Measuring communicative participation using the FOCUS^©: Focus on the Outcomes of Communication Under Six

Abstract

BackgroundThe FOCUS© is a new outcome tool for use by both parents and clinicians that measures changes in the communicative participation skills of preschool children. Changes in communicative participation skills as measured by the FOCUS were compared across three groups of children: those with speech impairments only (SI), those with language impairments only (LI) and those with both speech and language impairments (S/LI).MethodsParticipating families (n = 112, 75 male children) were recruited through 13 Canadian organizations. Children ranged from 10 months to 6 years 0 months (mean = 2.11 years; SD = 1.18 years) and attended speech-language intervention. Parents completed the FOCUS at the start and end of treatment. There were 23 children in the SI group, 62 children in the LI group and 27 children in the S/LI group. The average amount of the children's therapy varied from 7 to 10 h.ResultsThe FOCUS captures changes in communicative participation for children with a range of communication disorder types and severities. All three groups of children made clinically important improvements according to their FOCUS scores (MCID ≥ 16 points). The FOCUS captured improvements in intelligibility, independent communication, play and socialization.ConclusionsThe FOCUS measured positive changes in communicative participation skills for all three groups of children after 7–10 h of speech-language therapy. An outcome measure that targets only specific speech and language skills would miss many of the important social function changes associated with speech-language treatment.

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

“…12,14 A second contributing factor to the absence of significant finding between CFCS classifications and FOCUS change scores might be that opportunities for change in FOCUS scores were variable for children at each of the CFCS levels. This is because children in all the CFCS levels showed improvements in their functional communication skills over time.…”

“…6 Classification tools like the CFCS can be used with traditional measures of assessment to benefit clinicians, administrators, and researchers. 11,12 The CFCS has not yet been validated for use with children other than those with CP. 6 Administrators can use CFCS classifications to understand the functional status of the children they service and to plan and allocate resources for those children.…”

Promoting consistent use of the communication function classification system (CFCS)

“…The Focus on the Outcomes of Communication Under Six (FOCUSß) [2], and the Communication Function Classification System (CFCS) [3], address how communication issues affect children's social functioning and participation, and classify levels of communicative functioning, respectively. The FOCUSß is a validated parent-report measure that captures changes in children's communicative participation [4]; the CFCS is a validated classification system that allows clinicians and families to classify children's communication skills into one of five levels of function [3]. Both tools are meant to be completed for all children receiving services in the PSLP every 6 months.…”

Classification in Childhood Disability

“…Research is also underway using the Communication Function Classification System to classify communication performance with persons who do not have cerebral palsy 34 (also Lenski, personal communication). Again, the purpose of this global judgment is to describe the person's usual communication regardless of any underlying speech, language, and hearing difficulties.…”