Expressive communication function and its influence on participation of primary school-aged children with cerebral palsy.
Tracks
6
Alternative and Augmentative Communication (AAC)
Cerebral Palsy
Complex communication needs (CCN)
Disability
Expressive language
Innovative practice
Motor speech
Professional practice
School age
Speech
| Saturday, June 14, 2025 |
| 2:45 PM - 2:55 PM |
Overview
Katrina Caynes
Details
⏫ Research insights
⏲️ 2.45pm - 3.05pm
⌛20-minutes
📚 Assumed knowledge of attendees: Foundational (new/casual familiarity with the topic e.g. treated a single case)
⏲️ 2.45pm - 3.05pm
⌛20-minutes
📚 Assumed knowledge of attendees: Foundational (new/casual familiarity with the topic e.g. treated a single case)
Presenter
Dr Katy Caynes
University of Southern Queensland (UniSQ)
Expressive communication function and its influence on participation of primary school-aged children with cerebral palsy.
2:45 PM - 3:05 PMPresentation summary
The family of participation and related constructs (fPRC), provides a valuable framework to examine the participation of children with disabilities. Communication plays a vital role; however, limited research exists regarding the significance of expressive communication function on the participation of children with cerebral palsy (CP) across daily settings.
This study explored the contribution of expressive communication function to the participation of children with CP measured using the Participation and Environment Measure for Children and Youth (PEM-CY). Specific objectives were to determine the influence of (1) expressive communication function (Functional Communication Classification System, FCCS); speech intelligibility (Viking Speech Scale, VSS); use of Augmentative and Alternative Communication (Primary Expressive Mode Group, PEMG); alongside (2) gross motor function (Gross Motor Function Classification System, GMFCS), manual abilities (Manual Abilities Classification System, MACS) and (3) associated impairments (i.e., hearing, vision, and cognition).
Method: Parents of 54 children with CP aged 5-14 years (male=36), provided data on speech and communication (VSS, FCCS, PEMG), motor function (GMFCS, MACS), associated impairments, and participation across everyday settings (PEM-CY). Regression analysis identified variable contributions to participation frequency and involvement.
Results: Univariably, higher frequency was associated with one or multiple variables. Involvement was associated with multiple variables. On multivariable analysis, the FCCS was the best-fit model for variance in home (8%) and community (30%) frequency, and home (28%) and school (37%) involvement; Age was the best fit for school (9%) frequency; and together, manual ability and intellectual impairment best-explained community (44%) involvement.
Conclusion: Multivariable analysis found expressive communication function (FCCS) to be the strongest contributor to participation frequency and involvement for children with CP, except for school attendance and community involvement. Communication classification (FCCS, VSS, PEMG) is a valuable tool to support clinical reasoning and inform setting-specific interventions, technologies, and communication partner training to optimise the participation of children with CP.
This study explored the contribution of expressive communication function to the participation of children with CP measured using the Participation and Environment Measure for Children and Youth (PEM-CY). Specific objectives were to determine the influence of (1) expressive communication function (Functional Communication Classification System, FCCS); speech intelligibility (Viking Speech Scale, VSS); use of Augmentative and Alternative Communication (Primary Expressive Mode Group, PEMG); alongside (2) gross motor function (Gross Motor Function Classification System, GMFCS), manual abilities (Manual Abilities Classification System, MACS) and (3) associated impairments (i.e., hearing, vision, and cognition).
Method: Parents of 54 children with CP aged 5-14 years (male=36), provided data on speech and communication (VSS, FCCS, PEMG), motor function (GMFCS, MACS), associated impairments, and participation across everyday settings (PEM-CY). Regression analysis identified variable contributions to participation frequency and involvement.
Results: Univariably, higher frequency was associated with one or multiple variables. Involvement was associated with multiple variables. On multivariable analysis, the FCCS was the best-fit model for variance in home (8%) and community (30%) frequency, and home (28%) and school (37%) involvement; Age was the best fit for school (9%) frequency; and together, manual ability and intellectual impairment best-explained community (44%) involvement.
Conclusion: Multivariable analysis found expressive communication function (FCCS) to be the strongest contributor to participation frequency and involvement for children with CP, except for school attendance and community involvement. Communication classification (FCCS, VSS, PEMG) is a valuable tool to support clinical reasoning and inform setting-specific interventions, technologies, and communication partner training to optimise the participation of children with CP.
Refrences
1. Imms C. Children with cerebral palsy participate: A review of the literature. Disability and Rehabilitation. 2008 2008/01/01;30(24):1867-1884.
2. Michelsen SI, Flachs EM, Uldall P, et al. Frequency of participation of 8–12-year-old children with cerebral palsy: A multi-centre cross-sectional European study. Eur J Paediatr Neurol. 2009;13(2):165-177.
3. Imms C, Adair B, Rosenbaum P, et al. 'Participation': A systematic review of language, definitions, and constructs used in intervention research with children with disabilities. Developmental Medicine and Child Neurology. 2016;58(1):29-38.
4. Palisano RJ, Chiarello LA, Orlin M, et al. Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy. Developmental Medicine and Child Neurology. 2011 Feb 2011;53(2):142-149.
5. Parkes J, McCullough N, Madden A. To what extent do children with cerebral palsy participate in everyday life situations? Health & Social Care in the Community. 2010;18(3):304-315.
6. Pashmdarfard M, Richards LG, Amini M. Factors Affecting Participation of Children with Cerebral Palsy in Meaningful Activities: Systematic Review. Occupational Therapy In Health Care. 2021;35(4):442-479.
7. van Schie PEM, Siebes RC, Dallmeijer AJ, et al. Development of social functioning and communication in school- aged ( 5– 9 years) children with cerebral palsy. Res Dev Disabil. 2013;34(12):4485-4494.
8. Tan SS, van Der Slot WMA, Ketelaar M, et al. Factors contributing to the longitudinal development of social participation in individuals with cerebral palsy. Res Dev Disabil. 2016;57:125-135.
9. World Health Organisation. International Classification of Functioning, Disability and Health. Geneva, Switzerland: WHO; 2007. Available from: http://www.who.int/classifications/icf/en/.
10. Park E-Y, Kim W-H. Relationship between activity limitations and participation restriction in school-aged children with cerebral palsy. Journal of Physical Therapy Science. 2015;27(8):2611-2614.
11. Ploypetch T, Buasuk C, Pajareya K. Participation restriction of children with cerebral palsy living in Thailand and influential factors: A cross-sectional study. Developmental Neurorehabilitation. 2022;25(6):392-399.
12. Chiarello LA, Palisano RJ, McCoy SW, et al. Child engagement in daily life: a measure of participation for young children with cerebral palsy. Disability and Rehabilitation. 2014;36(21):1804-1816.
13. Alghamdi MS, Chiarello LA, Palisano RJ, et al. Understanding participation of children with cerebral palsy in family and recreational activities. Res Dev Disabil. 2017;69:96-104.
14. King GA, Law M, King S, et al. Measuring children’s participation in recreation and leisure activities: construct validation of the CAPE and PAC. Child: Care, Health and Development. 2007;33(1):28-39.
15. Ghaffari S, Kalantari M, Rezaee M, et al. Predictors of Leisure Participation in 6 to 14-Year-Old Children with Cerebral Palsy: Structural Equation Modeling. Iran J Child Neurol. 2020 Spring;14(2):41-57.
16. Adair B, Ullenhag A, Rosenbaum P, et al. Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review. Dev Med Child Neurol. 2018;60(11):1101-1116.
Coster W, Law M, Bedell G, et al. Development of the participation and environment measure for children and youth: conceptual basis. Disabil Rehabil. 2011;34(3):238-246.
18. Virella D, Pennington L, Andersen GL, et al. Classification systems of communication for use in epidemiological surveillance of children with cerebral palsy. Developmental Medicine & Child Neurology. 2016;58(3):285-291.
19. Barty E, Caynes K, Johnston LM. Development and reliability of the Functional Communication Classification System for children with cerebral palsy. Dev Med Child Neurol. 2016;58(10):1036-1041.
20. Hidecker MJC, Paneth N, Rosenbaum PL, et al. Developing and Validating the Communication Function Classification System for Individuals with Cerebral Palsy. Developmental Medicine & Child Neurology. 2011;53(8):704-710.
21. Hustad KC. Reflections on the Functional Communication Classification System for children with cerebral palsy. Dev Med Child Neurol. 2016;58(10):996-996.
22. Caynes K, Rose TA, Burmester D, et al. Reproducibility and validity of the Functional Communication Classification System for young children with cerebral palsy. Developmental Medicine & Child Neurology. 2021;63(7):866-873.
23. Caynes K, Rose TA, Theodoros D, et al. The Functional Communication Classification System: extended reliability and concurrent validity for children with cerebral palsy aged 5 to 18 years. Developmental medicine and child neurology. 2019;61(7):805-812.
24. McCartney E. The Functional Communication Classification System for children with cerebral palsy: the potential of a new measure. Dev Med Child Neurol. 2019;61(7):741-741.
25. Pennington L, Virella D, Mjøen T, et al. Development of The Viking Speech Scale to classify the speech of children with cerebral palsy. Res Dev Disabil. 2013;34(10):3202-3210.
2. Michelsen SI, Flachs EM, Uldall P, et al. Frequency of participation of 8–12-year-old children with cerebral palsy: A multi-centre cross-sectional European study. Eur J Paediatr Neurol. 2009;13(2):165-177.
3. Imms C, Adair B, Rosenbaum P, et al. 'Participation': A systematic review of language, definitions, and constructs used in intervention research with children with disabilities. Developmental Medicine and Child Neurology. 2016;58(1):29-38.
4. Palisano RJ, Chiarello LA, Orlin M, et al. Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy. Developmental Medicine and Child Neurology. 2011 Feb 2011;53(2):142-149.
5. Parkes J, McCullough N, Madden A. To what extent do children with cerebral palsy participate in everyday life situations? Health & Social Care in the Community. 2010;18(3):304-315.
6. Pashmdarfard M, Richards LG, Amini M. Factors Affecting Participation of Children with Cerebral Palsy in Meaningful Activities: Systematic Review. Occupational Therapy In Health Care. 2021;35(4):442-479.
7. van Schie PEM, Siebes RC, Dallmeijer AJ, et al. Development of social functioning and communication in school- aged ( 5– 9 years) children with cerebral palsy. Res Dev Disabil. 2013;34(12):4485-4494.
8. Tan SS, van Der Slot WMA, Ketelaar M, et al. Factors contributing to the longitudinal development of social participation in individuals with cerebral palsy. Res Dev Disabil. 2016;57:125-135.
9. World Health Organisation. International Classification of Functioning, Disability and Health. Geneva, Switzerland: WHO; 2007. Available from: http://www.who.int/classifications/icf/en/.
10. Park E-Y, Kim W-H. Relationship between activity limitations and participation restriction in school-aged children with cerebral palsy. Journal of Physical Therapy Science. 2015;27(8):2611-2614.
11. Ploypetch T, Buasuk C, Pajareya K. Participation restriction of children with cerebral palsy living in Thailand and influential factors: A cross-sectional study. Developmental Neurorehabilitation. 2022;25(6):392-399.
12. Chiarello LA, Palisano RJ, McCoy SW, et al. Child engagement in daily life: a measure of participation for young children with cerebral palsy. Disability and Rehabilitation. 2014;36(21):1804-1816.
13. Alghamdi MS, Chiarello LA, Palisano RJ, et al. Understanding participation of children with cerebral palsy in family and recreational activities. Res Dev Disabil. 2017;69:96-104.
14. King GA, Law M, King S, et al. Measuring children’s participation in recreation and leisure activities: construct validation of the CAPE and PAC. Child: Care, Health and Development. 2007;33(1):28-39.
15. Ghaffari S, Kalantari M, Rezaee M, et al. Predictors of Leisure Participation in 6 to 14-Year-Old Children with Cerebral Palsy: Structural Equation Modeling. Iran J Child Neurol. 2020 Spring;14(2):41-57.
16. Adair B, Ullenhag A, Rosenbaum P, et al. Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review. Dev Med Child Neurol. 2018;60(11):1101-1116.
Coster W, Law M, Bedell G, et al. Development of the participation and environment measure for children and youth: conceptual basis. Disabil Rehabil. 2011;34(3):238-246.
18. Virella D, Pennington L, Andersen GL, et al. Classification systems of communication for use in epidemiological surveillance of children with cerebral palsy. Developmental Medicine & Child Neurology. 2016;58(3):285-291.
19. Barty E, Caynes K, Johnston LM. Development and reliability of the Functional Communication Classification System for children with cerebral palsy. Dev Med Child Neurol. 2016;58(10):1036-1041.
20. Hidecker MJC, Paneth N, Rosenbaum PL, et al. Developing and Validating the Communication Function Classification System for Individuals with Cerebral Palsy. Developmental Medicine & Child Neurology. 2011;53(8):704-710.
21. Hustad KC. Reflections on the Functional Communication Classification System for children with cerebral palsy. Dev Med Child Neurol. 2016;58(10):996-996.
22. Caynes K, Rose TA, Burmester D, et al. Reproducibility and validity of the Functional Communication Classification System for young children with cerebral palsy. Developmental Medicine & Child Neurology. 2021;63(7):866-873.
23. Caynes K, Rose TA, Theodoros D, et al. The Functional Communication Classification System: extended reliability and concurrent validity for children with cerebral palsy aged 5 to 18 years. Developmental medicine and child neurology. 2019;61(7):805-812.
24. McCartney E. The Functional Communication Classification System for children with cerebral palsy: the potential of a new measure. Dev Med Child Neurol. 2019;61(7):741-741.
25. Pennington L, Virella D, Mjøen T, et al. Development of The Viking Speech Scale to classify the speech of children with cerebral palsy. Res Dev Disabil. 2013;34(10):3202-3210.
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Dr Katy Caynes is a speech pathologist with over three decades of clinical experience working with infants, children, and youth with developmental disability. Katy has held a variety of clinical, supervisory, and senior management statewide positions in disability and health organisations, and continues to provide direct clinical support in her private practice. Katy is a longstanding member of a national allied health professional (AHP) teaching team and has extensive experience teaching in the areas of communication and mealtime development, assessment, and interventions for children with cerebral palsy.
Katy's passion is supporting best practice frameworks for children with disability and their families that enable a child’s optimal participation. Katy’s PhD titled Functional communication in children with cerebral palsy: Classification and participation outcomes, involved extended psychometric testing of the Functional Communication Classification System (FCCS), a tool she coauthored for children and young people with cerebral palsy.
The information contained in this program is current at of the time of publishing but is subject to changes made without notice.
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