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Daniel E. Lumsden - One of the best experts on this subject based on the ideXlab platform.
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burke fahn marsden dystonia severity gross motor manual ability and Communication Function classification scales in childhood hyperkinetic movement disorders including cerebral palsy a rosetta stone study
Developmental Medicine & Child Neurology, 2016Co-Authors: Markus C. Elze, Hortensia Gimeno, Kylee Tustin, Lesley Baker, Daniel E. Lumsden, Jane L. HuttonAbstract:AIM: Hyperkinetic movement disorders (HMDs) can be assessed using impairment-based scales or Functional classifications. The Burke-Fahn-Marsden Dystonia Rating Scale-movement (BFM-M) evaluates dystonia impairment, but may not reflect Functional ability. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) are widely used in the literature on cerebral palsy to classify Functional ability, but not in childhood movement disorders. We explore the concordance of these three Functional scales in a large sample of paediatric HMDs and the impact of dystonia severity on these scales. METHOD: Children with HMDs (n=161; median age 10y 3mo, range 2y 6mo-21y) were assessed using the BFM-M, GMFCS, MACS, and CFCS from 2007 to 2013. This cross-sectional study contrasts the information provided by these scales. RESULTS: All four scales were strongly associated (all Spearman's rank correlation coefficient rs >0.72, p<0.001), with worse dystonia severity implying worse Function. Secondary dystonias had worse dystonia and less Function than primary dystonias (p<0.001). A longer proportion of life lived with dystonia is associated with more severe dystonia (rs =0.42, p<0.001). INTERPRETATION: The BFM-M is strongly linked with the GMFCS, MACS, and CFCS, irrespective of aetiology. Each scale offers interrelated but complementary information and is applicable to all aetiologies. Movement disorders including cerebral palsy can be effectively evaluated using these scales.
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pp12 1 2938 comparison of burke fahn marsden dystonia severity gross motor manual abilities and Communication Function classification scales in childhood hyperkinetic movement disorders including cerebral palsy a rosetta stone study
European Journal of Paediatric Neurology, 2015Co-Authors: Markus C. Elze, Hortensia Gimeno, Kylee Tustin, Lesley Baker, Daniel E. LumsdenAbstract:Objective The Burke-Fahn-Marsden Dystonia Rating Scale-Movement (BFM-M) evaluates dystonia impairment, but may not reflect Functional ability in paediatric movement disorders (PMD). The Gross Motor Classification System (GMFCS), Manual Ability Classification System (MACS) and Communication Function Classification System (CFCS) are widely used in the cerebral palsy (CP) literature to classify Functional ability. This study explores the concordance of the three Functional scales in a large sample of PMD and the impact of dystonia severity on these Functional scales. Methods Children with PMD (n=161, median age 10y3mo SD 4y) were assessed using the BFM-M, and classified using the 3 scales. Data analysis was performed using the R language and environment for statistical computing, version 3.01 RDev. Overall relationships between BFM-M and categorical variables were evaluated with the Kruskal-Wallis Rank Sum Test and the proportion variation explained (R b ). Relationships between two categorical variables were assessed using Pearson's chi-squared test and Pearson residuals. Spearman correlations (rs) were also provided as an estimate of the strength of the association between variables. The information provided by these scales is compared. Results Of the 161 children included, secondary dystonias (n=125, 78%) included those of both static (n=99, 61%), including dystonic/dyskinetic CP (n=75, 47%), and progressive (n=26, 16%) dystonia. All four scales were strongly associated (all rS>0.72, p Conclusion The BFM-M is strongly linked with the GMFCS, MACS and CFCS, irrespective of aetiology. PMD other than CP could be effectively evaluated using these scales. The ability of the BFM-M scale to discriminate between GMFCS levels in this sample offers the possibility to compare samples across different studies. However, the similarity between MACS I-III in terms of BFM-M scores indicates that non-motor components such as process skills and planning are required for Functional activities and cannot be explained by dystonia alone.
Hortensia Gimeno - One of the best experts on this subject based on the ideXlab platform.
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burke fahn marsden dystonia severity gross motor manual ability and Communication Function classification scales in childhood hyperkinetic movement disorders including cerebral palsy a rosetta stone study
Developmental Medicine & Child Neurology, 2016Co-Authors: Markus C. Elze, Hortensia Gimeno, Kylee Tustin, Lesley Baker, Daniel E. Lumsden, Jane L. HuttonAbstract:AIM: Hyperkinetic movement disorders (HMDs) can be assessed using impairment-based scales or Functional classifications. The Burke-Fahn-Marsden Dystonia Rating Scale-movement (BFM-M) evaluates dystonia impairment, but may not reflect Functional ability. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) are widely used in the literature on cerebral palsy to classify Functional ability, but not in childhood movement disorders. We explore the concordance of these three Functional scales in a large sample of paediatric HMDs and the impact of dystonia severity on these scales. METHOD: Children with HMDs (n=161; median age 10y 3mo, range 2y 6mo-21y) were assessed using the BFM-M, GMFCS, MACS, and CFCS from 2007 to 2013. This cross-sectional study contrasts the information provided by these scales. RESULTS: All four scales were strongly associated (all Spearman's rank correlation coefficient rs >0.72, p<0.001), with worse dystonia severity implying worse Function. Secondary dystonias had worse dystonia and less Function than primary dystonias (p<0.001). A longer proportion of life lived with dystonia is associated with more severe dystonia (rs =0.42, p<0.001). INTERPRETATION: The BFM-M is strongly linked with the GMFCS, MACS, and CFCS, irrespective of aetiology. Each scale offers interrelated but complementary information and is applicable to all aetiologies. Movement disorders including cerebral palsy can be effectively evaluated using these scales.
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pp12 1 2938 comparison of burke fahn marsden dystonia severity gross motor manual abilities and Communication Function classification scales in childhood hyperkinetic movement disorders including cerebral palsy a rosetta stone study
European Journal of Paediatric Neurology, 2015Co-Authors: Markus C. Elze, Hortensia Gimeno, Kylee Tustin, Lesley Baker, Daniel E. LumsdenAbstract:Objective The Burke-Fahn-Marsden Dystonia Rating Scale-Movement (BFM-M) evaluates dystonia impairment, but may not reflect Functional ability in paediatric movement disorders (PMD). The Gross Motor Classification System (GMFCS), Manual Ability Classification System (MACS) and Communication Function Classification System (CFCS) are widely used in the cerebral palsy (CP) literature to classify Functional ability. This study explores the concordance of the three Functional scales in a large sample of PMD and the impact of dystonia severity on these Functional scales. Methods Children with PMD (n=161, median age 10y3mo SD 4y) were assessed using the BFM-M, and classified using the 3 scales. Data analysis was performed using the R language and environment for statistical computing, version 3.01 RDev. Overall relationships between BFM-M and categorical variables were evaluated with the Kruskal-Wallis Rank Sum Test and the proportion variation explained (R b ). Relationships between two categorical variables were assessed using Pearson's chi-squared test and Pearson residuals. Spearman correlations (rs) were also provided as an estimate of the strength of the association between variables. The information provided by these scales is compared. Results Of the 161 children included, secondary dystonias (n=125, 78%) included those of both static (n=99, 61%), including dystonic/dyskinetic CP (n=75, 47%), and progressive (n=26, 16%) dystonia. All four scales were strongly associated (all rS>0.72, p Conclusion The BFM-M is strongly linked with the GMFCS, MACS and CFCS, irrespective of aetiology. PMD other than CP could be effectively evaluated using these scales. The ability of the BFM-M scale to discriminate between GMFCS levels in this sample offers the possibility to compare samples across different studies. However, the similarity between MACS I-III in terms of BFM-M scores indicates that non-motor components such as process skills and planning are required for Functional activities and cannot be explained by dystonia alone.
Jane L. Hutton - One of the best experts on this subject based on the ideXlab platform.
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burke fahn marsden dystonia severity gross motor manual ability and Communication Function classification scales in childhood hyperkinetic movement disorders including cerebral palsy a rosetta stone study
Developmental Medicine & Child Neurology, 2016Co-Authors: Markus C. Elze, Hortensia Gimeno, Kylee Tustin, Lesley Baker, Daniel E. Lumsden, Jane L. HuttonAbstract:AIM: Hyperkinetic movement disorders (HMDs) can be assessed using impairment-based scales or Functional classifications. The Burke-Fahn-Marsden Dystonia Rating Scale-movement (BFM-M) evaluates dystonia impairment, but may not reflect Functional ability. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) are widely used in the literature on cerebral palsy to classify Functional ability, but not in childhood movement disorders. We explore the concordance of these three Functional scales in a large sample of paediatric HMDs and the impact of dystonia severity on these scales. METHOD: Children with HMDs (n=161; median age 10y 3mo, range 2y 6mo-21y) were assessed using the BFM-M, GMFCS, MACS, and CFCS from 2007 to 2013. This cross-sectional study contrasts the information provided by these scales. RESULTS: All four scales were strongly associated (all Spearman's rank correlation coefficient rs >0.72, p<0.001), with worse dystonia severity implying worse Function. Secondary dystonias had worse dystonia and less Function than primary dystonias (p<0.001). A longer proportion of life lived with dystonia is associated with more severe dystonia (rs =0.42, p<0.001). INTERPRETATION: The BFM-M is strongly linked with the GMFCS, MACS, and CFCS, irrespective of aetiology. Each scale offers interrelated but complementary information and is applicable to all aetiologies. Movement disorders including cerebral palsy can be effectively evaluated using these scales.
Mary Jo Cooley Hidecker - One of the best experts on this subject based on the ideXlab platform.
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validity of the Communication Function classification system for use with preschool children with Communication disorders
Developmental Medicine & Child Neurology, 2017Co-Authors: Barbara Jane Cunningham, Peter Rosenbaum, Mary Jo Cooley Hidecker, Nancy Thomasstonell, Bruce OddsonAbstract:Aim To evaluate construct and predictive validity of the Communication Function Classification System (CFCS) for use with preschool children with a range of speech and language disorders. Method Seventy-seven preschool children with speech and language disorders (50 males, 27 females; mean 2y 7mo, standard deviation [SD] 1y) participated in this cohort study. Preschool children had speech and language, language-only, or speech-only disorders. Together with parent input, speech–language pathologists (SLPs) completed the CFCS at time 1. Parents and SLPs then independently completed a validated change-detecting Functional Communication outcome measure, the Focus on the outcomes of Communication Under Six (FOCUS), three times: at assessment (time 1), at the start of treatment (time 2), and at the end of treatment (time 3). Results There was a significant negative correlation between CFCS classifications and FOCUS scores at all three measurement points for the ratings by both parents and SLPs (correlations ranged from −0.60 to −0.76). As expected, no correlations between CFCS classifications and FOCUS change scores were statistically significant. Interpretation This study provides evidence of construct and predictive validity of the CFCS, demonstrating its value as a discriminative tool for use with preschool children with a range of speech and language disorders.
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reliability of the dutch language version of the Communication Function classification system and its association with language comprehension and method of Communication
Developmental Medicine & Child Neurology, 2016Co-Authors: Karlijn Vander E Zwart, Mary Jo Cooley Hidecker, Jan Willem Gorter, Joke J M Geytenbeek, Maaike De Kleijn, Kim J Oostrom, Jeroen R VermeulenAbstract:AIM The aims of this study were to determine the intra- and interrater reliability of the Dutchlanguage version of the Communication Function Classification System (CFCS-NL) and to investigate the association between the CFCS level and (1) spoken language comprehension and (2) preferred method of Communication in children with cerebral palsy (CP). METHOD Participants were 93 children with CP (50 males, 43 females; mean age 7y, SD 2y 6mo, range 2y 9mo–12y 10mo; unilateral spastic [n=22], bilateral spastic [n=51], dyskinetic [n=15], ataxic [n=3], not specified [n=2]; Gross Motor Function Classification System level I [n=16], II [n=14], III, [n=7], IV [n=24], V [n=31], unknown [n=1]), recruited from rehabilitation centres throughout the Netherlands. Because some centres only contributed to part of the study, different numbers of participants are presented for different aspects of the study. Parents and speech and language therapists (SLTs) classified the Communication level using the CFCS. Kappa was used to determine the intra- and interrater reliability. Spearman’s correlation coefficient was used to determine the association between CFCS level and spoken language comprehension, and Fisher’s exact test was used to examine the association between the CFCS level and method of Communication. RESULTS Interrater reliability of the CFCS-NL between parents and SLTs was fair (r=0.54), between SLTs good (r=0.78), and the intrarater (SLT) reliability very good (r=0.85). The association between the CFCS and spoken language comprehension was strong for SLTs (r=0.63) and moderate for parents (r=0.51). There was a statistically significant difference between the CFCS level and the preferred method of Communication of the child (p<0.01). Also, CFCS level classification showed a statistically significant difference between parents and SLTs (p<0.01). INTERPRETATION These data suggest that the CFCS-NL is a valid and reliable clinical tool to classify everyday Communication in children with CP. Preferably, professionals should classify the child’s CFCS level in collaboration with the parents to acquire the most comprehensive information about the everyday Communication of the child in various situations both with familiar and with unfamiliar partners. Within the activity level of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), Communication is described as transmitting and receiving messages in different environments using multiple means including listening, speaking, reading, and writing. 1 Functional Communication is defined as the ability to receive or convey a message regardless of the method of Communication, and to communicate effectively and independently in a given environment. 1 Thus, commu
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inter relationships of Functional status in cerebral palsy analyzing gross motor Function manual ability and Communication Function classification systems in children
Developmental Medicine & Child Neurology, 2012Co-Authors: Mary Jo Cooley Hidecker, Peter Rosenbaum, Jaime Slaughter, Nancy Dodge, Edward A. Hurvitz, Marilyn Seif Workinger, Ray D. Kent, Madeleine Lenski, Nhan Thi Ho, Bridget M MessarosAbstract:Many researchers and clinicians working in the field of cerebral palsy (CP) have adopted the framework of the International Classification of Functioning, Disability, and Health (ICF) to inform choices of outcomes and measures.1 Applying this framework, CP clinical practice and research go beyond describing the anatomy and physiology of individuals with CP to considering their ability to participate in daily activities. The potential interactions among these ICF components with environmental and personal contextual factors have are receiving growing attention.2–4 This broader perspective has fostered development of classification tools to describe daily activities of mobility, handling objects, and communicating, which can be affected by CP.5 The Gross Motor Function Classification System (GMFCS),6 Manual Ability Classification System (MACS),7 and Communication Function Classification System (CFCS)8 classify mobility, handling objects, and Communication respectively, at the activity/participation level of the ICF. The purpose of this study was to describe and correlate GMFCS, MACS, and CFCS levels in a case series of children with CP. To our knowledge, this is the first study to describe a large series of children with CP who had all three classifications. We hypothesized that these classifications would not be strongly correlated. Mobility, handling objects, and Communication are activities that are not Functionally related, but the degree and locations of original brain injuries may overlap neural systems used in these activities. This could result in some correlations between the classifications. Understanding relationships among the three scales may be important in establishing Functional profiles for children with CP.
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developing and validating the Communication Function classification system for individuals with cerebral palsy
Developmental Medicine & Child Neurology, 2011Co-Authors: Peter Rosenbaum, Mary Jo Cooley Hidecker, Ray D. Kent, Nigel Paneth, Janet Lillie, J B Eulenberg, Ken Chester, Brenda Johnson, Lauren Michalsen, Morgan EvattAbstract:Individuals with cerebral palsy (CP) have sensorimotor and developmental issues that affect their daily lives by restricting their mobility, manipulation of objects, and/or Communication.1 Within the framework of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF),2,3 the Gross Motor Function Classification System (GMFCS)4 and the Manual Ability Classification System (MACS) for children with CP5 make it possible to classify mobility and handling objects respectively, at the ICF activity/participation level.6 However, no analogous classification of Functional Communication has been available for use in CP practice and research. The lack of a Communication classification tool that is quick, reliable, valid, and easy to use limits the comparison of descriptive CP epidemiology studies as well as the interpretation and generalizability of CP treatment studies. Communication disorders can be described from several perspectives: body structure and Function level, activity level, and participation level, as well as environmental and personal levels.2,3,7–13 Estimates of Communication disorders in CP have varied from 31%14 to 88%.15 This wide range is partly a result of the lack of a consensus definition of Communication disorders within CP research and practice. A recent study from a Norwegian CP registry reported that 51% of children with CP had speech problems as classified by ratings of ‘slightly indistinct’, ‘obviously indistinct’, ‘severely indistinct’, or ‘no speech’, including 19% who had ‘no speech’.16 This population-based estimate reporting indistinct or no speech may underestimate CP Communication disorders as it may not capture other types of Communication problems resulting from hearing or language impairments. However, reporting speech, language, and hearing difficulties simply suggests the range of associated impairments in CP, not the more pertinent daily-life issues of how well a child with CP communicates with family, friends, acquaintances, and strangers.13 The purpose of this study was to create and validate a Communication Function classification system (CFCS) for children with CP, for use by a wide variety of individuals interested in CP. This required a shift from the traditional focus on body structure and Function (i.e. assessing components of speech, language, and hearing problems), to a focus on activity/participation, specifically the way in which to classify a person’s Communication capacity within real-life situations.
Peter Rosenbaum - One of the best experts on this subject based on the ideXlab platform.
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validity of the Communication Function classification system for use with preschool children with Communication disorders
Developmental Medicine & Child Neurology, 2017Co-Authors: Barbara Jane Cunningham, Peter Rosenbaum, Mary Jo Cooley Hidecker, Nancy Thomasstonell, Bruce OddsonAbstract:Aim To evaluate construct and predictive validity of the Communication Function Classification System (CFCS) for use with preschool children with a range of speech and language disorders. Method Seventy-seven preschool children with speech and language disorders (50 males, 27 females; mean 2y 7mo, standard deviation [SD] 1y) participated in this cohort study. Preschool children had speech and language, language-only, or speech-only disorders. Together with parent input, speech–language pathologists (SLPs) completed the CFCS at time 1. Parents and SLPs then independently completed a validated change-detecting Functional Communication outcome measure, the Focus on the outcomes of Communication Under Six (FOCUS), three times: at assessment (time 1), at the start of treatment (time 2), and at the end of treatment (time 3). Results There was a significant negative correlation between CFCS classifications and FOCUS scores at all three measurement points for the ratings by both parents and SLPs (correlations ranged from −0.60 to −0.76). As expected, no correlations between CFCS classifications and FOCUS change scores were statistically significant. Interpretation This study provides evidence of construct and predictive validity of the CFCS, demonstrating its value as a discriminative tool for use with preschool children with a range of speech and language disorders.
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inter relationships of Functional status in cerebral palsy analyzing gross motor Function manual ability and Communication Function classification systems in children
Developmental Medicine & Child Neurology, 2012Co-Authors: Mary Jo Cooley Hidecker, Peter Rosenbaum, Jaime Slaughter, Nancy Dodge, Edward A. Hurvitz, Marilyn Seif Workinger, Ray D. Kent, Madeleine Lenski, Nhan Thi Ho, Bridget M MessarosAbstract:Many researchers and clinicians working in the field of cerebral palsy (CP) have adopted the framework of the International Classification of Functioning, Disability, and Health (ICF) to inform choices of outcomes and measures.1 Applying this framework, CP clinical practice and research go beyond describing the anatomy and physiology of individuals with CP to considering their ability to participate in daily activities. The potential interactions among these ICF components with environmental and personal contextual factors have are receiving growing attention.2–4 This broader perspective has fostered development of classification tools to describe daily activities of mobility, handling objects, and communicating, which can be affected by CP.5 The Gross Motor Function Classification System (GMFCS),6 Manual Ability Classification System (MACS),7 and Communication Function Classification System (CFCS)8 classify mobility, handling objects, and Communication respectively, at the activity/participation level of the ICF. The purpose of this study was to describe and correlate GMFCS, MACS, and CFCS levels in a case series of children with CP. To our knowledge, this is the first study to describe a large series of children with CP who had all three classifications. We hypothesized that these classifications would not be strongly correlated. Mobility, handling objects, and Communication are activities that are not Functionally related, but the degree and locations of original brain injuries may overlap neural systems used in these activities. This could result in some correlations between the classifications. Understanding relationships among the three scales may be important in establishing Functional profiles for children with CP.
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developing and validating the Communication Function classification system for individuals with cerebral palsy
Developmental Medicine & Child Neurology, 2011Co-Authors: Peter Rosenbaum, Mary Jo Cooley Hidecker, Ray D. Kent, Nigel Paneth, Janet Lillie, J B Eulenberg, Ken Chester, Brenda Johnson, Lauren Michalsen, Morgan EvattAbstract:Individuals with cerebral palsy (CP) have sensorimotor and developmental issues that affect their daily lives by restricting their mobility, manipulation of objects, and/or Communication.1 Within the framework of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF),2,3 the Gross Motor Function Classification System (GMFCS)4 and the Manual Ability Classification System (MACS) for children with CP5 make it possible to classify mobility and handling objects respectively, at the ICF activity/participation level.6 However, no analogous classification of Functional Communication has been available for use in CP practice and research. The lack of a Communication classification tool that is quick, reliable, valid, and easy to use limits the comparison of descriptive CP epidemiology studies as well as the interpretation and generalizability of CP treatment studies. Communication disorders can be described from several perspectives: body structure and Function level, activity level, and participation level, as well as environmental and personal levels.2,3,7–13 Estimates of Communication disorders in CP have varied from 31%14 to 88%.15 This wide range is partly a result of the lack of a consensus definition of Communication disorders within CP research and practice. A recent study from a Norwegian CP registry reported that 51% of children with CP had speech problems as classified by ratings of ‘slightly indistinct’, ‘obviously indistinct’, ‘severely indistinct’, or ‘no speech’, including 19% who had ‘no speech’.16 This population-based estimate reporting indistinct or no speech may underestimate CP Communication disorders as it may not capture other types of Communication problems resulting from hearing or language impairments. However, reporting speech, language, and hearing difficulties simply suggests the range of associated impairments in CP, not the more pertinent daily-life issues of how well a child with CP communicates with family, friends, acquaintances, and strangers.13 The purpose of this study was to create and validate a Communication Function classification system (CFCS) for children with CP, for use by a wide variety of individuals interested in CP. This required a shift from the traditional focus on body structure and Function (i.e. assessing components of speech, language, and hearing problems), to a focus on activity/participation, specifically the way in which to classify a person’s Communication capacity within real-life situations.