Katılımı Değerlendiren Yeni Bir Araç ‘ Altı Yaş Altı Çocukları İletişimsel Çıktı Odaklı Değerlendirme Ölçeği’ (FOCUS-TR) Güvenilir midir??

Yıl 2021, Cilt: 4 Sayı: 3, 297 - 314, 30.12.2021

Nida Şanlı , Zeynep Merve Eken

Öz

Amaç: Dil ve konuşma terapistleri, değerlendirme ve müdahale sonrası iletişimsel becerileri ve katılımı ölçmek amacı ile Dünya Sağlık Örgütü’nün (WHO) önerdiği İşlevsellik, Yetiyitimi ve Sağlığın Uluslararası Sınıflandırması ((Çocuk-Ergen (ICF-CY)) bütüncül bakış açısını yansıtan iletişimsel katılım ölçeklerine ihtiyaç duymaktadırlar. Bu ihtiyaç doğrultusunda ICF-CY perspektifinde dil ve konuşma bozukluklarının gerçek hayata olan etkisini değerlendirmek için Altı Yaş Öncesi Çocuklar için İletişimsel Çıktı Odaklı Değerlendirme Ölçeği (Focus on Outcomes of Communication Under Six- FOCUS) geliştirilmiştir. FOCUS ‘Altı Yaş Altı Çocukları İletişimsel Çıktı Odaklı Değerlendirme’ olarak Türkçe’ye uyarlanmıştır (FOCUS-TR). Bu çalışmada FOCUS-TR ebeveyn ölçeğinin iç ve dış güvenirliğinin incelenmesi amaçlanmıştır. Yöntem: Araştırmanın katılımcıları okur yazar 30 ebeveynden (anne ya da baba) oluşmaktadır. FOCUS-TR ölçeği bir hafta ara ile ebeveynlere iki kez uygulanmıştır. Veri analizinde; Bağımlı Örneklem t Testi, Pearson korelasyon analizi, Cronbach  (CA) değeri kullanılarak test-tekrar test, iç tutarlılık ve iki yarı güvenirliği analiz edilmiştir. Bulgular: FOCUS-TR toplam başlangıç ve tekrar test puanları arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p=0,891). FOCUS-TR toplam puanı başlangıç ve tekrar test puanı arasında anlamlı çok yüksek düzeyde ilişki bulunmaktadır (r=0,918, p<0,05). Başlangıç testinde FOCUS-TR toplam puanlar dikkate alındığında ilk ve ikinci uygulamaya ilişkin CA katsayılarının sırasıyla 0,962, =0,970 olduğu gözlemlenmiştir. İki yarı test güvenirlik analizi hem ilk test hem de tekrar test için yapılmıştır. İlk test (rS=0,902) ve tekrar test (rS=0,933) için yarılar arasındaki ilişki oldukça yüksek olarak bulgulanmıştır. Sonuç: FOCUS-TR ebeveyn ölçeği yüksek güvenirliğe sahip bir ölçektir.

Anahtar Kelimeler

Dil ve konuşma bozuklukları, katılım, FOCUS-TR, ICF-CY, iletişimsel çıktı, müdahale

Is A Novel Tool That Assess Participation - Is Focus on Outcomes of Communication Under Six, Turkish (FOCUS-TR) Reliable?

Öz

Purpose: There are many different assessment, evaluation and intervention methods in speech and language field. Recently World Health Organization (WHO) proposed International Classification of Functioning, Disability and Health (ICF) and International Classification of Functioning, Disability and Health -Children and Youth (ICF-CY) classifications present holistic framework which consider body functioning, body part, activity, participation and environmental factors to capture wellness and functioning of the clients. In speech and language assessments, speech and language pathologists (SLPs) mostly consider body functioning and body parts but have limited tools to assess participation which reflects the effect on real life situations. Consequently, SLPs need tools to measure communicative skills and participation in assessment processes and following speech and language interventions to meet the holistic point of ICF–CY's proposed by WHO. In line with this need, Focus on Outcomes of Communication Under Six (FOCUS) is developed, a communicative output-oriented assessment for children before the age of six. FOCUS primarily measures ‘communicative participation’ for preschool children by assessing communication and interaction adequacy on real life situations such as at home, school or in community. Considering Turkish literature, due to lack of tools to provide ICF holistic framework and communicative participation, FOCUS has been adapted to Turkish (FOCUS-TR). There are two available versions of the FOCUS: one designed for the speech-language pathologist and one for the parent. In this research it was aimed to investigate the internal and external reliability of the FOCUS-TR parent scale. Method: 30 literate parents (mother or father) were included this study. The FOCUS-TR was administered to the same parent with an interval of one week. In data analysis; test-retest, internal consistency and split-half reliability were analyzed using Paired Sample t-Test, Pearson correlation analysis, and Cronbach  (CA) coefficient. Results: The difference between the FOCUS-TR total test and retest scores was evaluated with the paired t-test and no statistically significant difference was found (p=0.891). There was high level correlation between the test and re-test scores of the FOCUS-TR total score (r=0.918, p<0.05). CA was calculated for both test and re-test. In the initial test, FOCUS-TR total score CA value was excellent (=0.962), re-test CA value was excellent (=0.970). Internal consistency of test and retest scores was analyzed with split-half test reliability. Split half reliability analysis was analyzed for both test and re-test. The initial test (rS=0.902) and the re- test (rS=0.933) were good half split reliability. Conclusion: FOCUS-TR, which is Turkish adaptation of FOCUS, has a high reliability.

Anahtar Kelimeler

speech and language therapy, participation, FOCUS-TR, ICF-CY, communicative output, intervention

Kaynakça

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
• Berument, S. K., & Güven, A. G. (2013). Türkçe İfade Edici ve Alıcı Dil (TİFALDİ) Testi: I. Alıcı Dil Kelime Alt Testi Standardizasyon ve Güvenilirlik Geçerlik Çalışması. Türk Psikiyatri Dergisi, 24(3), 192-201.
• Colay, İ. K. (2007). Gülhane Afazi Testi-2 (GAT-2)'nin standardizasyon, geçerlik ve güvenirlik çalışması (Master's thesis, Anadolu Üniversitesi).
• Cunningham, B. J., Thomas‐Stonell, N., & Rosenbaum, P. (2021). Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review. Developmental Medicine & Child Neurology, 63(1), 47-53.
• Evans, J. D. (1996). Straightforward statistics for the behavioral sciences. Thomson Brooks/Cole Publishing Co.
• Fujiki, M., Brinton, B., Isaacson, T., & Summers, C. (2001). Social behaviors of children with language impairment on the playground.
• Güven, S., & Topbaş, S. (2014). Erken Dil Gelişimi Testi-Üçüncü Versiyonu'nun (Test of Early Language Development-) Türkçe'ye Uyarlama, Geçerlik ve Güvenirlik Ön Çalışması. International Journal of Early Childhood Special Education, 6(2).
• Hammell K., Carpenter C. (2000). Introduction to Qualitative Research in Occupational Therapy and Physical Therapy. Using qualitative research: a practical introduction for occupational andphysical therapist. NewYork: Churchill Livingstone, 1–12.
• İnal, H. C. (2013). Günay S. Olasılık ve Matematiksel İstatistik. 7th ed. Ankara: Hacettepe Üniversitesi Yayınları.
• Jette, A., & Haley, S. (2005). Contemporary measurement techniques for rehabilitation outcomes assessment. Journal of Rehabilitation Medicine, 37(6), 339-345.
• Kline, P. (2000). The handbook of psychological testing. Psychology Press.
• Konrot, A. (2003). İletişim yetersizliği olan çocuklar. A. Ataman (ed). Özel Gereksinimi Olan Çocuklar ve Özel Eğitime Giriş. Ankara: Gündüz Eğitim ve Yayıncılık.
• Koo, T. K., & Li, M. Y. (2016). Cracking the code: providing insight into the fundamentals of research and evidence-based practice a guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15(2), 155-163.
• McCormack, J., McLeod, S., Harrison, L. J., & McAllister, L. (2010). The impact of speech impairment in early childhood: Investigating parents’ and speech-language pathologists’ perspectives using the ICF-CY. Journal of communication disorders, 43(5), 378-396.
• McCormack, J., McLeod, S., McAllister, L., & Harrison, L. J. (2009). A systematic review of the association between childhood speech impairment and participation across the lifespan. International Journal of Speech-Language Pathology, 11(2), 155-170.
• McLeod, S., & McKinnon, D. H. (2007). Prevalence of communication disorders compared with other learning needs in 14 500 primary and secondary school students. International journal of language & communication disorders, 42(S1), 37-59.
• Mutlu, A. İ. (2021). Çocukluk Çağı Kekemeliğini Değerlendirme Testinin (Test of Childhood Stuttering) Türkçe’ye Uyarlanması, Geçerlilik ve Güvenirliğinin Araştırılması’.
• Mutlu, A. İ., Tırank, Ş. B., & Gündüz, B. (2020). 6 ve 16 Yaş Okul Çocukları Arasındaki SSI-4-TR/Keşida-4 Dördüncü Baskının Türkçe Versiyonunun Güvenirliği ve Geçerliliği. Izmir Democracy University Health Sciences Journal, 3(2), 135-144.
• Namasivayam, A.K., Huynh, A., Granata, F. et al. PROMPT intervention for children with severe speech motor delay: a randomized control trial. Pediatr Research  89, 613–621 (2021). https://doi.org/10.1038/s41390-020-0924-4
• Namasivayam, A. K., Pukonen, M., Goshulak, D., Hard, J., Rudziczs, F., Rietveld, T., Baassen, B., Kroll, R, Van Lieshout, P (2015). Treatment intensity and childhood apraxia of speech. International Journal of Lanaguage and Communication Disorders, 50 (4), 529-546.
• Neumann, S., Salm, S., Rietz, C., & Stenneken, P. (2017). The German Focus on the Outcomes of Communication Under Six (FOCUS-G): Reliability and validity of a novel assessment of communicative participation. Journal of Speech, Language, and Hearing Research, 60(3), 675-681.
• Oddson, B., Thomas‐Stonell, N., Robertson, B., & Rosenbaum, P. (2019). Validity of a streamlined version of the Focus on the Outcomes of Communication Under Six: Process and outcome. Child: care, health and development, 45(4), 600-605.
• Oddson, B., Washington, K., Robertson, B., Thomas-Stonell, N., & Rosenbaum, P. (2013). RESEARCH NOTE: Inter-rater Reliability of Clinicians' Ratings of Preschool Children Using the FOCUS©: Focus on the Outcomes of Communication Under Six. Canadian Journal of Speech-Language Pathology & Audiology, 37(2).
• Piazzalunga, S., Salerni, N., Limarzi, S., Ticozzell, B., & Schindler, A. (2020). Assessment of children's communicative participation: a preliminary study on the validity and reliability of the Italian Focus on the Outcomes of Communication Under Six (FOCUS-I) in preschool age. Speech, Language and Hearing, 23(3), 167-179.
• Roulstone, S., Coad, J., Ayre, A., Hambly, H., Lindsay, G. (2013). The preffered outcomes of childrenw ith speech, language and communicationneedsand their parents. UK Department for Education Research Report DFE-RR247-BCRP12
• Shepherd, J., Brollier, C. B., & Dandrow, R. L. (1994). Play skills of preschool children with speech and language delays. Physical & Occupational Therapy in Pediatrics, 14(2), 1-20.
• Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach's alpha. International journal of medical education, 2, 53.
• Thomas-Stonell, N., Oddson, B., Robertson, B., & Rosenbaum, P. (2009). Predicted and observed outcomes in preschool children following speech and language treatment: Parent and clinician perspectives. Journal of communication disorders, 42(1), 29-42.
• Thomas‐Stonell, N., Oddson, B., Robertson, B., & Rosenbaum, P. (2013). Validation of the Focus on the Outcomes of Communication under Six outcome measure. Developmental Medicine & Child Neurology, 55(6), 546-552.
• Thomas‐Stonell, N. L., Oddson, B., Robertson, B., & Rosenbaum, P. L. (2010). Development of the FOCUS (Focus on the Outcomes of Communication Under Six), a communication outcome measure for preschool children. Developmental Medicine & Child Neurology, 52(1), 47-53.
• Threats, T. T. (2010). The complexity of social/cultural dimension in communication disorders. Folia Phoniatrica et Logopaedica, 62(4), 158-165.
• Timler, G. R., Olswang, L. B., & Coggins, T. E. (2005). " Do I know what I need to do?" A social communication intervention for children with complex clinical profiles. Language, Speech, and Hearing Services in Schools.
• Toğram, B., & Maviş, İ. (2012). Afazi Dil Değerlendirme Testi’nin Geçerlik, Güvenirlik ve Standardizasyon Çalışması. Turkish Journal of Neurology/Turk Noroloji Dergisi, 18(3).
• Yorkston, K. M., Klasner, E. R., & Swanson, K. M. (2001). Communication in context: A qualitative study of the experiences of individuals with multiple sclerosis.
• Washington, K., Thomas‐Stonell, N., Oddson, B., McLeod, S., Warr‐Leeper, G., Robertson, B., & Rosenbaum, P. (2013). Construct validity of the FOCUS (Focus on the Outcomes of Communication Under Six): a communicative participation outcome measure for preschool children. Child: Care, health and development, 39(4), 481-489.
• World Health Organization. (2007). International classification of functioning, disability and health: Children and youth version: ICF-CY.
• World Health Organization. (2013). International classification of functioning, disability and health: Children and youth version: ICF-CY.
• Hayhow, R., Lindsay, G., Rouldsone, S, White, P. (2012). Prospective cohort study of speech and language therapy servicesfor young who stutter in England. UK Department of Education Research Report DFE-RR247-BCRP16.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
• Berument, S. K., & Güven, A. G. (2013). Türkçe İfade Edici ve Alıcı Dil (TİFALDİ) Testi: I. Alıcı Dil Kelime Alt Testi Standardizasyon ve Güvenilirlik Geçerlik Çalışması. Türk Psikiyatri Dergisi, 24(3), 192-201.
• Colay, İ. K. (2007). Gülhane Afazi Testi-2 (GAT-2)'nin standardizasyon, geçerlik ve güvenirlik çalışması (Master's thesis, Anadolu Üniversitesi).
• Cunningham, B. J., Thomas‐Stonell, N., & Rosenbaum, P. (2021). Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review. Developmental Medicine & Child Neurology, 63(1), 47-53.
• Evans, J. D. (1996). Straightforward statistics for the behavioral sciences. Thomson Brooks/Cole Publishing Co.
• Fujiki, M., Brinton, B., Isaacson, T., & Summers, C. (2001). Social behaviors of children with language impairment on the playground.
• Güven, S., & Topbaş, S. (2014). Erken Dil Gelişimi Testi-Üçüncü Versiyonu'nun (Test of Early Language Development-) Türkçe'ye Uyarlama, Geçerlik ve Güvenirlik Ön Çalışması. International Journal of Early Childhood Special Education, 6(2).
• Hammell K., Carpenter C. (2000). Introduction to Qualitative Research in Occupational Therapy and Physical Therapy. Using qualitative research: a practical introduction for occupational andphysical therapist. NewYork: Churchill Livingstone, 1–12.
• İnal, H. C. (2013). Günay S. Olasılık ve Matematiksel İstatistik. 7th ed. Ankara: Hacettepe Üniversitesi Yayınları.
• Jette, A., & Haley, S. (2005). Contemporary measurement techniques for rehabilitation outcomes assessment. Journal of Rehabilitation Medicine, 37(6), 339-345.
• Kline, P. (2000). The handbook of psychological testing. Psychology Press.
• Konrot, A. (2003). İletişim yetersizliği olan çocuklar. A. Ataman (ed). Özel Gereksinimi Olan Çocuklar ve Özel Eğitime Giriş. Ankara: Gündüz Eğitim ve Yayıncılık.
• Koo, T. K., & Li, M. Y. (2016). Cracking the code: providing insight into the fundamentals of research and evidence-based practice a guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15(2), 155-163.
• McCormack, J., McLeod, S., Harrison, L. J., & McAllister, L. (2010). The impact of speech impairment in early childhood: Investigating parents’ and speech-language pathologists’ perspectives using the ICF-CY. Journal of communication disorders, 43(5), 378-396.
• McCormack, J., McLeod, S., McAllister, L., & Harrison, L. J. (2009). A systematic review of the association between childhood speech impairment and participation across the lifespan. International Journal of Speech-Language Pathology, 11(2), 155-170.
• McLeod, S., & McKinnon, D. H. (2007). Prevalence of communication disorders compared with other learning needs in 14 500 primary and secondary school students. International journal of language & communication disorders, 42(S1), 37-59.
• Mutlu, A. İ. (2021). Çocukluk Çağı Kekemeliğini Değerlendirme Testinin (Test of Childhood Stuttering) Türkçe’ye Uyarlanması, Geçerlilik ve Güvenirliğinin Araştırılması’.
• Mutlu, A. İ., Tırank, Ş. B., & Gündüz, B. (2020). 6 ve 16 Yaş Okul Çocukları Arasındaki SSI-4-TR/Keşida-4 Dördüncü Baskının Türkçe Versiyonunun Güvenirliği ve Geçerliliği. Izmir Democracy University Health Sciences Journal, 3(2), 135-144.
• Namasivayam, A.K., Huynh, A., Granata, F. et al. PROMPT intervention for children with severe speech motor delay: a randomized control trial. Pediatr Research  89, 613–621 (2021). https://doi.org/10.1038/s41390-020-0924-4
• Namasivayam, A. K., Pukonen, M., Goshulak, D., Hard, J., Rudziczs, F., Rietveld, T., Baassen, B., Kroll, R, Van Lieshout, P (2015). Treatment intensity and childhood apraxia of speech. International Journal of Lanaguage and Communication Disorders, 50 (4), 529-546.
• Neumann, S., Salm, S., Rietz, C., & Stenneken, P. (2017). The German Focus on the Outcomes of Communication Under Six (FOCUS-G): Reliability and validity of a novel assessment of communicative participation. Journal of Speech, Language, and Hearing Research, 60(3), 675-681.
• Oddson, B., Thomas‐Stonell, N., Robertson, B., & Rosenbaum, P. (2019). Validity of a streamlined version of the Focus on the Outcomes of Communication Under Six: Process and outcome. Child: care, health and development, 45(4), 600-605.
• Oddson, B., Washington, K., Robertson, B., Thomas-Stonell, N., & Rosenbaum, P. (2013). RESEARCH NOTE: Inter-rater Reliability of Clinicians' Ratings of Preschool Children Using the FOCUS©: Focus on the Outcomes of Communication Under Six. Canadian Journal of Speech-Language Pathology & Audiology, 37(2).
• Piazzalunga, S., Salerni, N., Limarzi, S., Ticozzell, B., & Schindler, A. (2020). Assessment of children's communicative participation: a preliminary study on the validity and reliability of the Italian Focus on the Outcomes of Communication Under Six (FOCUS-I) in preschool age. Speech, Language and Hearing, 23(3), 167-179.
• Roulstone, S., Coad, J., Ayre, A., Hambly, H., Lindsay, G. (2013). The preffered outcomes of childrenw ith speech, language and communicationneedsand their parents. UK Department for Education Research Report DFE-RR247-BCRP12
• Shepherd, J., Brollier, C. B., & Dandrow, R. L. (1994). Play skills of preschool children with speech and language delays. Physical & Occupational Therapy in Pediatrics, 14(2), 1-20.
• Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach's alpha. International journal of medical education, 2, 53.
• Thomas-Stonell, N., Oddson, B., Robertson, B., & Rosenbaum, P. (2009). Predicted and observed outcomes in preschool children following speech and language treatment: Parent and clinician perspectives. Journal of communication disorders, 42(1), 29-42.
• Thomas‐Stonell, N., Oddson, B., Robertson, B., & Rosenbaum, P. (2013). Validation of the Focus on the Outcomes of Communication under Six outcome measure. Developmental Medicine & Child Neurology, 55(6), 546-552.
• Thomas‐Stonell, N. L., Oddson, B., Robertson, B., & Rosenbaum, P. L. (2010). Development of the FOCUS (Focus on the Outcomes of Communication Under Six), a communication outcome measure for preschool children. Developmental Medicine & Child Neurology, 52(1), 47-53.
• Threats, T. T. (2010). The complexity of social/cultural dimension in communication disorders. Folia Phoniatrica et Logopaedica, 62(4), 158-165.
• Timler, G. R., Olswang, L. B., & Coggins, T. E. (2005). " Do I know what I need to do?" A social communication intervention for children with complex clinical profiles. Language, Speech, and Hearing Services in Schools.
• Toğram, B., & Maviş, İ. (2012). Afazi Dil Değerlendirme Testi’nin Geçerlik, Güvenirlik ve Standardizasyon Çalışması. Turkish Journal of Neurology/Turk Noroloji Dergisi, 18(3).
• Yorkston, K. M., Klasner, E. R., & Swanson, K. M. (2001). Communication in context: A qualitative study of the experiences of individuals with multiple sclerosis.
• Washington, K., Thomas‐Stonell, N., Oddson, B., McLeod, S., Warr‐Leeper, G., Robertson, B., & Rosenbaum, P. (2013). Construct validity of the FOCUS (Focus on the Outcomes of Communication Under Six): a communicative participation outcome measure for preschool children. Child: Care, health and development, 39(4), 481-489.
• World Health Organization. (2007). International classification of functioning, disability and health: Children and youth version: ICF-CY.
• World Health Organization. (2013). International classification of functioning, disability and health: Children and youth version: ICF-CY.
• Hayhow, R., Lindsay, G., Rouldsone, S, White, P. (2012). Prospective cohort study of speech and language therapy servicesfor young who stutter in England. UK Department of Education Research Report DFE-RR247-BCRP16.