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Volume 17, Number 1 2015

Journal of Clinical Practice in Speech-Language Pathology

for back translation by translators who were accredited by

the National Accreditation Authority for Translators and

Interpreters (NAATI). The two translations were checked

and occasionally the original translators were asked to

clarify wording to ensure consistency. Some of the

differences have been as a result of discrepancies between

words that were accessible to parents versus words that

would be correct in an academic context. For example, two

versions of the title were possible for the Danish translation:

“Vurdering af barnets forståelighed i sine omgivelser” which

was easier for parents to understand and “Vurdering af

forståelighed i kontekst” which contained the more

academic word “kontekst” (context). Eventually, the more

parent-friendly translation was chosen and the direct

translation is: “Evaluation/assessment of the child’s

intelligibility in his/her surroundings.”

Some languages that are commonly spoken in Australia

and other parts of the world had no available speech

pathologists or linguists who could translate the ICS. So

the second way that translations were undertaken was

by translators from Australian Multi Lingual Services.

Most of the translators were NAATI accredited (e.g.,

for Gujarati, Hindi, Hmong, Karen, Khmer, Polish, and

Serbian). However, in a few cases the translators were

not accredited (e.g., for Somali and Tongan), so the third

method of translation was by non-accredited translators

employed by Australian Multi Lingual Services. The final

method of translation was undertaken when there were

available speech pathologists/linguists, but no available

translators at the Australian translation company (e.g., for

Irish, Jamaican, Sesotho, Tshivenda, isiXhosa, and isiZulu).

In these instances, translations were undertaken (and

back translated) by colleagues and other speakers of the

language as organized by the translators. For example, in

South Africa, Dr Michelle Pascoe organised translations

of the ICS in Afrikaans, Sesotho, Tshivenda, isiXhosa,

and isiZulu by working with groups of speech pathology

students studying at the University of Cape Town to

translate, back translate, and check the ICS translations

with community members. They used protocols for forward

and backward translation of health-related materials from

the World Health Organisation (2012). Their research is

continuing so that eventually translations will be available

in the remaining official languages of South Africa (i.e.,

isiNdebele, Sepedi, Setswana, SiSwati, and Xitsonga).

Research using the ICS in

languages other than English

To date, the ICS has been used with children with typically

developing speech in Slovenia (Kogovšek & Ozbiˇc, 2013),

Sweden (Lagerberg, 2013), Hong Kong (Ng, To & McLeod,

2014) and Croatia (Tomi´c & Mildner, 2014). It has been

used with typically developing multilingual children who

speak Korean and English in New Zealand (Kim, Ballard &

McCann, 2014). It has been used with children with speech

sound disorders who speak Cantonese in Hong Kong (Ng

et al., 2014) and with children with cochlear implants in

Iceland (Thoroddsen, 2014). Validiation studies have been

undertaken in Traditional Chinese/Cantonese (Ng et al.,

2014), Slovenian (Kogovšek & Ozbiˇc, 2013), and Croatian

(Tomi´c & Mildner, 2014). For example, Ng et al. (2014)

validated the Traditional Chinese version of the ICS in Hong

Kong with 72 Cantonese-speaking preschoolers (33

typically developing and 39 with speech sound disorders).

status or the number of languages spoken. There were

significant differences in ICS scores between the group of

children whose parents had concerns about their child’s

speech (


= 3.9) and those who did not (


= 4.6),

establishing criterion validity. The ICS had high internal

consistency and satisfactory test-retest reliability. Sensitivity

of .82 and specificity of .58 was established as the optimal

cut-off. In another study, McLeod, Harrison, McAllister, and

McCormack (2013) studied 109 children with speech

sound disorders and found that there was a significant

difference between ICS scores for those who had and had

not attended speech pathology services. In each of these

three studies, the children’s speech was most intelligible to

their parent, then their immediate family, and was least

intelligible to strangers.

Translation of the ICS

Over the past three years, the ICS has been translated into

60 languages (see Table 1 and Appendix) with more

translations being added regularly. There have been four

ways that translations were undertaken. First, most of the

translations were undertaken by speech pathologists and

linguists in different countries throughout the world. Typically

these people worked in university and clinical settings and

regularly worked with children with speech sound disorders

who spoke the language used in the translation. Their

translations were sent to an Australian translation company

Translators of the Intelligibility in Context Scale. L:R – Dr Karla

Washington (Jamaican), Dr Dana Buntová (Slovak), Professor

Martin Ball (Welsh), Professor Vesna Mildner (Croatian),

Professor Sharynne McLeod (English)

Articulation and Phonology (Dodd, Zhu, Crosbie, Holm &

Ozanne, 2002), establishing criterion validity. Subsequently,

the ICS was validated and normed on 804 different

Australian preschool-aged children (McLeod, Crowe, &

Shahaeian, 2014). Each of the children spoke English and

in addition, 36.9% spoke at least one of 59 other

languages. The mean ICS score for the 804 children was

4.4 (


= 0.7). Significant differences in scores were

identified based on sex and age, but not socioeconomic