Purpose The purpose of this study was to calibrate the items for the Communicative Participation Item Bank (CPIB) using Item Response Theory (IRT). One overriding objective was to examine if the IRT item parameters would be consistent across different diagnostic groups, thereby allowing creation of a disorder-generic instrument. The intended outcomes were the final item bank and a short form ready for clinical and research applications. Methods Self-report data were collected from 701 individuals representing four diagnoses: multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis and head and neck cancer. Participants completed the CPIB and additional self-report questionnaires. CPIB data were analyzed using the IRT Graded Response Model (GRM). Results The initial set of 94 candidate CPIB items were reduced to an item bank of 46 items demonstrating unidimensionality, local independence, good item fit, and good measurement precision. Differential item function (DIF) analyses detected no meaningful differences across diagnostic groups. A 10-item, disorder-generic short form was generated. Conclusions The CPIB provides speech-language pathologists with a unidimensional, self-report outcomes measurement instrument dedicated to the construct of communicative participation. This instrument may be useful to clinicians and researchers wanting to implement measures of communicative participation in their work.

A systematic review of studies that focused on the executive functions of problem solving, planning, organising and multitasking by adults with traumatic brain injury (TBI) was performed through 2004. Qualitative and quantitative methods were used to evaluate the 15 studies that met inclusion criteria. Demographic variables, design and intervention features, and impairment and activity/participation outcomes (ICF) (World Health Organization, 2001) were documented. Five randomised control treatment (RCT) studies used step-by-step, metacognitive strategy instruction (MSI) and outcomes were evaluated in a meta-analysis. Effect sizes (ESs) from immediate impairment outcomes after MSI and "control" intervention were similar to each other, and both were significantly larger than chance. ESs from immediate activity/participation outcomes after MSI were significantly larger than the ESs from control intervention, and both were significantly larger than chance. These results, along with positive outcomes from the other group, single-subject design and single case studies, provided sufficient evidence to make the clinical recommendation that MSI should be used with young to middle-aged adults with TBI, when improvement in everyday, functional problems is the goal (Level A) (American Academy of Neurology, 2004). Although maintenance effects were generally positive, there was insufficient data quantitatively to evaluate this. Furthermore, there was insufficient evidence to make clinical recommendations for children or older adults. Intervention that trained verbal reasoning and multi-tasking was promising, although the evidence is insufficient to make clinical recommendations at this time. Additional research needs were highlighted.

Falls are common and may be associated with significant health care costs. Most importantly, health care providers may be missing many opportunities to provide fall prevention information to older people.

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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...