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Spanish cross-cultural adaptation and validation of the National Institutes of Health Stroke Scale. OBJECTIVES: To adapt and validate a Spanish-language version (SV) of the National Institutes of Health Stroke Scale (NIHSS) to facilitate its use in Spanish-speaking contexts. PATIENTS AND METHODS: The methods recommended by the International Quality of Life Assessment Project were followed. Two forward translations and 1 back translation of the NIHSS were developed to ensure lingual and cultural equivalence. A final revised SV-NIHSS was administered by 8 physicians to patients with stroke in 3 clinics in Buenos Aires, Argentina, from September 2003 to December 2003. RESULTS: The study included 102 patients (mean +/- SD age, 73.3+/-6.5 years; 56% women) with stroke (86% ischemic). The SV-NIHSS mean baseline score was 9.78+/-7.04. Interrater reliability was Independently evaluated for 98 patients, showing a high agreement: kappa, 0.77 to 0.99 for the 15 items; interrater correlation coefficient, 0.991 (95% confidence Interval, 0.987-0.994). Intrarater reliability was excellent: kappa, 0.86 to 1.00 for the 15 items; mean intrarater correlation coefficient, 0.994 (95% confidence interval, 0.991-0.996). Construct validity was also adequate; the SV-NIHSS had a negative correlation with baseline Glasgow Coma Scale (Spearman coefficient = -0.574, P < .001) and with Barthel index at 3 months (Spearman coefficient = -0.658, P < .001). Patients with different Rankin scores at 3 months also had significantly different baseline SV-NIHSS scores, from a mean of 4.29+/-2.21 for Rankin score of 0 to a mean of 29.40+/-3.97 for Rankin score of 6 (P < .001). CONCLUSION: This study shows that a Spanish-language version of the NIHSS developed with internationally recommended methods is reliable and valid when applied in a Spanish-speaking setting. MCP

Verbal fluency tasks in a Spanish sample of young adults (20-49 years of age): normative data of clustering and switching strategies. INTRODUCTION: The aim of this study is to establish normative data on phonological and semantic verbal fluency tests, measuring total production of words, clusters and switching of words in a healthy young adult Spanish population. MATERIAL AND METHODS: We assessed 53 healthy adults between 20-49 years old (32.8 +/- 9.5) with 8-18 years of formal education (9 +/- 3.3 years). The semantic fluency category included: animals, fruits, clothes and the initial letters F, A, S in 1 minute of time. Clustering and switching strategies were examined and scored according to a protocol elaborated ad hoc by the authors. Pearson correlations between number of "clusters", "switching" and total number of words was used and we evaluated the possible influence of age, years of schooling and gender in each one of the categories in 1 minute and in intervals of 15 seconds. RESULTS: The variable years of formal education was the only demographical factor that significantly influenced semantic verbal fluency (r = 0.43; p = 0.04). Switching and clustering were positively correlated with the number of words generated. Clustering was highly correlated with total number of words generated on semantic fluency (r = 0.846; p < 0.01). In contrast, switching was more highly correlated than clustering with total number of words generated on phonemic fluency (r = 0.864; p < 0.01). CONCLUSIONS: Rules for scoring switching and clustering in our population are provided. Optimal fluency performance requires some type of balance between clustering and switching strategies and should be taken into account in studies regarding verbal fluency. N

Effectiveness of Spanish intervention for first-grade English language learners at risk for reading difficulties. The effectiveness of an explicit, systematic reading intervention for first-grade students whose home language was Spanish and who were at risk for reading difficulties was examined. Participants were 69 students in 20 classrooms in 7 schools from 3 districts who initially did not pass the screening in Spanish and were randomly assigned within schools to a treatment or comparison group; after 7 months, 64 students remained in the study. The intervention matched the language of instruction of their core reading program (Spanish). Treatment groups of 3 to 5 students met daily for 50 min and were provided systematic and explicit instruction in oral language and reading by trained bilingual intervention teachers. Comparison students received the school's standard intervention for struggling readers. Observations during core reading instruction provided information about the reading instruction and language use of the teachers. There were no differences between the treatment and comparison groups in either Spanish or English on any measures at pretest, but there were significant posttest differences in favor of the treatment group for the following outcomes in Spanish: Letter-Sound Identification (d = 0.72), Phonological Awareness composite (d = 0.73), Woodcock Language Proficiency Battery-Revised Oral Language composite (d = 0.35), Word Attack (d = 0.85), Passage Comprehension (d = 0.55), and two measures of reading fluency (d = 0.58-0.75). JLD

 
 
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