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psychometric properties such as reliability and validity are needed. The Focus © is a new measure available for use by SLPs (www.focusoutcomemeasurment.ca). This measure is specific to evaluating communicative participation in young children. To date, there have been a limited number of measures available to evaluate this area of functioning. The support provided for the FOCUS © by this study is timely because it shows the reliability of a new measures designed to evaluate real-world functioning for young children with speech-language impairments. Acknowledgements The authors would like to thank the families, children, speech pathologists, graduate-SLP students and research assistants who made this research possible. The authors especially thank Joan Walker, research assistant to the last author. This study was funded by the Social Sciences and Humanities Research Council (first author) and the Canadian Institutes of Health Research (last author) (Funding reference #: Grant numbers 86884 and 86573). Peter Rosenbaum holds a Canada Research Chair from the Canadian Institutes of Health Research. This research data was collected for a postdoctoral project completed at the Bloorview Research Institute and the Graduate Department of Speech-Language Pathology, University of Toronto in Toronto, Ontario, Canada. References Eadie, T., Yorkston, K., Klasner, E., Dudgeon, B., Deitz, J., Baylor, C., Miller, R., & Amtmann, D. (2006). Measuring communicative participation: A review of self-report instruments in speech-language pathology. American Journal of Speech-Language Pathology , 15 , 307–320. Enderby, P., & John, A. (1997). Therapy outcome measures: Speech-language pathology technical manual . London, UK: Singular Press. Hidecker, M., Paneth, N., Rosenbaum, P., Kent, R., Lillie, J., Eulenberg J.,...Taylor, K. (2011). Developing and validating the communication function classification system (CFCS) for Individuals with cerebral palsy. Developmental Medicine and Child Neurology , 53 (8), 704–710. Hinkle, D., Wiersma, W., & Jurs, S. (2003). Applied Jette, A., & Haley, S. (2005). Contemporary measurement techniques for rehabilitation outcomes assessment. Journal of Rehabilitation Medicine , 37 , 339–345. John, A., & Enderby, P. (2000). Reliability of speech and language therapists using therapy outcome measures. International Journal of Language and Communication Disorders ; 35 (2), 287–302. Law, J., Boyle, J., Harris, F., Harkness, A., & Nye, C. (2000). Prevalence and natural history of primary speech and language delay: Findings from a systematic review of the literature. International Journal of Language and Communication Disorders , 35 (2), 165–188. McCabe, P. (2005). Social and behavioral correlates of preschoolers with specific language impairment. Psychology in Schools , 42 (4), 373–387. McLeod, S., & Harrison, L. (2009). Epidemiology of speech and language impairment in a nationally representative sample of 4- to 5-year-old children. Journal of Speech, Language, and Hearing Research , 52 , 1213– 1229. McLeod, S., & Threats, T. (2008). The ICF-CY and children with communication disabilities. International statistics for the behavioral sciences . (5th ed.). Independence, KY: Wadsworth Publishing.

Results of the study indicated that SLPs’ administration of the FOCUS © was reliable. Comparisons of the FOCUS © for test-retest reliability were very high (r = .96), revealing the same SLPs could reliably administer the FOCUS © within a 1-month time interval. The very high test-retest reliability estimates of the FOCUS © are in-line with impairment- based measures of speech and language for young children, such as the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P; Wiig, Secord, & Semel, 2004), MacArthur-Bates Communicative Developmental Inventories – Second Edition (CDI-II; Fenson et al., 2007), and the Preschool Language Scales – Fourth Edition (PLS- 4; Zimmerman, Steiner, & Pond, 2004). They are also in line with other participation-based measures (e.g., the TOMS and AusTOMs). The size of the correlation coefficients is indicative of the strength of the relationship between two variables (Hinkle et al., 2003). The very high values observed in this study indicate there is consistency in the administration of the FOCUS © by the same SLP, which suggests that it is psychometrically sound. This study also showed that the FOCUS © had high inter- rater reliability. Thus, two SLPs could reliably administer the FOCUS © for the same child with speech-language impairments. The developers of the TOMs also found that SLPs had high (>.80) inter-rater reliability for different test domains (Enderby & John, 1997). In addition, the high inter- rater reliability of the FOCUS © was consistent with values found for impairment-based measures (e.g., CELF-P and PLS-4). The difference between reliability scores obtained in the previous study of FOCUS © reliability (Thomas-Stonell et al., 2010) and the results from this study could be attributed to the reliability procedures not being completed for children receiving speech-language intervention, thus addressing a possible confound in the initial study. Measures that are valid, reliable, and reflective of the most current theoretical framework are needed within the rehabilitation sciences to quantify functional changes in skills (Jette & Haley, 2005; Wade & de Jong, 2000; Yorkston et al., 2001). The current findings support the consistency and accuracy in FOCUS © ratings when administered by SLPs. This new evidence for test-retest and inter-rater reliability expands on the already established evidence for parental administration and evidence of construct validity for this measure. Limitations and future directions Larger samples are typically used in describing the reliability of outcome measures. The sample used in this study was relatively small and there may have been a selection bias due to the convenience sample included. Thus, these findings should be interpreted with caution. Further, the sample of children may not be representative of all children with speech and/or language impairment as a large proportion was diagnosed with additional medical diagnoses. That said, the FOCUS © was developed using young children with medical diagnoses as well as those with a variety of speech-language characteristics. Consequently, the sample of children included in this study is reflective of those with whom the FOCUS © can be used. While there is evidence supporting the reliability of the FOCUS © additional research should be undertaken with a larger sample comprising a broader range of children with speech-language impairments. Clinical implications To further the evidence-based delivery of speech-language pathology services, clinical measures that have good

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JCPSLP Volume 15, Number 1 2013

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