Over the last ten years, the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-3), a leading developmental assessment for children ages 1–42 months, has been referenced as an endpoint in 145 clinical trials (Citeline, 2024). Of those, 6.21% have included sites in the Finno-Ugric countries of Estonia, Finland, and Hungary.
The challenge
The Finno-Ugric languages spoken in Estonia, Finland, and Hungary do not have direct equivalents to gendered pronouns, possessive pronouns, and verb tense forms, presenting complex linguistic challenges for clinical trials using outcome assessments (COAs) developed in English.
The clinical trial team recognized a need for a Bayley-3 translation that wouldn't compromise the instrument’s validity while maintaining international reach and preserving the nuances and cultural context of the Finnish language.
The solution
In 2023, Pearson and Lionbridge partnered to find a remedy to this unique challenge. The first hurdle? Identifying a suitable linguistic approach to maintain the source’s intent and meaning. Hungarian was brought up during brainstorming sessions due to its linguistic similarities with Finnish and later determined to be a suitable pivot language.
Lionbridge applied a flexible, customized approach with the use of an intermediary language, Hungarian - Hungary (huHU), by leveraging the already published Hungarian translation for the Bayley-3 as a starting point. The translation underwent a rigorous equivalence review process to ensure the language was reflective of the target population for which it would be used while maintaining the validity of the assessment. The Hungarian scale was then back-translated into English, and then this English translation was used to then translate the Bayley-3 into Finnish.
The Finnish translation, now internationally published, was found to effectively replace the original English constructs while maintaining the instrument’s ability to measure the intended outcomes.
What this means for your global clinical trial
The identification and use of an intermediary language [Hungarian – Hungary (huHU)] illustrates Lionbridge’s innovative and flexible approach to translation. Additionally, using the translation to create the Finnish – Finland (fiFI) version provided an additional quality review, allowing Lionbridge to both audit and refine a cultural adaptation uniquely suited for Finnish speakers. This process confirmed the Finnish-Finland (fiFI) version of Bayley-III accurately represented the original assessment.
When choosing a Pearson COA for your clinical trial, you can be assured any required translations accurately reflect the language’s unique linguistic features while maintaining the integrity of the assessment.
