چكيده فارسي :
زمينه و هدف: فرآيند ارزيابي بلع سابقه‌اي طولاني دارد. مقياس‌هاي ارزيابي بلع به ما توانايي مشاهدات نظام‌يافته را مي‌دهند كه به ارزيابي جامع نزديك‌ترند. پژوهش حاضر با هدف انتخاب و ترجمه و اعتبارسنجي مقياس ارزيابي دهاني‌حركتي كودكان انجام شد.
روش‌بررسي: ابتدا با جست‌و‌جو در پايگاه داده‌ها به مطالعات مرور منظم در زمينهٔ ارزيابي غيرابزاري بلع و خوردن در كودكان دسترسي حاصل شد. باتوجه به اموري مثل دربرداشتن حوزه‌هاي عملكرد بلع و نمرهٔ برش، مقياس ارزيابي دهاني‌حركتي كودكان از ريلي و همكارانش سال 1995، انتخاب شد. اين مقياس طبق پروتكل سازمان بهداشت جهاني به فارسي برگردانده شده كه شامل مراحل ترجمه، پانل كارشناسي، ترجمهٔ معكوس، اجراي پيش‌آزمون روي 10 كودك دچار اختلال بلع و تهيهٔ نسخهٔ نهايي مقياس بود. سپس اين نسخه به‌منظور بررسي توانايي ارزيابي درقالب پرسشنامه در اختيار 10 گفتاردرمانگر حاذق در حيطهٔ بلع قرار گرفت.
يافته‌ها: در تحقيق حاضر، مقياس ارزيابي دهاني‌حركتي كودكان به زبان فارسي با 65 گويه به‌دست آمد. اجراي پيش‌آزمون نشان داد اين مقياس بايد به‌صورت گويه به گويه و مشاهدهٔ مستقيم كودك نمره‌گذاري شود. گفتار درمانگران ارزياب، تمام گويه‌هاي اين مقياس را داراي توانايي ارزيابي برآورد كردند و بررسي اعتبار بين ارزياب مشخص كرد تفاوتي بين نتايج ارزياب‌ها وجود ندارد (0٫238=p و 0٫112=kendall's w).
نتيجه‌گيري: مقياس ارزيابي دهاني‌حركتي كودكان به‌عنوان مقياس ارزيابي غير ابزاري مبتني‌بر مشاهده براي آسيب‌شناسان گفتار و زبان ايراني امكان استفاده دارد و پيشنهاد مي‌شود مقياس در مطالعات بعدي از نظر پايايي تحت بررسي قرار گيرد.
چكيده لاتين :
Background&Objective: Proper nutrition is essential for the survival of newborn babies and child growth. Now-a-days with regard to the
advancement of medical care, we encounter a growing number of at risk babies and correspondingly a growing number of children with
swallowing and feeding disorders. Swallowing evaluation process has a long history. Typically, it is administered via imaging techniques.
What makes this assessment method inadequate is that it cannot catch important environmental and behavioral factors affecting children
during feeding. Specifying the safety of swallowing in children is not sufficient enough; oral sensory-motor skills and beyond it the parentchild
relationship should also be considered. Behavioral scales of swallowing and eating assessment enable us to make much more
observations needed for comprehensive assessments. Obviously, if we are to achieve effective treatment strategies in this area, the first step
could be a comprehensive assessment of swallowing and eating in children. The present study aimed at finding validating an appropriate oral
motor assessment scale of children.
Methods: Searching the various databases, we found systematic reviews in the field of non-instrumental evaluation of eating and swallowing
in children. Among the measures introduced in these reviews, we chose the Schedule for Oral-Motor Assessment (SOMA) developed by
Reilly et al (1995), which in our belief captured important factors such as being observational, encompassing all areas of swallowing and
eating, covering a clear scoring system and having a cut-off point. The scale was translated into Persian according to the protocol of World
Health Organization. Then a panel of experts including 5 speech and language pathologists holding a Ph.D. or speech therapy doctoral students
compared the original text and the translated version and tried to resolve the drawbacks and ambiguities of the Persian scale items. The
provided text was back translated into English. This version was compared to the original scale by the authors and revealed to be conceptually
the same. Just a slight editing was done on the Persian scale according to the back translated scale. This pre-final version was then pre-tested
on 10 dysphagic children. Observational intricacies were drawn from this pilot study, also some minor editions was done according to the
findings. Finally, the scale was sent to 10 qualified speech and language pathologists in the area of swallowing for examining the applicability
of the scale items.
Results: The Persian version of the schedule for oral-motor assessment with 65 items became ready for reliability assessment. All items
proved to be assessable according to reviewers' opinions. Kendall's w test was calculated to evaluate the inter-rater reliability and revealed that
the assessment results of ten experts did not differ (p=0.238, Kendall's w=0.112).
Conclusion: Regarding the implementation of the schedule for oral-motor assessment, it is noteworthy that this measure is quite executable in
the clinical setting. The other point is that items of this scale are based solely on observation; evaluation and assessment should be done online
i.e. the items should be scored while observing the eating behaviors. Sometimes it is needed that the child be exposed to an especial food
texture such as biscuit (which has more items than other tissues) more than one time, to complete the assessment.
