A Qualitative Study of Interference With Communicative Participation Across Communication Disorders in Adults

Abstract

Purpose To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Methods Interviews were conducted with 44 adults representing seven different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering, Parkinson’s disease, amyotrophic lateral sclerosis, and laryngectomy. This paper represents a secondary analysis of qualitative data collected in cognitive interviews during development of the Communicative Participation Item Bank. The data were analyzed to identify themes in participants’ experiences related to communicative participation. Results Participants described many situations in which they experienced interference in communicative participation. Two themes emerged from the data. The first theme was Interference is both “functional” and “emotional” in which participants defined interference as limitations in accomplishing tasks and emotional consequences. The second theme was “It depends” - Sources of interference in which participants described many variables that contribute to interference in participation. Participants had limited control of some variables such as symptoms and environmental contexts, but personal decisions and priorities also influenced participation. Conclusions Despite different impairments and activity limitations, participants described similar communicative participation restrictions. These similarities may have theoretical and clinical implications in terms of how we assess, treat and study the participation restrictions associated with communication disorders.

Guidelines for Adult Stroke Rehabilitation and Recovery

“…534 Addressing environmental factors during rehabilitation is consistent with the ICF and warrants consideration. [535][536][537] For individuals with motor speech disorders, this may include providing education that addresses the knowledge and attitudes of communication partners or modifying the characteristics of the physical environment such as reducing noise levels. [535][536][537] Telerehabilitation may be used to overcome barriers of access to services.…”

Exploring the Relevance of Items in the Communicative Participation Item Bank (CPIB) for Individuals With Hearing Loss

“…This would essentially create a new instrument that would be different in content than the existing CPIB, and direct comparison across communication disorders would not be feasible using the CPIB. Regardless of what quantitative data emerge regarding the measurement properties of the CPIB items in future research, from a descriptive perspective there were strong similarities between the individuals with hearing loss in this study and participants with speech and language impairments in prior studies (Baylor et al, 2011;Garcia, Laroche, & Barrette, 2002) with regards to the types of situations described as being difficult for communication. Participants from these different studies representing different communication disorders shared similarly restricted participation in a variety of environments, including noisy settings, group conversations, fast-paced situations, and the telephone and similar situations in which face-to-face communication is not possible.…”

“…These diagnostic groups included Parkinson's disease, stroke, multiple sclerosis, head and neck cancer, amyotrophic lateral sclerosis, and spasmodic dysphonia (Baylor et al, 2011;Yorkston et al, 2008). Although several participants included in these prior studies did have hearing loss in addition to a speech or language disorder, the primary focus in these prior interviews was the impact of the speech or language impairment on communicative participation.…”

“…Cognitive interviews explore not only the item stems but also structural aspects of the items, such as the response options, providing opportunities to observe if respondents interpret the response options as intended by the developers, if respondents find the range of response options applicable to reflect the range of their experiences, and if respondents feel that their perspectives are reflected in the response options provided. Through these cognitive interviewing methods, instrument developers are able to improve the likelihood that the items indeed target the construct of interest and will be received as relevant, accessible, and acceptable to the target population.The CPIB underwent prior cognitive interviewing examination with 44 individuals representing different populations of speech and language disorders (Baylor, Burns, Eadie, Britton, & Yorkston, 2011;Yorkston et al, 2008). These diagnostic groups included Parkinson's disease, stroke, multiple sclerosis, head and neck cancer, amyotrophic lateral sclerosis, and spasmodic dysphonia (Baylor et al, 2011;Yorkston et al, 2008).…”

“…The CPIB underwent prior cognitive interviewing examination with 44 individuals representing different populations of speech and language disorders (Baylor, Burns, Eadie, Britton, & Yorkston, 2011;Yorkston et al, 2008). These diagnostic groups included Parkinson's disease, stroke, multiple sclerosis, head and neck cancer, amyotrophic lateral sclerosis, and spasmodic dysphonia (Baylor et al, 2011;Yorkston et al, 2008).…”