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.

Validation of the Persian version of the dysphagia in multiple sclerosis questionnaire for the assessment of dysphagia in multiple sclerosis.

BACKGROUND: This study is to evaluate swallowing problems (dysphasia) in multiple sclerosis (MS) patients; the importance of using tools that are durable and appropriate is well understood. One of the most trusted tools is the dysphagia in multiple sclerosis (DYMUS) test. The aim of this study was to prepare a Persian version and to evaluate the validity and reliability of the test. MATERIALS AND METHODS: This methodological study was conducted on 236 MS patients in Southeast of Iran from August 2015 to February 2016. After translation and cultural adaptation of the test in Persian, the validity of this test was determined using expert opinions accordance with the International Quality of Life Assessment Project. In addition, exploratory factor analysis (EFA) was performed with varimax rotation. The confirmatory factor analysis (CFA) was conducted and the goodness of fit indices was calculated. Moreover, to test the reliability, Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were used. RESULTS: In total, 236 MS patients were included in the study (81 males and 155 females). All the questions in the test's Persian version obtained an acceptable face and content validity (content validity ratio = 1, Scale content validity index/Ave = 1). EFA revealed that the scale has two factors (solid-liquid) with 67.5% cumulative variance. CFA indicated a good fit to the intended two-factor structure, and the ratio of Chi-square to the degree of freedom was 1.79, and the root mean square error of approximation was 0.058. The internal consistency of total test indicated the appropriate level (Cronbach's alpha coefficient = 0.775), and test-retest reliability total questionnaire was found to be ICC = 0.985, indicating its high reliability. CONCLUSION: The results of this study indicated that the Persian version of the DYMUS questionnaire had good reliability and validity for patients with MS.

The Effects of Non-Nutritive Sucking and Pre-Feeding Oral Stimulation on Time to Achieve Independent Oral Feeding for Preterm Infants.

BACKGROUND: The survival rates of preterm infants has increased over the last years, but oral feeding difficulties are the most common problems encountered by them. OBJECTIVES: This study aimed at comparing the effects of non-nutritive sucking (NNS) and pre-feeding oral stimulation on feeding skills, length of hospital stay and weight gain of 26-32 weeks gestational age preterm infants in NICU, to determine the more effective intervention. PATIENTS AND METHODS: Thirty-two preterm infants were assigned randomly into three groups. One intervention group received pre-feeding oral stimulation program and the other received non-nutritive sucking stimulation, while the control group received a sham intervention. Gestational age of infants was calculated during 1, 4 and 8 oral feeding and discharge time from NICU. The infants' weights were measured weekly from birth and at discharge time. RESULTS: Mean gestational age on 8 time oral feeding per day, in 3 groups was not significant (P = 0.282). Although NNS and pre-feeding oral stimulation groups has fulfilled this criterion 7.55 and 6.07 days sooner than the control group, respectively (a result which is of great clinical and economic importance), but the difference did not reach statistical significance. Weight gaining at discharge time in NNS group was significantly higher than control and pre-feeding oral stimulation groups (P < 0.05). CONCLUSIONS: This study revealed that pre-feeding oral stimulation and NNS programs both were effective on oral feeding skills and weight gaining of the immature newborns. Yet, it seems that NNS program was more effective than pre-feeding oral stimulation on weight gaining.

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.

Temporal characteristics of nasalization in Persian speaker children with and without cleft palate.

OBJECTIVES: The purpose of this study was to measure and compare temporal patterns of nasalization in Persian children with and without cleft palate in three vowel contexts. METHODS: A Sample of 14 children with repaired cleft palates with or without cleft lip with moderate to severe hyper nasality and 14 children without cleft palate was chosen as subjects. The subjects were chosen from the ages of 4 to 12 years. The nasal onset interval, nasal offset interval and total nasalization duration were obtained from acoustic waveforms and spectrograms in three vowel contexts using Praat Software. For eliminating the effect of different speed of speech in the cleft palate group and control group, the ratio of nasalization duration was calculated. RESULTS: Total nasalization duration are demonstrated by acoustic signals which shows the total significant different temporal patterns in children with cleft palate and without cleft palate and across the vowel contexts (P<0.000). CONCLUSIONS: Longer nasalization durations in children with cleft palate in comparison to children without cleft palate show the delayed or deviant temporal patterns in children with cleft palate. The duration of nasalization reflecting temporal patterns of the oral-nasal acoustic impedance in children with cleft palate may have an influence on the perception of hyper nasality.