There is a need to assess communication in daily life situations for people with speech and language disorders. Although language proficiency and communication in daily life are correlated, their relationship is far from linear or straightforward. This paper aims to demonstrate the usefulness of the construct of communicative participation by unravelling the relationship and overlap between participation and communication. We explored the relationship between communication, participation, and communicative participation by reviewing common definitions mentioned in the literature. Next, we evaluated to what extent communication plays a role in each of the World Health Organization’s International Classification of Functioning (ICF) “Activity and Participation” chapters by counting how many items in each chapter should be considered for describing communicative participation.
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BackgroundSeveral conditions and diseases can result in speech problems that can have a negative impact on everyday functioning, referred to as communicative participation. Subjective problems with acquired speech problems are often assessed with the speech handicap index (SHI). To assess generic participation problems, the Utrecht Scale for Evaluation of Rehabilitation–Participation (USER-P) questionnaire is frequently used. The English questionnaire Communicative Participation Item Bank—short form (CPIB short form) is a 10-item valid, reliable instrument that assesses communicative participation. In the absence of a Dutch equivalent, translation and validation of the CPIB short form was required.AimsTo translate the CPIB short form into Dutch, and to determine its psychometric properties for the group of adults with speech problems resulting from a neurological aetiology or head and neck cancer.Methods & ProceduresTranslation of the CPIB short form was performed following the instructions of the European Organisation for Research and Treatment for Cancer (EORTC). In a cross-sectional multi-centre study, participants completed the Dutch CPIB short form together with the SHI and USER-P, and the CPIB a second time after 2 weeks. We assessed internal consistency and test–retest reliability of the CPIB. Construct validity was assessed based on correlations with SHI, USER-P and speech assessments.Outcomes & ResultsIn the validation study, 122 participants were included: 51 with dysarthria due to different neurological disorders, 48 with speech problems due to head and neck cancer treatment and 23 healthy controls. Internal consistency of the items was high (Cronbach's alpha = 0.962), the intraclass correlation coefficient (ICC) for test–retest reliability was high 0.908 (95% CI = 0.870–0.935). Construct validity was supported by a strong correlation between the Dutch CPIB short form and the SHI total score (SHI total rs = 0.887) and a moderate correlation between the Dutch CPIB-10 and the USER-P subscales (USER-P Frequency rs = 0.365; USER-P restrictions and USER-P satisfaction rs = 0.546). A moderate correlation was found between the Dutch CPIB-10 and the speech performance assessments (degree of distortedness r = −0.0557; p ≤ 0.001; degree of intelligibility r = 0.0562).Conclusions & ImplicationsThe Dutch CPIB short form provides a valid and reliable tool for clinical practice and research purposes. It allows clinicians to start using this PROM in clinical and research practice to systematically investigate the impact of the speech problems on communicative participation in a Dutch-speaking population.What this paper addsWhat is already known on the subjectCommunicative participation allows people to take part in life situations, but can be affected by acquired speech problems. The CPIB is a patient-reported outcome measure for the assessment of this concept. For the English language the 46-item bank and a 10-item short form is available.What this paper adds to existing knowledgeThis paper describes the process of translation of the CPIB short form into Dutch, and confirms its reproducibility and validity.What are the potential or actual clinical implications of this work?With this validated Dutch version of the CPIB short form available, professionals can implement this tool in clinical and research practice to systematically evaluate communicative participation.
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BACKGROUND: Communicative participation is the primary outcome of speech and language therapy for people with communication disorders. However, there are no instruments that measure communicative participation from the perspective of adolescents and young adults. Moreover, little research has been conducted in which adolescents and young adults with various communication problems were asked about relevant participation situations in which they need to communicate. Before a new measurement instrument can be developed, it is necessary to explore adolescents' and young adults' views on their communicative participation.AIMS: In this study we identified situations in which adolescents and young adults experience barriers participating because of communication problems, as well as situations in which they have no difficulties. In addition, we identified aspects of these situations that influence communicative participation in order to gain a deeper understanding of concepts related to communicative participation.METHODS AND PROCEDURES: This concept elicitation study concerned in-depth interviews on self-experienced communicative participation, in which diaries were used as a sensitizing exercise. Participants were asked to keep a diary for 1-2 weeks in which they described their communicative participation during the day. They were asked to describe situations in which they were not able to participate because of their communication disorder, and to describe situations in which they were able to participate. Within 1 week after completing the diary, participants were invited for an in-depth interview, in which the content of the diary was discussed.OUTCOMES AND RESULTS: Twelve participants were included in this study (7 females, 5 males; 13-27 years) with a variety of communication disorders, including language disorders, speech disorders, hearing loss, or a combination of them. They described a total of 234 situations related to different domains (e.g., communicative participation in school or with friends). Out of these situations, 37 concepts that influence communicative participation were found that were related to the six categories: person (e.g., strangers), topic (e.g., figurative language), pace (e.g., time pressure), location (e.g., school), moment (e.g., energy) and mode (e.g., group conversations).CONCLUSIONS AND IMPLICATIONS: The results of the study provide understanding in adolescents' and young adults' perspectives on communicative participation. The identified situations form the basis for developing an item bank for measuring communicative participation in adolescents and young adults with communication disorders. In upcoming studies, the items will be extensively assessed on the quality aspects of comprehensiveness, comprehensibility and relevance.WHAT THIS PAPER ADDS: What is already known on this subject Communicative participation is the most important outcome of speech and language therapy. However, measurement instruments (preferably patient reported outcome measures, PROMs) to assess communicative participation of adolescents and young adults are scarce. Moreover, perspectives of adolescents and young adults on self-experienced communicative participation, which can lead to the development of a measurement instrument, have not yet been identified. What this paper adds to existing knowledge This study is about the self-experienced communicative participation situations mentioned by adolescents and young adults themselves. It presents 37 concepts describing communicative participation that were identified from communicative participation situations mentioned by adolescents and young adults themselves. What are the potential or actual clinical implications of this work? This study provides more insight into concepts that describe communicative participation from the perspectives of adolescents and young adults. The results will be used to develop an item bank measuring communicative participation in the target population.
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Bij spraak-, taal-, stem- en gehoorproblemen wordt communiceren lastig. Dat heeft grote gevolgen voor de participatie van de persoon. In dit promotieonderzoek ontwikkelen we een instrument gericht op het meten van communicatieve participatie bij volwassenen met verschillende communicatieve problemen, die ook toegankelijk is voor mensen met afasie.
Bij afasie is spreken en begrijpen van taal lastig. Dat heeft grote gevolgen voor de participatie van de patiënt. In dit promotieonderzoek ontwikkelen we een meetinstrument gericht op communicatieve participatie van mensen met afasie.Doel Er zijn in Nederland geen bruikbare instrumenten om communicatieve participatie van mensen met afasie in kaart te brengen. Dit onderzoek heeft tot doel om zo'n instrument te ontwikkelen. We vertalen een itembank gericht op de communicatieve participatie bij mensen met afasie na niet aangeboren hersenletsel (NAH) en we ontwikkelen deze tot een betrouwbaar en valide meetinstrument. Resultaten Dit onderzoek loopt nog. Na afloop vind je hier de resultaten. Looptijd 01 september 2019 - 31 augustus 2023 Aanpak We vertalen de Communicative Participation Item Bank en ontwikkelen deze door. We gebruiken daarbij de methodologie van het internationale meetsysteem voor patiëntuitkomsten PROMIS. We maken de itembank afasievriendelijk op basis van criteria uit de literatuur. We onderzoeken alle klinimetrische meeteigenschappen volgens de COSMIN-methodologie.
