Development of the Communication Complexity Scale

Brady, Nancy C.; Fleming, Kandace; Thiemann-Bourque, Kathy; Olswang, Lesley B.; Dowden, Patricia; Saunders, Muriel D.; Marquis, Janet

doi:10.1044/1058-0360(2011/10-0099)

Cited by 90 publications

(108 citation statements)

References 41 publications

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“…Two individuals (17 and 18) could not overcome an open mouth posture at rest to round the lips. Tongue protrusion, elevation, and lateral movement were also impaired, with 6 (8, 9, 11, 15, 16, 18) unable to elevate the tongue and 3 (16,17,18) showing involuntary tongue movement.…”

Section: Resultsmentioning

confidence: 99%

“…Saliva control management included medication in 3 (3,5,18) and salivary duct surgery in 1 that was not beneficial (18). Mild dysphagia was reported in 5/20 individuals, including 1 with a VNS (17). Three had percutaneous endoscopic gastrostomy for nutrition (3,4,11 …”

Section: Resultsmentioning

confidence: 99%

“…Two (2, 4) had symbolic communication (CCS score 10), using single words recognized by an unfamiliar observer. In the V group, conversational speech intelligibility was severely impaired in 3 (16,18,19), moderately impaired in 4 (11,13,15,17), mildly reduced in 5 (8,9,10,12,14), and normal in 1 (20). All had inadequate breath support for speech.…”

Section: Cognitionmentioning

confidence: 99%

“…Clinical observation and attempt of formal cognitive assessment with Wechsler Abbreviated Scale of Intelligence, 2nd edition, 25 or Wechsler Intelligence Scale for Children, 4th edition, Australian Standardized Edition, 26 and Vineland Adaptive Behaviour Scales, 2nd edition, 27 for estimation of intellectual disability range Bayley Scales of Infant and Toddler Development, 3rd edition, 28 or Wechsler Abbreviated Scale of Intelligence, 2nd edition, 25 and Vineland Adaptive Behaviour Scales, 2nd edition, 27 for estimation of intellectual disability range Table 2 Patient details and results of oral motor and language assessment (n 5 20) (6,7,20) showed no oral motor impairment; 2 were unable to finish the assessment due to fatigue (17) and a seizure during testing (11 communicative behavior (Complexity of Communication Scale [CCS] score 7b) such as eye contact, gesture, vocalization (1, 5), or using an adult's hand as a tool (3) regarded as nonsymbolic communication. Two (2, 4) had symbolic communication (CCS score 10), using single words recognized by an unfamiliar observer.…”

Section: Cognitionmentioning

confidence: 99%

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Dysarthria and broader motor speech deficits in Dravet syndrome

et al. 2017

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Objective: To analyze the oral motor, speech, and language phenotype in 20 children and adults with Dravet syndrome (DS) associated with mutations in SCN1A.Methods: Fifteen verbal and 5 minimally verbal DS patients with SCN1A mutations (aged 15 months-28 years) underwent a tailored assessment battery.Results: Speech was characterized by imprecise articulation, abnormal nasal resonance, voice, and pitch, and prosody errors. Half of verbal patients had moderate to severely impaired conversational speech intelligibility. Oral motor impairment, motor planning/programming difficulties, and poor postural control were typical. Nonverbal individuals had intentional communication. Cognitive skills varied markedly, with intellectual functioning ranging from the low average range to severe intellectual disability. Language impairment was congruent with cognition. Conclusions:We describe a distinctive speech, language, and oral motor phenotype in children and adults with DS associated with mutations in SCN1A. Recognizing this phenotype will guide therapeutic intervention in patients with DS. Dravet syndrome (DS) is an infantile-onset developmental epileptic encephalopathy with poor outcome. Typically, a 6-month-old infant presents with febrile hemiclonic status epilepticus in the setting of reputedly normal development, and then develops multiple seizure types over the next 4 years, with developmental slowing from 1-2 years of age.1 More than 80% of cases have mutations of the sodium channel gene SCN1A. Intellectual disability (ID) is usual, with almost all patients having severe ID.Speech and language function in adults and children with DS has not been specifically characterized. Three pediatric studies have examined language (understanding and use of words) in the context of a broader neuropsychological battery and include SCN1A positive and negative cases.2-4 The results are varied, ranging from cohorts with severe ID and severe language impairment to others with mild to moderate ID and borderline to average naming and comprehension.In terms of speech (how speech sounds are produced or articulated), dysarthria and speech planning difficulties have been reported anecdotally.2,4-6 Oral motor skills have not been investigated.We aimed to determine whether there was a characteristic developmental speech, language, and oral motor phenotype in children and adults with DS associated with mutations in SCN1A. Recognition of progressive patterns of dysfunction will inform diagnosis and guide therapeutic intervention.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Cognitionmentioning

confidence: 99%

Section: Cognitionmentioning

confidence: 99%

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Dysarthria and broader motor speech deficits in Dravet syndrome

et al. 2017

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“…Fortunately, Brady et al (2012) developed the Communication Complexity Scale (CCS) to describe more objectively emergent communicative behaviors along a continuum. The CCS consists of a 12-point scale used to describe behaviors ranging from bodily reactions (a rating of 1) to twoword constructions (a rating of 12).…”

Section: Reducing Informant/observer Subjectivity/variancementioning

confidence: 99%

Nonstandardized Evaluation of Emergent Communication in Individuals with Severe Intellectual Disabilities: Exploring Existing Options and Proposing Innovations

Ogletree

Price

2017

Adv Neurodev Disord

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Procedures to evaluate the communication of individuals with severe intellectual disabilities have grown to include myriad nonstandardized tests and procedures. This article examines the utility of existing nonstandardized assessment methods for generating representative and reliable findings for individuals with severe disabilities limited to nonsymbolic or emergent symbolic communicative abilities. Specifically, the use of informants, observations, and structured sampling are explored as to their strengths and limitations as assessment tools. Strategies for improving these methods are provided including preassessment planning, efforts to minimize observer subjectivity, and informant/observer training. Potential new directions for nonstandardized communication evaluation with this special population including applications of eye gaze and digital recording technology are also proposed.

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Assessing the Minimally Verbal School‐Aged Child With Autism Spectrum Disorder

et al. 2013

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This paper addresses the issue of assessing communication, language, and associated cognitive and behavioral abilities of minimally verbal children with Autism Spectrum Disorder (ASD), presenting a summary of a year-long series of meetings held by a group of experts in the field of ASD and NIH staff. In this paper, our goals were to first define the population and then present general guidelines for optimizing assessment sessions for this challenging population. We then summarize the available measures that can be used across a variety of behavioral domains that are most directly relevant to developing language skills, including: oral motor skills, vocal repertoire, receptive and expressive language, imitation, intentional communication, play, social behavior, repetitive and sensory behaviors, special interests, atypical behavior and nonverbal cognition. We conclude with a discussion of some of the limitations in the available measures and highlight recommendations for future research in this area.

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Development of the Communication Complexity Scale

Cited by 90 publications

References 41 publications

Dysarthria and broader motor speech deficits in Dravet syndrome

Dysarthria and broader motor speech deficits in Dravet syndrome

Nonstandardized Evaluation of Emergent Communication in Individuals with Severe Intellectual Disabilities: Exploring Existing Options and Proposing Innovations

Assessing the Minimally Verbal School‐Aged Child With Autism Spectrum Disorder

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