Department of Speech-Language Pathology, University of Central Arkansas, Conway, AR 72035-0001, USA.
Dev Med Child Neurol. 2011 Aug;53(8):704-10. doi: 10.1111/j.1469-8749.2011.03996.x. Epub 2011 Jun 27.
The purpose of this study was to create and validate the Communication Function Classification System (CFCS) for children with cerebral palsy (CP), for use by a wide variety of individuals who are interested in CP. This paper reports the content validity, interrater reliability, and test-retest reliability of the CFCS for children with CP.
An 11-member development team created comprehensive descriptions of the CFCS levels, and four nominal groups comprising 27 participants critiqued these levels. Within a Delphi survey, 112 participants commented on the clarity and usefulness of the CFCS. Interrater reliability was completed by 61 professionals and 68 parents/relatives who classified 69 children with CP aged 2 to 18 years. Test-retest reliability was completed by 48 professionals who allowed at least 2 weeks between classifications. The participants who assessed the CFCS were all relevant stakeholders: adults with CP, parents of children with CP, educators, occupational therapists, physical therapists, physicians, and speech-language pathologists.
The interrater reliability of the CFCS was 0.66 between two professionals and 0.49 between a parent and a professional. Professional interrater reliability improved to 0.77 for classification of children older than 4 years. The test-retest reliability was 0.82.
The CFCS demonstrates content validity and shows very good test-retest reliability, good professional interrater reliability, and moderate parent-professional interrater reliability. Combining the CFCS with the Gross Motor Function Classification System and the Manual Ability Classification System contributes to a functional performance view of daily life for individuals with CP, in accordance with the World Health Organization's International Classification of Functioning, Disability and Health.
本研究旨在为脑瘫儿童创建并验证沟通功能分类系统（CFCS），供对脑瘫感兴趣的各类人群使用。本文报告了脑瘫儿童 CFCS 的内容效度、评分者间信度和重测信度。
由 11 名成员组成的开发团队创建了 CFCS 各级别的综合描述，由 27 名参与者组成的 4 个名义小组对这些级别进行了评估。在德尔菲调查中，112 名参与者对 CFCS 的清晰度和实用性发表了意见。61 名专业人员和 68 名父母/亲属对 69 名 2 至 18 岁脑瘫儿童进行了评分者间信度评估。48 名专业人员至少间隔 2 周对 69 名脑瘫儿童进行了重测信度评估。评估 CFCS 的参与者均为相关利益相关者：脑瘫成年人、脑瘫儿童的父母、教育工作者、职业治疗师、物理治疗师、医生和言语治疗师。
两名专业人员间 CFCS 的评分者间信度为 0.66，一名家长和一名专业人员间的信度为 0.49。专业人员间的评分者间信度在对 4 岁以上儿童的分类中提高至 0.77。重测信度为 0.82。
CFCS 具有内容效度，显示出很好的重测信度、良好的专业人员间信度和中等的家长-专业人员间信度。将 CFCS 与粗大运动功能分类系统和手动能力分类系统相结合，根据世界卫生组织的《国际功能、残疾和健康分类》，为脑瘫患者的日常生活功能表现提供了一个综合视图。
