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languages required changes to the term 'influenza', with 14% needing further explanation in non-medical terminology. Regarding the cognitive debriefing of symptoms presented in the PRO, it was found that 17% of languages required further localisation after participant feedback. Of these, it was noted that for 'body aches and pains', 24% required updates to better reflect both types of discomfort, while 20% of languages only had one term for both 'aches' and 'pains' in the target language. CONCLUSIONS: The results show that concept elaborations are essential to ensure that the nuances in meaning of the source text are explained thoroughly, enabling linguists to convey the terminology accurately -especially when symptoms discussed are similar in meaning. The outcomes also highlight the importance of back translation and cognitive debriefing reviews to determine the most precise and natural term in the target language that will allow optimum PRO data collection.

Early childhood special educators are increasingly challenged to demonstrate program impact. When appropriate control groups are not available, several investigators have proposed evaluating child developmental progress with various formulas which attempt to compensate for differential preintervention rates of development. This study applied a set of these formulas to Bayley data for three groups of handicapped infants. The results of the analyses indicate that these formulas fall into two classifications—those that measure rate of development and those that measure change in rate of development. Finally, issues and cautions in the use and interpretation of these formulas for evaluating program impact are discussed.