Simultaneous forward-translation (i.e., translation from English to the new language) by two native speakers of the new language. These two translations must be done independent from each other.

A third native speaker looks at the two forward translations from step 1, reconciles the differences, and decides on the ideal forward translation. This may be done as a team.

A fourth native speaker (who has not been previously involved and who has not seen the original instrument) then back translates the version of the instrument created in step 2 back into English.

A team of people reviews and reconciles issues with the back-translated English version created in step 3 to compare it to the original English version of the instrument. This team should include at least one of the original authors of the English version of the instrument. Ideally, this team should include as many of the translators from steps 1, 2, and 3 as possible, at least one professional with experience caring for infants/children with feeding difficulties, and at least one lay person (i.e., parent).

Steps 1-4 are required for using the translated tool in clinical practice. Steps 5 & 6 are required before the translated tool can be considered valid and reliable for research purposes. In step 5, cognitive interviews should be conducted in the new language with 5-10 parents of children with and without feeding difficulty. The goal of this step is to ensure that parents understand the translated version the way it is intended.

Psychometric Testing of the New Version. In order for the translated version to be considered valid and reliable, psychometric testing needs to be conducted, including internal consistency reliability, test-retest reliability, and construct validity. Factor analysis is not recommended.