title: The Communication Attitude Test (CAT-S): normative values for 220 Swedish children.
abstract: BACKGROUND
  The risk of developing a negative attitude to communication as a consequence of having a speech disorder has been in focus for decades in research concerning fluency disorders in relation to both children and adults. The Communication Attitude Test (CAT), which was created to measure children's attitudes towards their own communication, has been widely used. Research has shown that children who stutter have a significantly more negative attitude to their own communication than normal-speaking children and preliminary results show a similar picture in children with other types of speech disorders. However, the setting for obtaining data on normal-speaking children often differs from that on children with speech disorders. In order to make a significant interpretation of results from children with a speech disorder, comparable data on normal-speaking children are needed.
  
  
  OBJECTIVE
  The main purpose of this study was to obtain norm values for the Swedish version of the test (CAT-S) and examine possible differences related to age, sex or small town/big city. A second aim was to investigate some aspects of reliability, such as internal consistency, and validity in terms of item analysis as well as a qualitative analysis of the answers to the different items. In addition, group setting was compared with individual setting for the test procedure.
  
  
  METHODS
  CAT-S was completed in a group setting by 220 normal-speaking children aged 7-15 years and by an additional group of 35 normal-speaking 10-year-old children who completed the test individually.
  
  
  RESULTS
  The 220 Swedish children had a mean score of 6.05 (a slightly higher mean score have been found in other countries, i.e. Belgium = 7.05 and USA = 8.24). The 7-year-olds had a significantly higher mean score than children at the other ages, except for the 15-year-olds. No other differences were found related to age, sex or size of community. The aspects of reliability and validity investigated for the CAT-S were satisfactory. Furthermore, there was no significant difference between the groups of 10-year-olds objected to different test procedures.
  
  
  CONCLUSIONS
  The norm values of CAT-S could be used for comparison of scores from Swedish children with speech disorders. The CAT-S is easy to administer and could be used either in a group setting for research purpose or individually at the clinic.
authors.affiliation: Institute of Neuroscience and Physiology/Speech and Language Pathology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. tove.johannisson@neuro.gu.se
authors.forename: Tove B
authors.initials: TB
authors.lastname: Johannisson
authors.forename: Susanna
authors.initials: S
authors.lastname: Wennerfeldt
authors.forename: Christina
authors.initials: C
authors.lastname: Havstam
authors.forename: Maria
authors.initials: M
authors.lastname: Naeslund
authors.forename: Kajsa
authors.initials: K
authors.lastname: Jacobson
authors.forename: Anette
authors.initials: A
authors.lastname: Lohmander
mesh_terms: D000293:Adolescent; D000375:Aging; D001290:Attitude; D001530:Belgium; D002648:Child; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D011581:Psychological Tests; D012016:Reference Values; D015203:Reproducibility of Results; D012727:Sex Characteristics; D013064:Speech Disorders / Q000175:diagnosis / Q000523:psychology; D013548:Sweden; D014481:United States