title: Developing and validating the Communication Function Classification System for individuals with cerebral palsy.
abstract: OBJECTIVE
  The purpose of this study was to create and validate the Communication Function Classification System (CFCS) for children with cerebral palsy (CP), for use by a wide variety of individuals who are interested in CP. This paper reports the content validity, interrater reliability, and test-retest reliability of the CFCS for children with CP.
  
  
  METHODS
  An 11-member development team created comprehensive descriptions of the CFCS levels, and four nominal groups comprising 27 participants critiqued these levels. Within a Delphi survey, 112 participants commented on the clarity and usefulness of the CFCS. Interrater reliability was completed by 61 professionals and 68 parents/relatives who classified 69 children with CP aged 2 to 18 years. Test-retest reliability was completed by 48 professionals who allowed at least 2 weeks between classifications. The participants who assessed the CFCS were all relevant stakeholders: adults with CP, parents of children with CP, educators, occupational therapists, physical therapists, physicians, and speech-language pathologists.
  
  
  RESULTS
  The interrater reliability of the CFCS was 0.66 between two professionals and 0.49 between a parent and a professional. Professional interrater reliability improved to 0.77 for classification of children older than 4 years. The test-retest reliability was 0.82.
  
  
  CONCLUSIONS
  The CFCS demonstrates content validity and shows very good test-retest reliability, good professional interrater reliability, and moderate parent-professional interrater reliability. Combining the CFCS with the Gross Motor Function Classification System and the Manual Ability Classification System contributes to a functional performance view of daily life for individuals with CP, in accordance with the World Health Organization's International Classification of Functioning, Disability and Health.
authors.affiliation: Department of Speech-Language Pathology, University of Central Arkansas, Conway, AR 72035-0001, USA. mjchidecker@uca.edu
authors.forename: Mary Jo Cooley
authors.initials: MJ
authors.lastname: Hidecker
authors.forename: Nigel
authors.initials: N
authors.lastname: Paneth
authors.forename: Peter L
authors.initials: PL
authors.lastname: Rosenbaum
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Kent
authors.forename: Janet
authors.initials: J
authors.lastname: Lillie
authors.forename: John B
authors.initials: JB
authors.lastname: Eulenberg
authors.forename: Ken
authors.initials: K
authors.lastname: Chester
authors.forename: Brenda
authors.initials: B
authors.lastname: Johnson
authors.forename: Lauren
authors.initials: L
authors.lastname: Michalsen
authors.forename: Morgan
authors.initials: M
authors.lastname: Evatt
authors.forename: Kara
authors.initials: K
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000145:classification / Q000150:complications / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003147:Communication Disorders / Q000175:diagnosis* / Q000209:etiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D010287:Parent-Child Relations; D011597:Psychomotor Performance / Q000502:physiology; D015203:Reproducibility of Results