Procedures to Assess Focus for the Capability-focus Treatment Framework

Background This technical report summarizes findings from a series of studies to measure focus, one of the two clinical constructs in the capability-focus treatment framework described in Kwiatkowski and Shriberg (in submission). Rationale and conceptual background for the capability-focus treatment framework (henceforth, the C-F framework) is reviewed elsewhere In this report we provide (a) complete procedures for the Focus Task, the Focus Rating System, and the Focus Scoring System (see appendices), (b) validity information for the focus construct and the Focus Scoring System, and (c) reliability information for the Focus Scoring System. Support for the predictive validity of the C-F framework is presented in Kwiatkowski and Shriberg (in submission). Readers interested in continued development of the C-F framework, including a project using structural equation modeling of capability and focus as latent traits, should contact the authors. Overview The Focus Rating System and the Focus Scoring System are ways to quantify a child’s perceived focus during a five-condition, extended stimulability protocol termed the Focus Task. The Focus Rating System, which requires clinicians to judge whether or not a child is focused during a specified segment of time, yields interval data on the proportion of time a child was perceived as focused. It was the first instrument developed to quantify clinicians’ subjective judgments of a child’s focus. The Focus Scoring System, which codes a child’s postural, verbal, and facial behaviors during the Focus Task, yields an interval-level focus 3 score. Each of these systems can be used to judge focus during the Focus Task or during ongoing treatment. For retrospective or prospective studies using only case records data, clinician logs have been used as the source to code a child’s focus status during each treatment session. The data of interest are the strategies used to facilitate the child’s learning and to manipulate effort and motivation for speech change. Children who made progress in treatment structures comparable to conditions V or IV on the Focus Task (see below) were classified as having high focus. Children whose logs indicated the need for structures comparable to conditions III, II, or I on the Focus Task were classified as having low focus. The following section describes the sequence of procedures used to obtain focus information from the Focus Task, using either the Focus Rating System or the Focus Scoring System. Included is information on changes to the procedures which were made after several pilot and development …