Construct validity of the FOCUS^© (Focus on the Outcomes of Communication Under Six): a communicative participation outcome measure for preschool children

Abstract

ObjectiveThe aim of this study was 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.MethodA 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).ResultsSignificant associations were found between the FOCUS©, measuring communicative participation, and the VABS-II domains for: (i) 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); (ii) 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 (iii) 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).ConclusionsThe 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.

Validity of the Communication Function Classification System for use with preschool children with communication disorders

“…15 The FOCUS is able to detect changes in communicative functioning in children across a range of speech and language disorders, and has high internal consistency and adequate test-retest reliability among raters. [16][17][18][19][20][21] The CFCS and the FOCUS both address children's functional communication skills, in ways that are complementary. The FOCUS describes a child's current communicative functioning in some detail, and has been validated to measure changes in those skills over time; the CFCS classifies children's levels of communicative functioning and has been validated as a discriminative tool.…”

Participation of children with disabilities: measuring subjective and objective outcomes

“…; Washington et al . ). This tool can be completed by parents and/or professionals and measures changes in communication for participation following intervention.…”

“…The second article (Washington et al . ) presents information on the construct validity of FOCUS© as a tool to measure changes in communication as needed in many life contexts for children with disabilities. Information on reliability and validity of new tools is critical so that they can be used in research and practice with confidence.…”

“…-to measure communicative participation for children younger than 6 years of age Washington et al 2013). This tool can be completed by parents and/or professionals and measures changes in communication for participation following intervention.…”

Validity of a streamlined version of the Focus on the Outcomes of Communication Under Six: Process and outcome

“…Focus on the Outcomes of Communication Under Six (FOCUS) is one of the few purpose‐designed broad speech and language outcome measures suitable for children, with established reliability and validity (Thomas‐Stonell, Oddson, Robertson, & Rosenbaum, ; Thomas‐Stonell, Oddson, Robertson, & Rosenbaum, ; Oddson, Washington, Robertson, & Rosenbaum, ; Washington, Thomas‐Stonell, Oddson, Robertson, & Rosenbaum, ). In the study by Thomas‐Stonell et al (), there was 75% agreement between change measured by the FOCUS and change measured by articulation, speech intelligibility, and expressive language measures obtained from blind videotape analysis.…”