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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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.
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Background Variations in communicative participation of children with developmental language disorder (DLD) cannot be wholly explained by their language difficulties alone and may be influenced by contextual factors. Contextual factors may support or hinder communicative participation in children, which makes their identification clinically relevant. Aims To investigate which contextual (environmental and personal) factors in early childhood are protective, risk or neutral factors for communicative participation among school-aged children with DLD, and to identify possible gaps in knowledge about this subject. Methods & Procedures A scoping review was conducted based on a systematic search of studies published from January 2007 to March 2022 in Pubmed, Embase (without MEDLINE), CINAHL and PsycINFO. In total, 8802 studies were reviewed using predefined eligibility criteria, of which 32 studies were included for data extraction and critically appraised using the Critical Appraisal Skills Programme (2021) tools. Main Contribution The methodological quality of included studies was adequate to strong. Personal protective factors identified are being a preschool girl, reaching school age and being prosocial, while personal risk factors are becoming a teenager or adolescent, having low socio-cognitive skills and experiencing comorbid mobility impairment or behavioural problems. Gender after the preschool years and non-verbal abilities were not found to be of influence, and the role of socio-emotional skills is inconclusive. Receiving therapy is an environmental protective factor, while the association between socio-economical family characteristics with communicative participation is inconclusive. Conclusions & Implications Limited research has been conducted on which risk and protective factors present in early childhood are associated with later communicative participation of children with DLD. The influence of co-occurring health conditions, social background variables, individual psychological assets, interpersonal relationships and attitudes of other people represent knowledge gaps. In addition, knowledge about the comparative effectiveness of different types of interventions and service delivery models, and the impact of administrative control, organizational mechanisms and standards established by governments on children's communicative participation is lacking. More longitudinal research is needed focusing on the identification of relevant personal and environmental factors and the interactions between them in relation to communicative participation outcomes.
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This PhD research explores how speech and language therapists (SLTs) can enhance the communicative participation of children with developmental language disorder (DLD) through shared decision-making with parents and a strong focus on the child's personal and environmental context. The work is grounded in the International Classification of Functioning, Disability and Health – Children and Youth Version (ICF-CY) framework (WHO, 2007), and focuses on four key concepts: DLD, communicative participation, shared decision-making, and contextual factors.
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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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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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Communicative participation is the most important outcome of speech and language therapy, but there are no measurement instruments for children, adolescents, and young adults. This paper describes the development of MyCommunication-Youth: an item bank to measure self-reported communicative participation in children, adolescents and young adults with various communication disorders.
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Purpose:Our aim was to develop consensus on the definition and operationalization of communicative participation (CP)in 2- to 8-year-old children with language disorders (LDs).A clear definition and operationalization can facilitate the discussion about children’s communication problems in daily life between parents and professionals. Method: In an online Delphi study, anonymized thoughts and opinions were collected on the definition and operationalization of CP in young children with LD. The 47 Delphi panel members were Dutch parents, young adults with LDs, teachers and assistants, speech-language pathologists, clinical linguists,and clinical researchers. Thematic content analysis was used to develop a concept definition and items operationalizing CP.The Delphi panel rated the suitability of concept definitions using a 7-point Likert scale. Concept definitions were revised with feedback from the Delphi panel until consensus was achieved. The Delphi panel rated items on how well they operationalize CP, using the same Likert scale. Results: The majority (79%) of the Delphi panel indicated that the essence of CP was captured by the definition:“CP is understanding and being understood in a social context,by applying verbal and non-verbal communication skills.”In addition, 33 behavioral items were developed.Conclusion:This study resulted in strong consensus on the definition of CP between Dutch parents and professionals.Items were developed that can inform speech-language pathologists on the type of questions to ask a child’s parents or teacher when discussing CP. Further research is needed on how the items can best be used in clinical practice.
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BackgroundVariations in communicative participation of children with developmental language disorder (DLD) cannot be wholly explained by their language difficulties alone and may be influenced by contextual factors. Contextual factors may support or hinder communicative participation in children, which makes their identification clinically relevant.AimsTo investigate which contextual (environmental and personal) factors in early childhood are protective, risk or neutral factors for communicative participation among school-aged children with DLD, and to identify possible gaps in knowledge about this subject.Methods & ProceduresA scoping review was conducted based on a systematic search of studies published from January 2007 to March 2022 in Pubmed, Embase (without MEDLINE), CINAHL and PsycINFO. In total, 8802 studies were reviewed using predefined eligibility criteria, of which 32 studies were included for data extraction and critically appraised using the Critical Appraisal Skills Programme (2021) tools.Main ContributionThe methodological quality of included studies was adequate to strong. Personal protective factors identified are being a preschool girl, reaching school age and being prosocial, while personal risk factors are becoming a teenager or adolescent, having low socio-cognitive skills and experiencing comorbid mobility impairment or behavioural problems. Gender after the preschool years and non-verbal abilities were not found to be of influence, and the role of socio-emotional skills is inconclusive. Receiving therapy is an environmental protective factor, while the association between socio-economical family characteristics with communicative participation is inconclusive.Conclusions & ImplicationsLimited research has been conducted on which risk and protective factors present in early childhood are associated with later communicative participation of children with DLD. The influence of co-occurring health conditions, social background variables, individual psychological assets, interpersonal relationships and attitudes of other people represent knowledge gaps. In addition, knowledge about the comparative effectiveness of different types of interventions and service delivery models, and the impact of administrative control, organizational mechanisms and standards established by governments on children's communicative participation is lacking. More longitudinal research is needed focusing on the identification of relevant personal and environmental factors and the interactions between them in relation to communicative participation outcomes.
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Purpose: This study aims to systematically identify items that measure comnicative participation from measurement instruments that measure (aspects communication and/or participation in children and adolescents (5–18 years with communication disorders, for developing an item bank. Method: A systematic literature search was performed in MEDLINE Embase to search for patient-reported outcome measures (PROMs) or pareports measuring aspects of communication and/or participation in childand adolescents. The individual items of the included measurement instrumwere reviewed on whether they measure communicative participation. The itwere then classified into one of the International Classification of FunctioDisability and Health (ICF) for Children and Youth (World Health Organiza2007) domains of activities and participation. Results: A total of 29 instruments were found, nine PROMs and 20 preports. One hundred forty-five items were identified that measure communtive participation. From these 145 items, 74 were retrieved from PROMs (5and 71 were retrieved from parent reports (49%). The majority of items classified in ICF Domain 7, interpersonal interactions and relationships (73.8followed by Domain 8, major life areas (13.8%), and Domain 9, commsocial, and civic life (8.3%). Only a few items were found in Domains 5 and none was found in Domains 1, 2, and 4. Conclusions: We identified 145 items potentially useful for developing an bank addressing communicative participation in children and adolescents communication disorders. However, item development in collaboration with target population is needed to ensure that these items fully reflect the const.
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