Document Type : original article
Authors
1 Speech Therapist (MSc.), Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Assistant Professor of Child & Adolescent Psychiatry, Behavioural Sciences Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Lecturer, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Abstract
Background: This study examined the diagnostic accuracy of the children's communication checklist-Persian version (CCC-Persian) in differentiating children with autism spectrum disorders (ASD) from typically developing (TD) children.
Methods: The parents of 47 children with ASD and the parents of 104 TD children completed the CCC-Persian. The children were monolingual Persian-speakers between 5 and 11 years of age. The sensitivity, specificity, likelihood ratios, and cut-off score of the CCC-Persian were calculated in identifying children with ASD.
Results: The mean pragmatic composite score (PCS) of the CCC-Persian was significantly lower in children with ASD than in the TD children (P>0.05). Corresponding cut-off score, sensitivity, and specificity were 107, 86%, and 97%, respectively. The positive and negative likelihood ratios were obtained as about 30 and 0.14, respectively.
Conclusion: The CCC-Persian has the potential to be used as a valid clinical tool for diagnosing pragmatic language impairment or screening ASD in Persian-speaking children.
Keywords
- Prutting CA, Kittchner DM. A clinical appraisal of the pragmatic aspects of language. J Speech Hear Disord. 1987; 52(2):105-19.
- Pritzker E. Pragmatic language and behavioral and emotional functioning-a systematic review: Implications for research and interprofessional practice: James Madison University; 2020.
- Cummings L. Research in clinical pragmatics: Springer; 2017.
- Blain-Brière B, Bouchard C, Bigras N. The role of executive functions in the pragmatic skills of children aged 4–5. Front Psychol. 2014; 5:240.
- Ketelaars MP, Cuperus JM, van Daal J, Jansonius K, Verhoeven L. Screening for pragmatic language impairment: The potential of the children's communication checklist. Res Dev Disabil. 2009; 30(5):952-60.
- Kotila A, Hyvärinen A, Mäkinen L, Leinonen E, Hurtig T, Ebeling H, et al. Processing of pragmatic communication in ASD: a video-based brain imaging study. Sci Rep. 2020; 10(1):1-10.
- Bignell S, Cain K. Pragmatic aspects of communication and language comprehension in groups of children differentiated by teacher ratings of inattention and hyperactivity. Br J Dev Psychol. 2007; 25(4):499-512.
- Barahimi M, Kazemi Y, Nakhshab M. Effectiveness of Intervention Focused on Pragmatics. J Res Rehabil Sci. 2017; 12(4):200-9.
- Leonard MA, Milich R, Lorch EP. The role of pragmatic language use in mediating the relation between hyperactivity and inattention and social skills problems. J Speech Lang Hear Res. 2011; 54(2), 567-579.
- Turkstra LS, Clark A, Burgess S, Hengst JA, Wertheimer JC, Paul D. Pragmatic communication abilities in children and adults: Implications for rehabilitation professionals. Disabil Rehabil. 2017; 39(18):1872-85.
- Carrow-Woolfolk E. CASL: Comprehensive assessment of spoken language: American Guidance Services; 1999.
- Phelps-Terasaki D, Phelps-Gunn T. TOPL-2: Test of Pragmatic Language: Pro-Ed Austin, TX; 2007.
- Bishop DV. Development of the Children's Communication Checklist (CCC): A method for assessing qualitative aspects of communicative impairment in children. J Child Psychol Psychiatry. 1998; 39(6):879-91.
- Cummings L. The Routledge pragmatics encyclopedia: Routledge; 2010.
- Volden J, Phillips L. Measuring pragmatic language in speakers with autism spectrum disorders: Comparing the Children’s Communication Checklist—2 and the Test of Pragmatic Language. Am J Speech Lang Pathol. 2010; 19(3), 204-212.
- Deckers A, Muris P, Roelofs J. Screening for autism spectrum disorder with the Achenbach System of Empirically Based Assessment scales. J Psychopathol Behav Assess. 2020; 42(1):25-37.
- Charman T, Baird G, Simonoff E, Loucas T, Chandler S, Meldrum D, et al. Efficacy of three screening instruments in the identification of autistic-spectrum disorders. Br J Psychiatry. 2007; 191(6):554-9.
- Bishop DV. The Children's communication checklist: Psychological Corporation London; 2003.
- Bishop DV, Baird G. Parent and teacher report on pragmatic aspects of communication: use of the Children's Communication Checklist in a clinical setting. Dev Med Child Neurol. 2001; 43(12):809-18.
- Geurts HM, Verté S, Oosterlaan J, Roeyers H, Hartman CA, Mulder EJ, et al. Can the Children's Communication Checklist differentiate between children with autism, children with ADHD, and normal controls? J Child Psychol Psychiatry. 2004; 45(8):1437-53.
- Geurts HM, Hartman C, Verté S, Oosterlaan J, Roeyers H, Sergeant JA. Pragmatics fragmented: the factor structure of the Dutch Children's Communication Checklist (CCC). Inter J Lang Commun Disord. 2009; 44(5):549-74.
- Andersen Helland W, Heimann M. Assessment of pragmatic language impairment in children referred to psychiatric services: A pilot study of the Children's Communication Checklist in a Norwegian sample. Logop Phoniatr Vocology. 2007; 32(1):23-30.
- Crespo-Eguilaz N, Magallon S, Sanchez-Carpintero R, Narbona J. The Spanish adapted version of the Children's Communication Checklist identifies disorders of pragmatic use of language and differentiates between clinical subtypes. Rev Neurol. 2016; 62:S49-57.
- Yliherva A, Loukusa S, Väisänen R, Pyper A, Moilanen I. Development of communication skills in Finnish pre-school children examined by the Children's Communication Checklist (CCC). Child Lang Teach Ther. 2009; 25(2):235-49.
- Chuthapisith J, Taycharpipranai P, Roongpraiwan R, Ruangdaraganon N. Translation and validation of the Children's Communication Checklist to evaluate pragmatic language impairment in Thai children. Pediatr Int. 2014; 56(1):31-4.
- Asghari, N., Kazemi, Y., Gholami Tehrani, L., Asleshirin, E. (2015). Content Validity of Persian version of Children's Communication Checklist for Iranian four to six year-old children. J Speech Lang Commun Disord, 4(1), 9-14. (In Persian).
- Kazemi Y, Afsharian E, Mirzaei B, Baghbani M, Sademinejad M, Gheleyempour L. Children's communication checklist: The study of persian children. Iran J Res Rehabil Sci. 2007; 2(3):1-5.
- Helland WA, Helland T, Heimann M. Language profiles and mental health problems in children with specific language impairment and children with ADHD. J Atten Disord. 2014; 18(3):226-35.
- Jarollahi F, Mohamadi R, Modarresi Y, Agharasouli Z, Rahimzadeh S, Ahmadi T, et al. Story retelling skills in Persian speaking hearing-impaired children. Int J Pediatr Otorhinolaryngol. 2017; 96:84-8.
- Mehri A, Nili-Pour R. Comparison of pragmatic competence and performance in two groups of deaf and normal students. Arch Rehabil. 2006; 7(3):0-.
- Mosavi N, Shirazi T, Darouie A. Danaye Tousi M, Pourshahbaz A, Rahgozar M. A study on some pragmatic skills of Persian 4-6 years old hardly hearing children and their normal hearing peers. J Rehabil. 2009; 10(3):60-5.
- Keyhani MR, Agharasuli Z, Modarresi Y, Nakhshab M. Conversational repair strategies in normal children. J Res Rehabil Sci. 2010; 6(1).
- Koohestani F, Rezaei P, Nakhshab M. Developing a Persian Version of the Checklist of Pragmatic Behaviors and Assessing Its Psychometric Properties: A Preliminary Study. Arch Rehabil. 2020; 21(3):358-75.
- Ajalloueyan M, Aghaz A, Mirdeharbab A, Hasanalifard M, Saeedi M. Long-Term Effects of Cochlear Implant on the Pragmatic Skills and Speech Intelligibility in Persian-Speaking Children. Int J Pediatr. 2021; 9(7):14033-41.
- Mahmoodi F, Zarifiyan T, Kazemi Y, Sima ST. Cultural adaptation and validation of the Persian version of the children's communication checklist-(CCC-2). 2014.
- Sackett DL, Haynes RB. The architecture of diagnostic research. BMJ. 2002; 324(7336):539-41.
- Verté S, Geurts HM, Roeyers H, Rosseel Y, Oosterlaan J, Sergeant JA. Can the Children's Communication Checklist differentiate autism spectrum subtypes? Autism. 2006; 10(3):266-87.
- Ahmadi S, Hemmatian S, Khalili Z. Investigation of the psychometric features of the GARS (Persion). Res Cog Behav J. 2011; 1:87-104.
- Samadi SA, McConkey R. The utility of the Gilliam autism rating scale for identifying Iranian children with autism. Disabil Rehabil. 2014; 36(6):452-6.
- Samadi SA, McConkey R. Screening for autism in Iranian preschoolers: Contrasting M-CHAT and a scale developed in Iran. J Autism Dev Disord. 2015; 45(9):2908-16.
- Yousefi N, Dadgar H, Mohammadi MR, Jalilevand N, Keyhani MR, Mehri A. The validity and reliability of the Autism Behavior Checklist in Iran. Iran J Psychiatry. 2015; 10(3):144.
- Zarafshan H, Mohammadian M, Mohammadi MR, Karimi I. Psychometric Properties of Short Version of Qualitative Checklist for Autism in Toddlers in a Sample of Iranian Toddlers: A Brief Report. Avicenna J Neuro Psycho Physiol. 2019; 6(2):53-6.
- Rutjes A, Reitsma J, Coomarasamy A, Khan K, Bossuyt P. Evaluation of diagnostic tests when there is no gold standard. A review of methods. Health Technol Assess. 2007; 11(50):1-4.
- Sugarman J, Mastroianni AC, Kahn JP. Ethics of research with human subjects: Selected policies and resources. 1998.
- Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979; 86(2):420.
- Peña ED, Bedore LM, Kester ES. Discriminant accuracy of a semantics measure with Latino English-speaking, Spanish-speaking, and English–Spanish bilingual children. J Commun Disord. 2015; 53:30-41.
- Loukusa S, Mäkinen L, Kuusikko-Gauffin S, Ebeling H, Leinonen E. Assessing social-pragmatic inferencing skills in children with autism spectrum disorder. J Commun Disord. 2018; 73:91-105.
- Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al. The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med. 2003; 138(1):W1-12.
- Cohen J. Statistical power analysis for the behavioral sciences, xxi. Hillsdale, NJ: L Erlbaum Associates. 1998.
- Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003; 56(11):1129-35.
- Yuan H, Dollaghan C. Measuring the diagnostic features of social (pragmatic) communication disorder: An exploratory study. Am J Speech Lang Pathol. 2018; 27(2):647-56.