Outcomes and predictors in preschoolers with speech-language and/or developmental mobility impairments

The following manuscript has been accepted for publication today
Washington, K., Thomas-Stonell, N., McLeod, S., & Warr-Leeper, G., (2014, in press May). Outcomes and predictorsin preschoolers with speech-language and/or developmental mobility impairments. Child Language Teaching and Therapy.

Here is the abstract

Purpose: Describe communicative-participation outcomes measured by the Focus on the Outcomes of Communication Under Six (FOCUS_©; Thomas-Stonell et al. 2013) for interventions provided by SLPs in different community settings for preschoolers with speech-language impairments (Sp/LI) with and without developmental mobility impairments (MI). The predictive relationships between communicative-participation and: a) functioning-and-disability, and b) contextual factors, was also investigated.

Method: Sixty-one preschoolers with Sp/LI and their parents participated. Twenty-six preschoolers were identified with Sp/LI and received speech-language interventions (Group 1), 20 preschoolers were identified with Sp/LI and MI and received speech-language interventions (Group 2), and 15 preschoolers with Sp/LI awaiting intervention served as waitlist-controls (Group 3). Parents completed structured interviews about children’s communicative-participation outcomes using the FOCUS_© at three time-points (pre-intervention; post-intervention; and 3-months post-intervention) with a speech-language pathologist.

Results: Only Groups 1 and 2 experienced statistically and clinically meaningful communicative-participation outcomes over time as measured by the FOCUS_©. Pre- to post-intervention communicative-participation was predicted by functioning-and-disability and contextual factors, initial social skills and intervention status, respectively. Post-intervention to 3-month post-intervention scores were also predicted by functioning-and-disability and contextual factors, risk status (Sp/LI only, Sp/LI+developmental MI) and intervention status, respectively.

Conclusion: Significant and clinically meaningful changes in communicative-participation over time are associated with speech-language interventions for preschoolers with Sp/LI.

Construct validity of the FOCUS: A functional communication outcome measure for preschool children

The following manuscript has been accepted for publication within a special issue on Participation:

Washington, K. Thomas-Stonell, N., Oddson, B., McLeod, S., Warr-Leeper, G., & Robertson, B., & Rosenbaum, P. (2013, in press January). Construct validity of the FOCUS© (Focus on the Outcomes of Communication Under Six): A functional communication outcome measure for preschool children. Child: Care, Health and Development

Here is the abstract:  

Objective To establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS_©). This measure is reflective of concepts in the International Classification of Functioning Disability and Health – Children and Youth framework. It was developed to capture “real-world” changes (e.g., communicative participation) in preschoolers’ communication following speech-language intervention.

 Method A pre-post design was used. Fifty-two parents of 3- to 6-year-old preschoolers attending speech-language therapy were included as participants. Speech-language therapists provided individual and/or group intervention to preschoolers. Intervention targeted: articulation/phonology, voice/resonance, expressive/receptive language, play, and use of augmentative devices. Construct validity for communicative participation was assessed using pre-intervention and post-intervention parent interviews using the FOCUS_© and the communication and socialization domains of the Vineland Adaptive Behavior Scales-II (VABS-II). 

Results Significant associations were found between the FOCUS_©, measuring communicative participation, and the VABS-II domains for: (a) pre-intervention scores in communication, r=0.53, p<0.001; 95% CI=0.30-0.70 and socialization, r=0.67, p<0.001; 95% CI=0.48-0.80; (b) change scores over-time in communication, r=0.45, p<0.001; 95% CI =0.201-0.65 and socialization, r=0.39, p=0.002; 95% CI=0.13-0.60, and (c) scores at post-intervention for communication, r=0.53, p<0.001; 95% CI=0.30-0.70 and for socialization, r=0.37, p=0.003; 95% CI=0.11-0.50. 

Conclusions The study provided evidence on construct validity of the FOCUS_© for evaluating real-world changes in communication. We believe that the FOCUS_© is a useful measure of communicative participation.