Factors Contributing to Preschoolers' Communicative Participation Outcomes: Findings From a Population-Based Longitudinal Cohort Study in Ontario, Canada

Cunningham, Barbara Jane; Hanna, Steven; Rosenbaum, Peter; Thomas‐Stonell, Nancy; Oddson, Bruce

doi:10.1044/2017_ajslp-17-0079

Cited by 14 publications

(33 citation statements)

References 47 publications

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“…It may be that impairment-and participation-based skills develop in parallel, but are unrelated, 21 or that the available studies lacked the power to document an effect. 25 It may also be that gains in multiple components of the ICF framework (e.g. Body Function and Structure, Activity, and Environmental/Personal Factors) combined are associated with the development of communicative participation.…”

Section: Discussionmentioning

confidence: 99%

“…3 Generally, children who had better functional communication had more rapid development and higher FOCUS scores, a finding also documented by Hidecker et al 19 Importantly, however, children in the lowest levels of function (CFCS levels IV and V) still developed, although at a slower rate. 18 Based on the data, children in CFCS levels I to III were predicted to make clinically meaningful change in under 4 months, while children in 28,33 Canada (n=17) 13,15,16,[18][19][20][21][22][23][24][25][26]29,[37][38][39]42 Germany (n=1) 41 Italy (n=1) 40 Jamaica (n=1) 32 UK (n=1) 27 USA (n=1) 34 Vietnam (n=1) 35…”

Section: Charting Communicative Development Over Timementioning

confidence: 99%

“…Cunningham et al reported a similar observation for children with speech versus language impairments. 25 Assessing outcomes in the context of the ICF Two intervention studies targeted children's impairments. 28,29 One evaluated intervention frequency for children with motor-based speech sound disorders and the other evaluated a computer-based intervention.…”

Section: Version Usedmentioning

confidence: 99%

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Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review

Cunningham

Thomas‐Stonell

Rosenbaum

2020

Develop Med Child Neuro

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Aim To describe uses of the Focus on the Outcomes of Communication Under Six (FOCUS) in research with children with and without various communication disorders since its publication in 2010. Method Six databases were searched for the term ‘Focus on the Outcomes of Communication Under Six’. With additional searches we ascertained 70 articles, of which 25 met inclusion criteria for full review and data extraction. Results The FOCUS has been used in research across multiple countries, purposes, populations, contexts, and versions. Evaluative studies have described: the development of children’s communicative participation skills and factors that impact the development of communicative participation; the impact of specific interventions on communicative participation; how FOCUS captures change relative to measures of impairment; and how FOCUS performs when used at different intervals. Adaptations have included: use of the FOCUS as a descriptive or discriminative tool; use with children outside the validated age range; use of select items; and use with typically developing children. Interpretation The FOCUS is used worldwide in research and practice, and much has been learned about children’s communicative participation. Future research is needed to explore the relationship between children’s impairments and their communicative participation, develop a FOCUS App, and develop and validate a FOCUS for school‐age children.

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Section: Discussionmentioning

confidence: 99%

Section: Charting Communicative Development Over Timementioning

confidence: 99%

Section: Version Usedmentioning

confidence: 99%

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Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review

Cunningham

Thomas‐Stonell

Rosenbaum

2020

Develop Med Child Neuro

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“…Despite its strong psychometric properties and initial implementation efforts, the adoption and consistency of use of the FOCUS continued to vary across the 30 PSL Program regions [27,28]. For instance, clinicians at some PSL program regions stopped collecting and reporting FOCUS data.…”

Section: Study Settingmentioning

confidence: 99%

Selecting and tailoring implementation interventions: a concept mapping approach

Kwok

Moodie

2020

BMC Health Serv Res

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Background: To improve the uptake of research into practice, knowledge translation frameworks recommend tailoring implementation strategies to address practice barriers. This study reports our experience pairing the Theoretical Domains Framework with information from multiple stakeholder groups to co-develop practiceinformed strategies for improving the implementation of an evidence-based outcome measurement tool across a large community health system for preschoolers with communication impairments. Methods: Concept mapping was used to identify strategies for improving implementation of the Focus on the Outcomes of Communication Under Six (FOCUS) in Ontario Canada's Preschool Speech and Language Program. This work was done in five stages. First, we interviewed 37 speech-language pathologists (clinicians) who identified 90 unique strategies to resolve practice barriers to FOCUS implementation. Second, clinicians (n = 34), policy-makers (n = 3), and members of the FOCUS research team (n = 6) sorted and rated the strategies by importance and feasibility. Third, stakeholders' sorting data were analyzed to generate a two-dimensional concept map. Based on the rating data from stakeholders, we prioritized a list of strategies that were rated as highly important and highly feasible, and summarized the practice barriers addressed by each of the prioritized strategies. Fourth, we validated these findings with stakeholders via an online survey. Fifth, the mechanisms of action of the prioritized list of strategies were considered based on available evidence from the Theoretical Domains Framework and associated behavior change literature. Results: Stakeholders categorized the 90 unique implementation strategies into a six-cluster concept map. Based on stakeholders' ratings, a list of 14 implementation strategies were prioritized. These implementation strategies were reported to resolve barriers within the environmental context and resources and beliefs about consequences domains of the Theoretical Domains Framework. All but one of the prioritized strategies have a demonstrated link in resolving existing barriers according to the behavioral change literature. Conclusions: Our study contributes to a growing literature that demonstrates the process of tailoring implementation strategies to specific barriers. Practical drawbacks and benefits of using concept mapping as a way to engage stakeholders in implementation research are discussed.

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“…Only a handful of studies to date have identified predictors of communicative participation outcomes related to intervention. The first found that children who participated in intervention had greater gains in communicative participation skills than children who did not, and that those who spent more time in intervention had greater gains than those who spent less time, but more specific predictors of outcome were not available (Cunningham et al 2018). The second study identified social skills, the presence of a comorbid mobility impairment, and active intervention status (as opposed to being on a waitlist for service) as significant predictors of communicative participation outcomes, but again, more specific predictors of outcome were not available (Washington et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a parent-implemented language intervention for late-to-talk children: A real-world retrospective clinical chart review

Kwok¹,

Cunningham²,

Cardy³

2018

Preprint

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Background: Previous research has examined the impact of early language interventions on the linguistic skills of late-to-talk children. However, we have little understanding of how such interventions impact communicative participation (i.e., the ability to communicate in real-world contexts) or what factors influence individual response to these interventions. Aims: (1) To evaluate the effectiveness of Target WordTM – The Hanen Program® for Parents of Children Who are Late Talkers, for improving the communicative participation skills of children who are late-to-talk. (2) To explore predictors of Target Word participation-based outcomes. Methods & Procedures: We conducted a retrospective clinical chart review for 76 families who participated in the Target Word program at a publicly-funded clinic. Families completed the Focus on the Outcomes of Communication Under Six (FOCUS) and MacArthur-Bates Communicative Development Inventories at three time points: pre-intervention, post-intervention, and after a 3-month consolidation period. Regression analysis explored the relation between children’s communicative participation outcomes and potential predictors of change identified by 26 Target Word certified speech and language therapists/pathologists. Outcomes & Results: At the end of intervention, 75% of children had made a clinically significant change on the FOCUS. Clinicians proposed verbal imitation, language development stagnation, and parent interaction style as the top predictors of communicative participation outcomes. Of these, only verbal imitation pre-intervention predicted communicative participation change following the Target Word program. Conclusions & Implications: The Target Word program can facilitate the development communicative participation skills in late-to-talk children. Modifications to the intervention may be needed in order to maximize outcomes for children with limited verbal imitation.

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Factors Contributing to Preschoolers' Communicative Participation Outcomes: Findings From a Population-Based Longitudinal Cohort Study in Ontario, Canada

Abstract: https://doi.org/10.23641/asha.6024422.

Cited by 14 publications

References 47 publications

Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review

Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review

Selecting and tailoring implementation interventions: a concept mapping approach

Effectiveness of a parent-implemented language intervention for late-to-talk children: A real-world retrospective clinical chart review

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