

RESULTS

The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K.

CONCLUSION

The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction.

Development and cross-cultural adaptation of the vestibular disorders activities of daily living scale in the kannada language and testing its psychometric properties

Background

Vestibular Disorders Activities of Daily Living Scale (VADL) is a self-reported survey for assessing functions of individuals affected by vestibular disorders, and this survey has been translated and cross-culturally adapted into many languages.

Objective

: Kannada is one of the most-spoken languages in India, with approximately 64 million speakers. We aimed to develop the Kannada version of VADL and to assess its psychometric properties.

Materials and Methods

The translation and adaptation of the English version of VADL into Kannada were accomplished with the input of medical professional language experts. Pretesting of the Kannada VADL (VADL-K) was conducted on 30 patients with vestibular disorders. Six professional experts with medical background provided their opinion during the content validation process of VADL-K, and 50 subjects aged between 30 and 70 years with variant vestibular disorders were administered VADL-K and the Dizziness Handicap Inventory to determine the internal consistency, test-retest reliability, and concurrent validity of this assessment.

Results

This study effectively translated, adapted, and pretested VADL-K. The scale's content validity was 0.95, its internal consistency (Cronbach's alpha = α) was 0.94, its test-retest reliability with Intra Class- Correlation Coefficient was 0.97, and its concurrent validity in comparison with DHI was significant, with a moderate correlation r-value of 0.58.

Conclusion

The English version of VADL was successfully translated and adapted into the Kannada language. VADL-K is a valid and reliable measure for patients with vestibular disorders in the state of Karnataka to report their functional performance.

Communication attitude of Kannada-speaking adults who do and do not stutter

The Communication Attitude Test for Adults who stutter (BigCAT) is an established measure of cognitive traits in adults who stutter (AWS). The primary purpose of the present study was to adapt and validate the BigCAT to the Kannada language. The secondary purpose was to compare AWS' and adults who do not stutter (AWNS) BigCAT-K scores and compare AWS' score in sub-populations in terms of severity and age. The study included a purposive sample of 100 AWS and 317 AWNS. There was high test-retest reliability and solid construct validity, as made evident by the results of the discriminant analysis and cross-validation. Further, as in other investigations with the BigCAT (Vanryckeghem & Brutten, 2019), this self-report test revealed a statistically significant group mean difference between AWS and AWNS, suggesting the presence of a negative attitude towards communication in Kannada-speaking AWS. Further, individuals with severe stuttering had a significantly higher level of speech-associated negative attitude compared to those with mild stuttering. Age does not seem to influence the AWS' speech-associated belief system. Both of these findings augment the existing scant literature on exploring the association between stuttering severity and age on the cognitive dimension of stuttering. The outcomes establish the BigCAT-K as an effective tool in the assessment and subsequent management of stuttering.

The uses of useful knowledge and the languages of vernacular science: Perspectives from southwest India

In the first half of the eleventh century, a group of scholars in southwest India did something new. They began composing systematic texts about everyday life in a register of language sometimes called New Kannada. While looking back toward earlier texts composed in Sanskrit - and even translating portions of them - these scholars centered their poetic ability and their personal experiences as opposed to prior authoritative texts. They described themselves as authoring "worldly sciences" that were "useful to the people of the world," and they provided extensive reflections on the systematics of knowledge. Epistemic, linguistic, and political concerns were significantly renegotiated in this moment as local context was turned into a virtue for the production of technical treatises. This article uses this moment to interrogate recent discussions of useful knowledge and vernacular science. Usefulness can mean different things at different times and vernacular sciences change according to their language. This article argues for a usage of both terms that is more attuned to historical particulars. A history of useful knowledge from a place that now appears under the double effacement of the non-modern and non-West offers an opportunity to think through central concepts of the history of science without relying on economic or utilitarian discourses. This paper presents one possible example of what a more global history of useful knowledge might look like.

Literacy-Based Normative Data for Elderly Adults on Linguistic Profile Test in Kannada and Malayalam

OBJECTIVES

Literacy is an important variable that can influence the performance of persons with aphasia on language tasks. This study aimed to generate the literacy-based normative data in two Indian languages (Kannada and Malayalam) for a linguistic tool originally designed for adults with acquired language impairment following brain damage-the Linguistic Profile Test (LPT).

METHODS

The Kannada and Malayalam versions of LPT were administered on 134 and 127 normal speakers of these languages, respectively. The participants were divided into three literacy groups (nonliterates, semiliterates, and literates). The scores on each section of the test as well as the overall scores were determined, as per the instructions provided in the test material.

RESULTS

The influence of literacy was apparent in semantic and syntax sections of the LPT. Participants from nonliterate group performed notably poorly on these two tasks compared to other two groups. Literacy, however, did not show an effect on the "phonology" section of LPT.

CONCLUSION

The literacy-based norms of LPT developed here could improve the sensitivity of clinical evaluation by reducing the "false positives," especially while evaluating the language skills of nonliterate persons with brain damage.

Adaptation and Validation of Reflux Symptom Index Into Kannada Language

OBJECTIVE

The present study aimed to translate, validate the Reflux Symptom Index in Kannada language and to compare its outcomes between normal individuals and individuals with laryngopharyngeal reflux.

STUDY DESIGN

Cross sectional study design MATERIALS AND METHOD: : The English version of Reflux Symptom Index was translated into Kannada language using standard procedures. A total of 162 participants participated in the study, 81 with laryngopharyngeal reflux and 81 controls. Internal consistency, test-retest reliability, and clinical validity were calculated.

RESULTS

Results revealed that the Kannada Reflux Symptom Index exhibited an excellent internal consistency (α = 0.87). The average intra-class correlation coefficient was 0.90 and 0.92, indicating excellent test-retest reliability. Independent sample t test revealed a statistically significant difference between the total scores of both the groups, thereby exhibiting good clinical validity of RSI-K (t = 42.71, df = 158, P < 0.001).

CONCLUSION

The Kannada Reflux Symptom Index is a reliable and valid tool for use in patients with laryngopharyngeal reflux. It can be used as a quick tool to assess laryngopharyngeal reflux.

Literacy Profile of Children with Language Impairment: Evidence from an Alphasyllabary

BACKGROUND

Most of the evidence explaining the language-literacy link is derived from children learning to read and write alphabetic orthography.

AIM

This study investigated the literacy deficits in children learning to read Kannada, a Dravidian language that employs an alphasyllabary.

METHODS

A group of 15 children with language impairment (CwLI) was compared with two groups of control (age- and language-matched) participants on a range of literacy measures.

RESULTS

The results showed that, compared to the age-matched group, the CwLI group performed significantly poorer on reading (words and nonwords) and written spelling tasks. However, the performance on akshara (the written symbol in the alphasyllabary) recognition task was comparable between groups. Similarly, comparison of the CwLI group with the language-matched control group revealed poorer performance in the former group on most literacy measures but not the akshara recognition task. Akshara recognition emerged as the most significant predictor of literacy performance in children learning to read and write the Kannada alphasyllabary. Detailed analyses of the written spelling errors unveiled several unique error types in the language-impaired group.

CONCLUSION

The findings of our study revealed both orthography-independent and orthography-dependent deficits in the literacy skills of CwLI mastering the Kannada alphasyllabary.

Communication Attitude of Kannada-Speaking School-Age Children Who Do and Do Not Stutter

BACKGROUND

A large body of evidence suggests that the Communication Attitude Test (CAT) is a reliable and valid tool for assessing the speech-associated attitude of school-age children who stutter (CWS).

OBJECTIVE

The purpose of the present study was to adapt and validate the CAT for the Kannada-speaking school-age CWS.

METHODS

The original version of the CAT was forward- and back-translated by the first author. The Communication Attitude Test Kannada (CAT-K) was then administered to 293 children who do not stutter (CWNS) and 100 CWS. All children were native speakers of the Kannada language and were between the ages of 7 and 14 years. The Stuttering Severity Instrument-fourth edition (SSI-4) was used to estimate the severity of stuttering.

RESULTS

The data revealed that, in comparison to CWNS, the CWS' mean CAT-K score was significantly higher, and a significant effect of stuttering severity and age on mean attitude scores was observed. In addition, results showed that the CAT-K is a reliable and valid test.

CONCLUSION

The findings suggest the presence of a negative attitude in Kannada-speaking CWS and that the CAT-K is a useful tool in the assessment of Kannada school-age CWS. Given the need for speech-language pathologists to address a speech-associated negative attitude in CWS, incorporating the CAT-K as part of the diagnostic assessment of stuttering is valuable.

Specific language impairment in a morphologically complex agglutinative Indian language-Kannada

Specific Language Impairment (SLI) remains an underinvestigated disorder in morphologically complex agglutinative languages such as Kannada. Currently, only a few case reports are available on SLI in Dravidian languages. The morphological complexity inherent to Dravidian languages such as Kannada provides a potential avenue to verify one of the two prevailing accounts of SLI: the morphological richness theory and CGC (Computational Grammatical Complexity) hypothesis. While the previous theory predicts the relatively spared performance of children with SLI (CwSLI) on syntactic morphology in morphologically complex languages, the latter predicts a diametrically opposite performance. Data from a group of 15 Kannada-speaking CwSLI supported the morphological richness theory, and further revealed five distinct profiles of SLI. The results of this study reflected that CwSLI learning the agglutinative language (Kannada) as compared with language-matched children without SLI, displayed some shared deficits (e.g., in phonological processing on a non-word repetition task) with CwSLI learning English. However, CwSLI learning the morphosyntactically rich language Kannada differed remarkably from English-learning CwSLI by not showing deficits in syntactic morphology relative to language-matched peers (e.g., PNG, verb, tense, case, and pronoun).

Stuttering in relation to the morphophonemics of Kannada

The present study investigated the effect of certain unique morphophonemic features of Kannada words on the rate of stutters in a group of 22 adolescent and adult persons who stuttered in an oral reading task. A linear regression analysis showed that word length ranging from 1 to 8 syllables was a potent variable in the occurrence of stutters accounting for 25.3% of stutters. A composite index of morphophonemic complexity with points assigned for sandhi, geminates, consonant clusters, and number of morphemes accounted for a small 7.5% variability in observed stutter rates. Sandhi words and the hybrid content-function words were no more effective than other words in determining stutter rates. Results are discussed in relation to past findings for other languages and current neurolinguistic models of speech production.

Articulation and acoustics of Kannada affricates: A case of geminate /ʧ/

Affricates have been observed to be problematic in phonological acquisition and disordered speech across languages, due to their relatively complex spatial and temporal articulatory patterns. Remediation of difficulties in the production of affricates requires understanding of how these sounds are typically produced. This study presents the first systematic articulatory and acoustic investigation of voiceless geminate affricate /ʧ/ in Kannada (a Dravidian language), compared to the palatal glide and the voiceless dental stop. Ultrasound data from 10 normal speakers from Mysore, India revealed that /ʧ/ is produced with the tongue shape intermediate between the palatal glide and the dental stop, and with the laminal constriction at the alveolar ridge. The observed articulatory differences are reflected in acoustic formant patterns of vowel transitions and stop/affricate bursts. Altogether, the results show that the Kannada consonant in question is an alveolopalatal affricate, supporting some of the previous descriptive phonetic accounts of the language and raising questions for further research on normal and disordered speech. The results and our survey of literature also suggest that affricates in South Asian languages tend to be phonetically variable and historically unstable compared to other consonant articulations.

Stroke and aphasia quality of life scale in Kannada-evaluation of reliability, validity and internal consistency

Background:

Quality of life (QoL) dwells in a person's overall well-being. Recently, QoL measures have become critical and relevant in stroke survivors. Instruments measuring QoL of individuals with aphasia are apparently rare in the Indian context. The present study aimed to develop a Kannada instrument to measure the QoL of people with aphasia. Study objectives were to validate Stroke and aphasia quality of life-39 (SAQOL-39) into Kannada, to measure test–retest reliability and internal consistency.

Materials and Methods:

The original English instrument was modified considering socio-cultural differences among native English and Kannada speakers. Cross-linguistic adaptation of SAQOL-39 into Kannada was carried out through forward–backward translation scheme. The scale was administered on 32 people from Karnataka (a state in India) having aphasia. For a direct understanding of the subject's QoL, scores were categorized into QoL severity levels. Item reliability of the Kannada version was examined by measuring Cronbach's alpha. Test–retest reliability was examined by calculating the intraclass correlation coefficient (ICC).

Results:

Kannada SAQOL-39 showed good acceptability with minimum missing data and excellent test–retest reliability (ICC = 0.8). Value of Cronbach's α observed for four items modified in the original version was 0.9 each and the mean α of all Kannada items was 0.9, demonstrating high internal consistency.

Conclusions:

The present study offers a valid, reliable tool to measure QoL in Kannada-speaking individuals with aphasia. This tool is useful in a cross-center, cross-national comparison of QoL data from people with aphasia. This instrument also permits direct translation into other Indian languages as the items are culturally validated to the Indian population. This study promotes future research using the Kannada SAQOL-39.