OBJECTIVES: The aim of this study is to assess how the age of the target audience in patient questionnaires impacts on translation decisions using, as an example, the linguistic validation of the Child Behavior Checklist (CBCL) aimed at preschool children aged from 1½ to 5. METHODS: We assessed the list of children’s commonly used terms from the CBCL for any potential linguistic difficulties. We thereby ascertained that some terms would need to be adapted from Modern Standard Arabic (MSA) into Lebanese Dialect, as the children would not understand MSA. We compared this approach to the translation process for Korean and Japanese. RESULTS: The word list was reviewed by the lead linguist, and we ascertained that a number of the MSA terms would be unfamiliar to a child. We decided to substitute terms where necessary, in order to provide terms in a dialect familiar to the child, as well as culturally appropriate for the age group concerned. Out of the 310 terms, 19 were also localized. We compared this to the approach taken in both Korean and Japanese where there was little need to adapt the translation to a local dialect. There was also little need to alter the source terms for localization purposes. CONCLUSIONS: To enable understanding, it was sometimes essential to either change the dialect or localize the source terms to ones that would be familiar to the target audience. In the case of Arabic for Lebanon, the decision to replace some of the original MSA terms demonstrates that in order to achieve comprehension, particularly for a young age group, country- and age-specific adaptation is sometimes a vital component of the translation process.