RESUMO
OBJECTIVE: To evaluate how the practice of specialist speech-language pathologists (SLPs) working with young children with cleft palate ± cleft lip (CP±L) maps onto the International Classification of Functioning, Disability, and Health - Children and Youth version (ICF-CY) and consider the functionality of the categories of the ICF-CY for this specialist area of practice. DESIGN: Cross-sectional, qualitative study. SETTING: Semistructured face-to-face interviews were conducted with SLPs working in tertiary-level hospitals, universities, and public clinics. PARTICIPANTS: Six specialist SLPs with 17 to 39 years of experience working with young children with CP±L as researchers and clinicians in Australia, Brazil, Denmark, Ireland, New Zealand, and the United States. MAIN OUTCOME MEASURE(S): Specialists' practices were captured using in-depth, semistructured interviews. Data collected were analyzed by directed content analysis applying the ICF-CY as a coding schema. RESULTS: In total, 4077 data points were coded. Most mapped onto Body Structures (684, 16.8%), Body Functions (906, 22.2%), and Environmental Factors (1626, 39.9%) with less emphasis on Activities and Participation (560, 13.7%). A "best fit" approach was taken to topics that did not map exactly onto categories of the ICF-CY (eg, velopharyngeal insufficiency [VPI]); however, there was not always an ideally suitable category available. CONCLUSIONS: The current study revealed strengths and challenges in categorizing practice within the ICF-CY for children with CP±L, including collaboration with parents and significant others, specificity around speech, language, and articulation, and the different types of VPI. Therefore, future discussion around how best to use the framework with children with CP±L is needed.
Assuntos
Fissura Palatina , Fala , Adolescente , Austrália , Brasil , Pré-Escolar , Estudos Transversais , Avaliação da Deficiência , Humanos , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Irlanda , Nova Zelândia , Patologistas , EspecializaçãoRESUMO
PURPOSE: To describe validation of the Intelligibility in Context Scale (ICS; McLeod, Harrison, & McCormack, 2012a) and ICS-Jamaican Creole (ICS-JC; McLeod, Harrison, & McCormack, 2012b) in a sample of typically developing 3- to 6-year-old Jamaicans. METHOD: One-hundred and forty-five preschooler-parent dyads participated in the study. Parents completed the 7-item ICS (n = 145) and ICS-JC (n = 98) to rate children's speech intelligibility (5-point scale) across communication partners (parents, immediate family, extended family, friends, acquaintances, strangers). Preschoolers completed the Diagnostic Evaluation of Articulation and Phonology (DEAP; Dodd, Hua, Crosbie, Holm, & Ozanne, 2006) in English and Jamaican Creole to establish speech-sound competency. For this sample, we examined validity and reliability (interrater, test-rest, internal consistency) evidence using measures of speech-sound production: (a) percentage of consonants correct, (b) percentage of vowels correct, and (c) percentage of phonemes correct. RESULTS: ICS and ICS-JC ratings showed preschoolers were always (5) to usually (4) understood across communication partners (ICS, M = 4.43; ICS-JC, M = 4.50). Both tools demonstrated excellent internal consistency (α = .91), high interrater, and test-retest reliability. Significant correlations between the two tools and between each measure and language-specific percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct provided criterion-validity evidence. A positive correlation between the ICS and age further strengthened validity evidence for that measure. CONCLUSIONS: Both tools show promising evidence of reliability and validity in describing functional speech intelligibility for this group of typically developing Jamaican preschoolers.