AIM: This paper describes the development, validation, and reliability of the Functional Communication Classification System (FCCS), designed to classify expressive communication skills of children with cerebral palsy (CP) aged 4 years and 5 years (between their fourth and sixth birthdays). METHOD: The Functional Communication Classification System (FCCS) was developed in 2006 using a literature review, client file audit, and expert consultative committee process in order to devise scale content, structure, and check clinical validity and utility. Interrater reliability was examined between speech-language pathologists (SLPs), other allied health professionals (AHPs), and parents of 48 children with CP. The scale was revised and a clinical reasoning prompt sheet added, then trialled again for 42 children. The result was a five-level system with descriptors and decision-making guides for classification of functional expressive communication for children with CP. RESULTS: Overall interrater reliability was excellent for the final FCCS, intraclass correlation coefficient=0.97 (95% confidence interval 0.95 to 0.98). Kappa values were 0.94 between SLPs and AHPs, 0.59 between SLPs and parents, and 0.60 between AHPs and parents. INTERPRETATION: The FCCS is a reliable tool for describing functional communication in young children with CP, appropriate for use by SLPs, other AHPs, and parents of children with CP.
AIM: This paper describes the development, validation, and reliability of the Functional Communication Classification System (FCCS), designed to classify expressive communication skills of children with cerebral palsy (CP) aged 4 years and 5 years (between their fourth and sixth birthdays). METHOD: The Functional Communication Classification System (FCCS) was developed in 2006 using a literature review, client file audit, and expert consultative committee process in order to devise scale content, structure, and check clinical validity and utility. Interrater reliability was examined between speech-language pathologists (SLPs), other allied health professionals (AHPs), and parents of 48 children with CP. The scale was revised and a clinical reasoning prompt sheet added, then trialled again for 42 children. The result was a five-level system with descriptors and decision-making guides for classification of functional expressive communication for children with CP. RESULTS: Overall interrater reliability was excellent for the final FCCS, intraclass correlation coefficient=0.97 (95% confidence interval 0.95 to 0.98). Kappa values were 0.94 between SLPs and AHPs, 0.59 between SLPs and parents, and 0.60 between AHPs and parents. INTERPRETATION: The FCCS is a reliable tool for describing functional communication in young children with CP, appropriate for use by SLPs, other AHPs, and parents of children with CP.
Authors: Roslyn N Boyd; Peter Sw Davies; Jenny Ziviani; Stewart Trost; Lee Barber; Robert Ware; Stephen Rose; Koa Whittingham; Leanne Sakzewski; Kristie Bell; Christopher Carty; Steven Obst; Katherine Benfer; Sarah Reedman; Priya Edwards; Megan Kentish; Lisa Copeland; Kelly Weir; Camilla Davenport; Denise Brooks; Alan Coulthard; Rebecca Pelekanos; Andrea Guzzetta; Simona Fiori; Meredith Wynter; Christine Finn; Andrea Burgess; Kym Morris; John Walsh; Owen Lloyd; Jennifer A Whitty; Paul A Scuffham Journal: BMJ Open Date: 2017-07-12 Impact factor: 2.692