The Efficacy of Structural Priming in the Production of Sentences with Prepositions in Persian Patients with Poststroke Aphasia.

INTRODUCTION: Problems with the production of sentences with prepositions are one of the most common language problems in people with aphasia (PWA). Structural priming (SP) is one of the theory-based therapeutic approaches to improve these deficits. Although several studies have been conducted on the sentence construction problems of PWA, there is no study on the SP protocol for the production of sentences with Persian prepositions. This study aimed to investigate the effectiveness of SP in the production of these sentences among Persian-speaking PWA. METHODS: This study, with a single-subject ABA design, evaluated the efficacy of SP in the production of trained and untrained sentences containing Persian prepositions in four aphasic individuals with agrammatism and investigated the maintenance effects at 4 weeks post-training. RESULTS: Two subjects (A.G. and M.S.) showed notable changes in the production of trained sentences with Persian prepositions (50% to 91.67% for A.G. and 0% to 66.67% for M.S.). This significant improvement was generalized to sentences with untrained prepositions (50% to 91.67% for A.G. and 0% to 83.33% for M.S.). The treatment effects were also maintained in the 4-week follow-up (d2 = 10.3 for A.G. and d2 = 19.06 for M.S.). However, the other two participants only showed a slight increase in these variables after treatment. CONCLUSION: The findings of the present study revealed that SP for sentences with prepositions could be useful to varying degrees for Persian-speaking PWA with agrammatism and lead to improved language skills in producing these sentences. Overall, individuals with better language skills and cognitive status in early assessments showed better treatment outcomes than others.

Physicians' Perspective on a Multidisciplinary Approach to Dysphagia Management.

INTRODUCTION: Professionals need a multidisciplinary approach to manage oropharyngeal dysphagia (OPD). Each team member should be aware of the signs and symptoms of OPD and collaborate with other team members to reach an optimum outcome. This study aimed to evaluate the knowledge and attitude of Iranian physicians regarding dysphagia and speech and language therapy roles in the management of dysphagia. MATERIALS AND METHODS: In this nonexperimental descriptive study, 133 physicians filled a researcher-made questionnaire entailing three sections, each of which recorded the participants' demographic information, OPD knowledge (23 items), and attitude toward OPD (5 items). RESULTS: Iranian physicians correctly answered 70.3% of the questions indicating that they had a moderate level of knowledge on OPD. However, only 53% of the physicians referred their patients to speech-language pathologists, and almost 50% of them reported a significant recovery after speech therapy in their patients. CONCLUSION: It seems that Iranian physicians need to adopt an interdisciplinary approach to manage OPD. Achievement of sufficient knowledge on the pathology of OPD, along with collaboration with other team members, can improve the outcome for patients with OPD.

Validity and Reliability of the Persian Version of the Dysphagia Handicap Index (DHI).

INTRODUCTION: The Dysphagia Handicap Index (DHI) is one of the instruments used for measuring a dysphagic patient's self-assessment. In some ways, it reflects the patient's quality of life. Although it has been recognized and widely applied in English speaking populations, it has not been used in its present forms in Persian speaking countries. The purpose of this study was to adapt a Persian version of the DHI and to evaluate its validity, consistency, and reliability in the Persian population with oropharyngeal dysphagia. MATERIALS AND METHODS: Some stages for cross-cultural adaptation were performed, which consisted in translation, synthesis, back translation, review by an expert committee, and final proof reading. The generated Persian DHI was administered to 85 patients with oropharyngeal dysphagia and 89 control subjects at Zahedan city between May 2013 and August 2013. The patients and control subjects answered the same questionnaire 2 weeks later to verify the test-retest reliability. Internal consistency and test-retest reliability were evaluated. The results of the patients and the control group were compared. RESULTS: The Persian DHI showed good internal consistency (Cronbach's alpha coefficients range from 0.82 to 0.94). Also, good test-retest reliability was found for the total scores of the Persian DHI (r=0.89). There was a significant difference between the DHI scores of the control group and those of the oropharyngeal dysphagia group (P<0.001). CONCLUSION: The Persian version of the DHI achieved Face and translation validity. This study demonstrated that the Persian DHI is a valid tool for self-assessment of the handicapping effects of dysphagia on the physical, functional, and emotional aspects of patient life and can be a useful tool for screening and treatment planning for the Persian-speaking dysphagic patients, regardless of the cause or the severity of the dysphagia.