Alignment of classification paradigms for communication abilities in children with cerebral palsy

Aim We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed interjudge reliability, whether the V...

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Bibliographic Details
Published in:Developmental medicine and child neurology 2016-06, Vol.58 (6), p.597-604
Main Authors: Hustad, Katherine C, Oakes, Ashley, McFadd, Emily, Allison, Kristen M
Format: Article
Language:English
Subjects:
Cerebral Palsy - classification
Cerebral Palsy - complications
Child
Child, Preschool
Communication Disorders - classification
Communication Disorders - etiology
Female
Humans
Male
Reproducibility of Results
Severity of Illness Index
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Summary:Aim We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed interjudge reliability, whether the VSS and the CFCS captured impairments in speech and language, and whether there were differences in speech intelligibility among levels within each classification paradigm. Method Eighty children (42 males, 38 females) with a range of types and severity levels of CP participated (mean age 60mo, range 50–72mo [SD 5mo]). Two speech‐language pathologists classified each child via parent–child interaction samples and previous experience with the children for the CFCS and VSS, and using quantitative speech and language assessment data for the SLPG. Intelligibility scores were obtained using standard clinical intelligibility measurement. Results Kappa values were 0.67 (95% confidence interval [CI] 0.55–0.79) for the CFCS, 0.82 (95% CI 0.72–0.92) for the VSS, and 0.95 (95% CI 0.72–0.92) for the SLPG. Descriptively, reliability within levels of each paradigm varied, with the lowest agreement occurring within the CFCS at levels II (42%), III (40%), and IV (61%). Neither the CFCS nor the VSS were sensitive to language impairments captured by the SLPG. Significant differences in speech intelligibility were found among levels for all classification paradigms. Interpretation Multiple tools are necessary to understand speech, language, and communication profiles in children with CP. Characterization of abilities at all levels of the International Classification of Functioning, Disability and Health will advance our understanding of the ways that speech, language, and communication abilities present in children with CP. What this paper adds Tools for classifying communication in children with cerebral palsy vary in their reliability. The Communication Function Classification System (CFCS) and the Viking Speech Scale (VSS) did not definitively capture language impairment relative to the Speech Language Profile Groups (SLPG). The CFCS, VSS, and SLPG showed differences among levels in speech intelligibility. This article is commented on by Pennington on pages 534–535 of this issue.
ISSN:0012-1622
1469-8749
DOI:10.1111/dmcn.12944