Evaluating the Convergent and Discriminant Validity of the FOCUS (Focus on the Outcomes

Evaluating the Convergent and Discriminant Validity of the FOCUS (Focus on the Outcomes of Communication Under Six)

Thomas-Stonell, N. (1) Robertson, B. (1), Oddson, B. (2), Walker, J. (1),

Jamie Young (1) & Rosenbaum, P. (3)

(1) Bloorview Research Institute, Bloorview Kids Rehab, Toronto, ON.; (2) School of Human Kinetics, Laurentian University, Sudbury, ON.; (3) CanChild Centre for Childhood Disability Research, Hamilton, ON.

Objective: The objective of this project was to evaluate the convergent and discriminant validity of the FOCUS with the Ages and Stages Questionnaire – Social/Emotional (ASQ-SE). It was hypothesized that the FOCUS would correlate moderately with the communication domain of the ASQ-SE. This would demonstrate convergent validity. It was also hypothesized that the FOCUS would not correlate with the remaining, non-communication related domains of the ASQ-SE. This would demonstrate discriminant validity.

Target population: Preschool children with communication disabilities

Introduction/background: Communication disorders are very common in children, affecting 6% of the preschool population. Measuring the outcomes of treatment is critical to providing effective and efficient therapy for these children. The FOCUS is an outcome tool designed to measure the changes in communication and participation skills of preschool children following speech and language therapy. It was designed to identify changes in speech, communication, and real world changes associated with speech therapy.

Methods: Data was collected from a convenience sample of 43 children, aged 1.25 to 4.83 (Mean = 2.7) at Holland Bloorview Kids Rehabilitation Hospital, KidsAbility and Alberta Health Services. Parents of each child completed the FOCUS and ASQ-SE at three times: 1) assessment 2) start of treatment 3) end of treatment. On average, there were 36 days in between times 1) and 2) and 107 days in between times 2) and 3). Intervention was provided between times 2) and 3). The average amount of treatment given to each child was 9.7 hours.

The ASQ-SE is a screening instrument designed to examine the social and emotional competence of children aged 6-60 months. The ASQ-SE addresses seven behavioral areas. The seven areas are communication, adaptive functioning, compliance, affect, interaction with others, autonomy and self-regulation. Pearson correlation coefficients were calculated between FOCUS and ASQ-SE domain scores.

Results: The FOCUS scores significantly improved from the start to the end of treatment (p < .05). In contrast, there was no significant improvement in FOCUS scores during the wait list interval. Scores on the communication domain of the ASQ-SE, also improved over time with more change happening once intervention had commenced. As predicted there was a moderate correlation between the FOCUS and scores from the communication domain of the ASQ-SE (p < .01). There was no significant correlation between FOCUS scores and the scores from the ASQ-SE non-related domains. These domains did not show any significant change over time.

Conclusion: The FOCUS is able to measure changes in communication skills after 9 hours of speech-language therapy. The predicted relationships with the ASQ-SE were confirmed, indicating strong construct validity.