Cross-Cultural Validation of the Italian Version of the Functional Oral Intake Scale

Outcome measures and scales translated into other languages according to conventions are important for international clinical research in dysphagia. Typically, assessments and scales are translated locally without cultural adaptation and validation. The Functional Oral Intake Scale (FOIS) is widely used in dysphagia research and clinical practice in English-speaking countries. Nevertheless, it is not available in Italian. The aim of this study was to translate the FOIS into Italian and validate it, allowing the FOIS to be available to speech-language pathologists (SLPs) and clinicians working with individuals with dysphagia in Italy. The FOIS was translated following 5 stages of cross-cultural adaptations. This involved (1) translation from English to Italian, (2) synthesis and solution of discrepancies between translators, (3) back-translation from Italian to English, (4) expert revisions, and (5) pretesting. To validate the translated scale, 10 SLPs were recruited from 3 different facilities across Italy. A questionnaire containing similar information to the FOIS and the Italian version of the FOIS (FOIS-It) was completed by SLPs for 227 people with dysphagia; the correlation was high (intraclass correlation coefficient [ICC] = 0.99). Interrater reliability, calculated for 2 blinded SLPs completing scales for 30 patients, was excellent (ICC = 0.99). In conclusion, the FOIS-It is now available for use in clinical practice and research studies in Italy.