Caynes Katy, Rose Tanya A, Burmester Debbie, Ware Robert S, Johnston Leanne M
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia.
Choice Passion Life, Brisbane, Qld, Aust.
Dev Med Child Neurol. 2021 Jul;63(7):866-873. doi: 10.1111/dmcn.14844. Epub 2021 Feb 26.
To examine interrater agreement and validity of the Functional Communication Classification System (FCCS) for young children with cerebral palsy (CP) aged 2 or 3 years.
Speech-language pathologist (SLP) and parent FCCS ratings for 31 children with CP (aged 2y, n=16; aged 3y, n=15; 18 males, 13 females) were examined for interrater agreement using a weighted Cohen's kappa statistic. Relationships between FCCS (SLP) ratings and: (1) concurrent validity with the Language Use Inventory, a standardized pragmatic assessment for children aged 18 to 47 months, (2) gross motor and fine motor function, (3) associated impairments (visual and intellectual), and (4) primary expressive communication mode were examined using Spearman's correlation coefficients.
Almost perfect interrater agreement between SLP and parent FCCS ratings were found (k =0.94). Correlations with FCCS (SLP) were excellent for pragmatic function (r =-0.83, p<0.001), intellectual function (r =0.89, p<0.001), and primary expressive communication mode (r =0.92, p<0.001). Correlations were good for gross motor function (r =0.72, p<0.001) and visual impairment (r =0.70, p<0.001) and fair for fine motor function (r =0.53, p<0.002). Analysis was unwarranted for epilepsy (n=1 out of 31) and hearing-associated impairments (n=0 out of 31).
The FCCS has excellent interrater agreement and validity for communication classification of children with CP aged 2 or 3 years and is highly suitable for surveillance and research purposes. What this paper adds The Functional Communication Classification System (FCCS) is a valid instrument for children with cerebral palsy (CP) aged 2 or 3 years. Excellent agreement exists between speech-language pathologist and parent FCCS ratings. The FCCS has excellent correlation with intelligence, pragmatic function, and primary expressive mode. Stronger correlations with the Gross Motor Function Classification System and vision exist for children aged 2 or 3 years. Weaker correlations with manual ability exist when compared to older children with CP.
检验功能沟通分类系统（FCCS）在2至3岁脑瘫（CP）幼儿中的评分者间信度和效度。
使用加权科恩kappa统计量检验31名脑瘫儿童（2岁组16名，3岁组15名；男18名，女13名）的言语病理学家（SLP）和家长FCCS评分的评分者间信度。使用斯皮尔曼相关系数检验FCCS（SLP）评分与以下各项之间的关系：（1）与语言使用量表的同时效度，该量表是针对18至47个月儿童的标准化语用评估；（2）粗大运动和精细运动功能；（3）相关障碍（视觉和智力）；（4）主要表达沟通方式。
SLP和家长FCCS评分之间发现了几乎完美的评分者间信度（k =0.94）。FCCS（SLP）与语用功能（r = -0.83，p<0.001）、智力功能（r =0.89，p<0.001）和主要表达沟通方式（r =0.92，p<0.001）的相关性极佳。与粗大运动功能（r =0.72，p<0.001）和视力障碍（r =0.70，p<0.001）的相关性良好，与精细运动功能的相关性一般（r =0.53，p<0.002）。对癫痫（31例中有1例）和听力相关障碍（31例中0例）的分析无必要。
FCCS在2至3岁脑瘫儿童的沟通分类方面具有出色的评分者间信度和效度，非常适合用于监测和研究目的。本文补充内容：功能沟通分类系统（FCCS）是用于2至3岁脑瘫（CP）儿童的有效工具。言语病理学家和家长FCCS评分之间存在极佳的一致性。FCCS与智力、语用功能和主要表达模式具有极佳的相关性。2至3岁儿童与粗大运动功能分类系统和视力的相关性更强。与年龄较大的脑瘫儿童相比，与手部能力的相关性较弱。
