Purpose-To assess the adequacy of self-report instruments in speech-language pathology for measuring a construct called communicative participation.Method-Six instruments were evaluated relative to (a) the construct measured, (b) the relevance of individual items to communicative participation, and (c) their psychometric properties.Results-No instrument exclusively measured communicative participation. Twenty-six percent (n = 34) of all items (N = 132) across the reviewed instruments were consistent with communicative participation. The majority (76%) of the 34 items were associated with general communication, while the remaining 24% of the items were associated with communication at work, during leisure, or for establishing relationships. Instruments varied relative to psychometric properties.Conclusions-No existing self-report instruments in speech-language pathology were found to be solely dedicated to measuring communicative participation. Developing an instrument for measuring communicative participation is essential for meeting the requirements of our scope of practice. WHO, 2001). The purpose of the ICF is to offer clinical providers a common language for describing human functioning and disability, as well as to provide a conceptual framework for gathering data and measuring clinical outcomes. The ICF framework also is useful for speech-language pathologists (SLPs) for describing the consequences of communication disorders at several levels, including communication in social settings. 1 NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptThe ICF defines a person's functioning and disability in relation to health condition and contextual factors. It has three levels: (a) "Body Functions and Structures," which include the physiological functions of body systems or anatomical elements such as organs, limbs, and their components; (b) "Activities," which are the execution of specific actions; and (c) "Participation," which encompasses involvement in life situations (WHO, 2001). It is well recognized that difficulties in body functions and structures ("Impairments") are the most studied outcomes in communication disorders (Eadie, 2001;Threats, 2000). Impairment measures of speech, language, voice, and fluency include measures of articulatory accuracy, grammatical complexity of language, physiological functioning of the vocal folds, and number of disfluencies, to name but a few. Although many instruments exist at the level of body functions and structures, there is a paucity of instruments as performance challenges become less "biomedical" in nature (Eadie, 2001;Simmons-Mackie, Threats, & Kagan, 2005). This is related to the nature of the problem. That is, it is easier to measure the regularity of vocal fold movement, the accuracy of naming objects, or the percentage of words understood by a listener than it is to measure an individual's ability to participate in valued activities or situations such as negotiating a medical plan with a physician, applying for a job, or persuad...

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The purpose of this study was to examine an insider’s perspective on communication in multiple sclerosis (MS), a disease of the central nervous system in which scattered lesions or plaques produce varying combinations of motor, sensory, and/or cognitive impairments. Qualitative research methods were used because they are designed to provide a systematic way of exploring complex issues, such as communication, that cannot be separated from the context in which they occur. Seven participants, all of whom had mild communication impairments, described their everyday experiences of communication and the impact of MS on these experiences. Themes derived via inductive analysis of verbatim transcripts included: watching the communication changes , it’s about participating in my life , and communicating is unpredictable . Using the World Health Organization model of disablement, the participants’ communication impairments were mild. However, participants reported major lifestyle changes characterized by important limitations in communicative participation. Whereas some of the limitations were attributed to changes in speech and language, others were thought to be the result of changes in cognition, vision, mobility, and susceptibility to fatigue. Clinical implications include the need to develop assessment protocols and outcome measures that capture issues related to communicative participation in natural contexts and participation in society.

Individuals with MS develop strategies and utilize resources in order to get the work done. Comparisons are made between existing intervention theories or programmes and the experiences described by participants in this study.