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Yu-Wei Chen,1 Anita C Bundy,1 Reinie Cordier,2 Yi-Ling Chien,3 Stewart L Einfeld1,4 1Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia; 2School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 3Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; 4Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia Objective: The purpose of the present study was to examine motivation for the contextual nature of motivations for social participation in cognitively able adolescents and adults with autism spectrum disorder, using self-determination theory as a theoretical framework.Methods: Fourteen Australians and 16 Taiwanese (aged 16–45 years) with Asperger’s syndrome and high functioning autism were asked to carry a device which prompted them seven times/day for 7 days, to record what they were doing, with whom, perceived difficulty and social reciprocity, and the reasons for engaging in a situation, which were then coded into degree of self-determination.Results: Multilevel analyses showed that participants were more likely to be self-determined while engaging in “solitary/parallel leisure” and “social activities” than in other types of activities. Interactions with “family members” and “casual/intimate friends” were also positively associated with self-determined motivation. Further, participants were more likely to perceive higher levels of being listened to during interaction with casual/intimate friends than in interaction with other people. Global social anxiety served as a moderator for their perceptions of difficulty and social reciprocity during social engagement.Conclusion: The findings highlight the context-dependent motivations for social engagement of cognitively able individuals with autism spectrum disorder. Keywords: autism, real-life experience, social motivation, social interaction, ecological momentary assessment

Introduction. Patients with head and neck cancer suffer from various impairments due to the primary illness, as well as secondary consequences of the oncological treatment. This systematic review describes the effects of radiotherapy and/or chemotherapy on the functions of the upper aerodigestive tract in patients with head and neck cancer. Methods. A systematic literature search was performed by two independent reviewers using the electronic databases PubMed and Embase. All dates up to May 2016 were included. Results. Of the 947 abstracts, sixty articles met the inclusion criteria and described one or more aspects of the sequelae of radiotherapy and/or chemotherapy. Forty studies described swallowing-related problems, 24 described voice-related problems, seven described trismus, and 25 studies described general quality of life. Only 14 articles reported that speech pathologists conducted the interventions, of which only six articles described in detail what the interventions involved. Conclusion. In general, voice quality improved following intervention, whereas quality of life, dysphagia, and oral intake deteriorated during and after treatment. However, as a consequence of the diversity in treatment protocols and patient characteristics, the conclusions of most studies cannot be easily generalised. Further research on the effects of oncological interventions on the upper aerodigestive tract is needed. [ABSTRACT FROM AUTHOR]

Background: Studies have found differences in the nature and severity of social problems experienced by children with different subtypes of attention deficit hyperactivity disorder (ADHD). Given that play is often the context for acquiring social skills, there is surprisingly limited research examining whether these differences distinguish the play of children within the groups. Methods: Using the Test of Playfulness (ToP), we examined the similarities and differences in play between children (aged 5-11 years) diagnosed with the three DSM-IV ADHD subtypes: inattentive (I-subtype;n = 46), hyperactive-impulsive (HI-subtype;n = 28) and combined subtypes (C-subtype;n = 31). Results and conclusions: Bias interaction, an item-by-item analysis, revealed that the hierarchy of ToP items was similar for children with the HI- and C-subtypes, but differed for children with the I-subtype. Specifically, children with the I-subtype found it more difficult to become intensely engaged in play and to take on playful mischief and clowning; however, they found social play items to be easier. Conversely, whereas mischief and clowning were relatively easier for children with the HI- and C-subtypes, many items reflecting social interaction were more difficult. These findings suggest that interventions can be tailored to these differing presentations. However, further research is needed to confirm the findings. [ABSTRACT FROM AUTHOR]

Background/aim: The importance of play in the social development of children is undisputed. Even though children with attention-deficit hyperactivity disorder (ADHD) experience serious social problems, there is limited research on their play. By integrating literature on ADHD with literature on play, we can postulate how play is influenced by the characteristics of ADHD. These postulations enabled us to propose a theoretical model (proposed model) to depict the interactive process between the characteristics of ADHD and factors that promote play. This paper presents the revised model and principles for intervention based on the results of a study investigating the play of children with ADHD (reported elsewhere). Methods: We tested the proposed model in a study comparing two groups of children (n = 350) between the ages of 5 and 11 years. One group consisted of children diagnosed with ADHD (n = 112) paired with playmates (n = 112) who were typically developing; the control group consisted of typically developing children paired with typically developing playmates (n = 126). The Test of Playfulness was administered, and the model was revised in line with the findings. Results and conclusions: The findings suggest difficulties in the social play and lack of interpersonal empathy in the play of children with ADHD. We draw on the revised model to propose preliminary principles for play-based interventions for children with ADHD. The principles emphasise the importance of capturing the motivation of children with ADHD, counteracting the effects of lack of interpersonal empathy, and considerations for including playmates in the intervention process. [ABSTRACT FROM AUTHOR]

We investigated pulmonary mechanics in 25 patients, 9 to 55 years of age, with a variety of generalised neuromuscular diseases and variable degrees of respiratory muscle weakness. The average degree of inspiratory muscle force was 39.2% (range 8-83%) of predicted. The lung volume restriction far exceeded that expected for the degree of muscle weakness: the observed decrement in respiratory muscle force should, theoretically, decrease vital capacity to 78% of its control value, while the mean VC in our patients was only 50% of predicted. Analysis of lung pressure-volume curves indicated that the two principal causes of the disproportionate loss of lung volume were a reduction in lung distensibility probably caused by widespread microatelectasis, and a decrease in the outward pull of the chest wall. Because it reflects both direct (loss of distending pressure) and secondary (alterations in the elastic properties of the lungs and chest wall) effects of respiratory muscle weakness on lung function, we conclude that, in these patients, the vital capacity remains the most useful measurement to follow evolution of the disease process or response to treatment. [ABSTRACT FROM AUTHOR]

Ninety-one hay fever patients received either 0.5 mg/kg oxatomide b.i.d. or 0.4 mg/kg diphenhydramine b.i.d. in a two-month double-blind study. If necessary this dose could be doubled. The results showed that fewer oxatomide patients needed to double this starting dose and to use a nasal spray. Oxatomide proved to be more effective than diphenhydramine in limiting the severity of the hay fever attacks, as evidenced by the findings that oxatomide patients had fewer complaint-days, and that more of these patients were rated by the investigators to have excellent or good results. Apart from daytime fatigue, transient in several patients, no oxatomide-induced side-effects were found. [ABSTRACT FROM AUTHOR]

Background: Education systems on an international basis have experienced an increase of neurodiverse students in mainstream schools. Such students can experience a deficit in school connectedness which restricts inclusive participation. In My Shoes is an intervention programme developed in Australia to support the inclusion of pupils with autism in primary school settings. This study aimed to adapt this programme for delivery in UK primary schools and widen it to encompass all neurodiverse pupils., Methods: Focus groups of key stakeholders (Pupils, Parents, Teachers and Senior Leaders) explored and shared perspectives on the In My Shoes programme with regard to adapting and refining it for delivery in UK primary schools. Focus group data were analysed using a thematic approach., Results: Five themes emerged from the data focusing upon materials, curriculum, context, duration, and whole-school approach. Linking the intervention to the PSHE curriculum for delivery was a key finding., Conclusions: All key stakeholder groups found the programme beneficial to school connectedness and participation. They contributed to adaptations necessary to widen intervention to encompass all neurodiverse children and for deployment in UK primary schools. The biggest endorsement came from the pupil groups that were most enthusiastic about the intervention, who demonstrated an understanding and a relation to the concepts of the programme. Following revisions to the materials and adaptations suggested by stakeholders, a small feasibility study will be conducted with neurodiverse pupils and their typically developing peers across mainstream year 4 and year 5 classrooms (age 8-10 year olds) in the UK., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Young people who were in out-of-home care (OHC) face an accelerated transition to independent adulthood. Current evidence on outcomes for Australian care-leavers is scant., Objective: This study aims to develop a better understanding of the outcomes for young people leaving care., Participants and Setting: A birth cohort of children and young people born in Western Australia (WA) from 1993 to 2008. Three groups were identified and compared: young people with care-experience (OHC Cohort), those with child protection involvement but not care experience (CP Contact Cohort), and peers in the general population (No Contact Cohort)., Methods: This is a retrospective, population-based study utilising de-identified, linked administrative records provided by the WA state government agencies. Data from the three cohorts were compared through descriptive statistics, independent samples t-tests, and logistic regression modelling., Results: The birth cohort contained records for 414,266 individuals. The smallest comparison group in this study was the OHC Cohort (n = 6526), followed by the CP Contact Cohort (n = 78,095), and the No Contact Cohort (n = 329,645). Care-experienced young people in WA fared significantly worse than their peers across the domains of health (physical and mental), disability, education, social housing and criminal justice involvement., Conclusions: Those who have had child protection involvement, but have not been placed in care, had better outcomes than those who had been in care. However, their outcomes were still poorer than the population cohort with no child protection contact., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Early numeracy skills are considered essential predictors for later mathematical and educational achievement. Therefore, there is a need for early numeracy measures with psychometrically sound properties. This systematic review aimed to determine the content validity of all current early numeracy measures in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework and methodological guidelines, and was conducted and reported by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and checklist. Systematic literature searches were conducted in January 2024 in five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Eligible measures assessed numeracy, targeted children up to eight years of age, were published in English in 1995 or later, and had psychometric data on measure dimensionality. Eligible psychometric reports that were published in English described instrument development and/or content validity of included measures. The measures' methodological quality was assessed using the COSMIN Risk of Bias checklist, after which all three aspects of content validity (i.e., relevance, comprehensiveness and comprehensibility) were evaluated. Six early numeracy measures and eleven psychometric reports were included. None of the measures could be recommended for use in clinical practice, education, or research due to a lack of high-quality evidence on content validity. However, no high-quality evidence was found to indicate insufficient content validity, therefore, all measures still have the potential to be used. Limited access to measures in the domain of early numeracy, despite having contacted both publishers and instrument developers, may have negatively impacted the completeness of the current overview of content validity of early numeracy measures. In line with the COSMIN guidelines, after the initial evaluation of content validity, future studies should evaluate the remaining psychometric properties of the included measures to identify the most robust measures in terms of validity, reliability, and responsiveness., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Speyer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Self-regulation, which encompasses cognitive, behavioural, and emotional domains, poses challenges in consistent measurement due to diverse definitions and conceptual complexities. In recognition of its profound impact on long-term mental health and wellbeing in children, this systematic review examined available self-regulation measures for children and young people between 1 and 18 years of age. The systematic review followed the COSMIN taxonomy and reported on the measurement tools' characteristics and psychometric properties. The methodology and reporting were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. The protocol for this review was registered with PROSPERO (Number CRD42020155809). A search of six databases (Embase, MEDLINE, PsycINFO, Scopus, CINAHL and ERIC) was performed, and grey literature was searched to identify studies on the psychometric properties of measures assessing all three domains (cognitive, behavioural, and emotional) of self-regulation. The types of psychometric properties were examined against the COSMIN taxonomy of measurement properties. A total of 15,583 studies were identified, and 48 of these met the criteria that reported psychometric properties of 23 self-regulation measures assessing all three domains of self-regulation. Most measures relied on self-reports for ages 11-17, and all had limited psychometric evaluation. The Emotion Regulation Checklist was the most studied measure. Notably, none of the studies evaluated measurement error. The content validity was inadequately evaluated, particularly in terms of comprehensiveness and comprehensibility. Future research should focus on developing measures for young children, evaluating measurement error, and enhancing content validity for comprehensive understanding and effective intervention., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: This study aimed to evaluate the psychometric properties of the Australian Interprofessional Socialisation and Valuing Scale (ISVS)-21 and provide an invariant measure for health practitioners and students to assess interprofessional socialisation., Methods: The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used as guidelines. This research began with a key step: conducting a pilot study to assess content validity, a requirement of COSMIN for item development. The ISVS-21 has not yet been validated in Australia. Content validity checks ensure the developed items accurately represent the measured construct in the intended cultural context. In addition to conducting more comprehensive tests of psychometric properties compared to previous studies on ISVS-21, this paper introduces something new by evaluating the internal structure of the instrument involving measurement invariance and hypothesis testing for construct validity based on several assumptions related to interprofessional socialisation and values. An invariant measure validates the use of the Australian ISVS-21 on practitioner and student equivalently, allowing the comparison of outcomes at both levels., Results: The evaluation of content validity indicated that the items were relevant, comprehensible (practitioners and students had an agreement score of >70% for all 21 items), and comprehensive to the concepts intended to be measured. Structural validity confirms ISVS-21 Australia as unidimensional, with good internal consistency reliabilities, Cronbach's α scores = 0.96 (practitioner) and 0.96 (student). Measurement invariance tests confirm ISVS-21 Australia is configural, metric and scalar invariance (ΔCFI ≤ 0.01) across the tested groups of practitioner and student, and therefore suitable for use by both cohorts in Australia. Age and length of work/study were discriminant factors for interprofessional socialisation in both cohorts; the professional background was a differentiating factor for practitioners but not for students. Hypotheses testing results support the COSMIN construct validity requirement for the measure, with 83.3% of assumptions tested accepted., Conclusion: The Australian ISVS has good psychometric properties based on evaluating the content validity, internal structure, and hypotheses testing for construct validity. In addition, Australian ISVS is an invariant measure for use by health practitioners and students and, therefore, confirmed as a quality measure to assess interprofessional socialisation for both cohorts in Australia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ardyansyah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The PedsQL is widely used to retrospectively evaluate quality of life (QoL) in autistic adolescents. However, concerns have arisen regarding its ability to reflect real-time QoL, considering their challenges in recollecting past experiences., Objective: We examined the overall and social QoLs of autistic adolescents compared to neurotypical peers using the PedsQL and the experience sampling method (ESM), an ecological momentary assessment of QoL in real-time. Additionally, we explored the relationship between these measures in each group., Methods: A total of 175 participants, including 117 autistic and 58 neurotypical adolescents aged 10-16, completed the PedsQL and an ESM protocol with a mobile device to record their real-time experiences seven times a day for seven days. We performed multiple linear regression and multilevel analyses to compare QoLs between groups and the association between the two measures., Results: Autistic adolescents scored significantly lower than neurotypical peers on PedsQL overall and social QoL but not on the real-time experiences collected with ESM. Among neurotypical adolescents, we found significant associations between the Social Functioning score of the PedsQL and various aspects of real-time social experiences recorded with ESM. For autistic adolescents, only the real-time experience of 'loneliness' during social engagement was associated with Social Functioning on the PedsQL., Conclusions: The retrospective PedsQL does not entirely capture the real-time QoL via ESM. However, relying solely on ESM may overlook situations where participants opt out or could not complete surveys. Thus, using both retrospective and real-time assessments to examine QoL among autistic adolescents is recommended., Competing Interests: Declaration of competing interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024. Published by Elsevier Inc.)

Introduction: Implementing occupation-based practice in low-resourced settings can be challenging especially when working with children with HIV/Aids whose daily occupation of play is often affected by their health condition and other contextual factors such as poverty or stigma., Aim: The aim of this paper is to obtain consensus from experts on the content and application of a play-based intervention for children with HIV/Aids living in a low-resourced setting., Methods: A Delphi study involving two rounds using an online survey format was conducted with experts from the field of child development, play and/or HIV/Aids. Consensus agreement was reached when at least 70% of Delphi experts rated each item at 3 or higher on a 5-point Likert scale., Consumer and Community Involvement: This paper is part of a multi-stage study that involved input and feedback from families of children who were born HIV/Aids, occupational therapists working with families of children with HIV/Aids, and input from local and international experts working with people with HIV/Aids., Results: Thirty-seven experts completed the first round, and 35 completed the second round of the study. Consensus was achieved on the application of the Cooper's Model of Children's Play, techniques to be used and the structure of the intervention. Experts also agreed on the inclusion of a pre-intervention workshop as part of the play-based intervention., Discussion and Conclusion: The consensus on the content and application of a play-based intervention framework through a process of gaining expert perspectives provides confidence that the intervention planned to promote play for children with HIV/Aids living in low-resourced settings is likely to be effective., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Introduction: A peer-mediated, play-based intervention has been developed to address social participation challenges experienced by children with ADHD. To facilitate implementation into clinical practice, interventions should be evaluated for appropriateness to the end-user, as well as effectiveness. Previous research demonstrated the approach is effective for improving children's social play skills. This study aimed to evaluate the appropriateness of the intervention for children with ADHD and their families., Methods: Parents of children with ADHD who participated in the play-based intervention were interviewed 1 month after completion. Parents were asked about their perspective of parent and children's experiences of the intervention, the perceived benefits for children and parents, the logistics of participating, and recommended adaptations to the intervention. Interviews were analysed thematically, and themes were mapped to the elements of the adopted definition of appropriateness to understand whether parents supported the appropriateness of the intervention for their families., Consumer and Community Involvement: Consumers were not directly involved in the decisions made about this study., Findings: One core theme, 'collaborative efforts', emerged from the data. Major themes comprising the core theme were 'on the same page', 'therapeutic relationship', and 'getting the job done'. Three sub-themes of 'engagement and motivation', 'the effort was worth it for the reward', and 'Rome wasn't built in a day' were nested within the major themes., Conclusion: Parents largely supported the appropriateness of the intervention, indicating it addressed an important goal for their child, participation was a positive experience, and they perceived the intervention to be beneficial. Future adaptions of the intervention are needed to increase its ecological validity and to generalise the strategies to other social environments and playmates, such as peers at school., Plain Language Summary: This study looked at an intervention that uses play with peers to help children with ADHD develop their play skills. The researchers wanted to know if parents thought the intervention was a good fit for their families and if it helped their children. Parents gave an interview a month after the intervention ended. They were asked about their thoughts on the intervention, how it helped their children and themselves, how easy it was to take part, and what changes could be made to make the intervention better. After analysing parents' answers, the researchers found parents mostly agreed that the intervention was a good fit. They said it helped their children to play with their peers, and they had a good time doing it. Parents thought the intervention was helpful, they liked that it was a joint effort between them and the occupational therapist, and they felt it was worth the effort. However, they also suggested some changes. They wanted the intervention to fit into other real-life social situations, such as school, so their children could use the skills they learned in other places. Overall, parents thought the intervention was helpful and suitable for their children and themselves, but some changes might make it more helpful., (© 2024 The Author(s). Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Breastfeeding rates remain persistently low in the United Kingdom (UK) despite wide-scale rollout of UNICEF Baby Friendly Initiative training and accreditation. More must be done to ensure breastfeeding practitioners can provide effective support. The memory aide CHINS (Close, Head free, In-line, Nose to Nipple and Sustainable) could help practitioners remember, recall, and apply breastfeeding theory in practice and this paper presents a UK evaluation of its impact. A concurrent, convergent mixed methods approach was adopted using Normalisation Process Theory (NPT) as an overarching framework. An online survey targeted breastfeeding practitioners and academics from the UK (n = 115). A sub-set (n = 16) of respondents took part in qualitative focus groups. Survey data was subjected to descriptive and inferential statistical analysis, and the focus group data was analysed, using NPT. CHINS is widely used in breastfeeding education and practice largely because of its simplicity and ease of integration in everyday practice, as well as its sustained inclusion in UNICEF Baby Friendly Initiative training. CHINS has introduced a standardised approach to the principles of positioning for effective breastfeeding. Doing so has helped address inconsistencies and poor practice in this area, and CHINS plays a role in assisting practitioners in building confidence in their breastfeeding practice. More needs to be done to ensure the breastfeeding workforce develop and maintain the requisite skills to promote and support breastfeeding, including the role of memory aides such as CHINS in achieving this., (© 2024 The Author(s). Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Young people leaving state care often experience hardship in many areas of their life. At a population level, their outcomes in early adulthood are poorer compared to general populations. Effective preparation for leaving care and post-care support systems is vital to improving outcomes. Individual and systemic support for young people to acquire Independent Living Skills (ILS) in the following eight ILS domains have been identified: Financial Management, Knowledge of Accessing Available Supports, Managing Housing, Education Planning, Job Seeking, Health Risk Management, Domestic and Self-help Task, and Managing Relationships. This systematic review aims to identify, summarise, and appraise longitudinal studies that address ILS across these ILS domains to understand better how outcomes could be improved. Seven databases (CINAHL, Embase, ProQuest, PsychINFO, PubMed, Scopus, and Web of Science) were searched on 20th July 2023. In total, twenty-seven studies published between 1994 and 2022 from various countries met the eligibility criteria. The included studies reported on 2-4 waves and adopted different methodological approaches. Study quality was scored using Qualsyst. Study characteristics and details of the interventions are presented in tables. Studies cover overlapping ILS domains, which are mapped in a matrix. Results revealed that nearly three-quarters (74% or 20 out of 27) of studies explored four or fewer of the eight ILS domains. The most frequent ILS domain covered was 'Knowledge of Accessing Available Supports' (19/27 studies). The main conclusion considers the concept of independence as a misnomer, with ILS covering multiple, intersecting, and interdependent domains, which ultimately help and hinder one another. Further research is required to adopt a more comprehensive approach encompassing all the domains to better inform policy, programs, and practice. A limitation is that a meta-analysis was not conducted for this review. This study registered a 'Protocol' with OSF Registries (DOI: 10.17605/OSF.IO/MJ3ZX) on June 5th, 2022., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Starr et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: This study aimed to validate the Collaborative Practice Assessment Tool (CPAT) in the Australian setting and provide a quality instrument in terms of psychometric properties that can be used to measure interprofessional outcomes for both healthcare practitioners and students. The outcomes evaluated include the capacity to work in an interprofessional team, good interprofessional communication skills, leadership skills, ensuring clear division of tasks and roles in a team, effective conflict management, and being actively involved with patients and their families/communities in care., Methods: The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) taxonomy and standards were used as guides for evaluating the psychometric properties of the Australian CPAT, which include evaluations regarding instrument development requirements of sample target and size, content validity, internal structure (structural validity, internal consistency reliability and measurement invariance), and hypotheses testing. CPAT Australia was developed through two stages involving pilot studies and a validation study, both of which included healthcare practitioners and students as participants. A pilot study examined content validity regarding item relevance, item comprehensibility, and instrument comprehensiveness. The validation study was carried out to assess the internal structure of CPAT Australia for aspects of structural validity, internal consistency reliabilities, and configural, metric and scalar measurement invariance. The structural validity was explored using the following three steps: exploratory, confirmatory, and multi-group factor analysis. Construct validity was evaluated to confirm direct and indirect paths of assumptions based on a previously validated model. Data collected between August 2021 and May 2022., Results: The content validity evaluation confirmed that all items were relevant, understandable and comprehensive for measuring interprofessional collaborative care in Australia. Three hundred ninety-nine participants contributed to the validation study (n=152 practitioners; n=247 students). The original instrument model of 8-Factor 56-Item was improved in the Australian CPAT. Two items, Item 27 (Physicians assume the ultimate responsibility) and Item 49 (Final decision rest with the physician), were consistently rejected and therefore discarded. The internal structure of the 7-Factor 54-Item solution was confirmed as a suitable model with fit indices meeting COSMIN standards for a good model in practitioner and student cohorts. Configural, metric and scalar invariances were confirmed, indicating the invariance of the instruments when used for the practitioner and student cohorts. The construct validity evaluation indicated that 81.3% of direct and indirect assumptions were accepted, fulfilling the COSMIN requirement of >75% of proposed assumptions being accepted., Conclusion: The Australian CPAT with a 7-factor 54-item solution was confirmed as a quality measure for assessing interprofessional education and collaborative practice for both healthcare practitioners and students in Australia with robust psychometric properties., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ardyansyah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Lay Abstract: Individuals who cope well with challenges may engage in social situations more successfully. We examined how well autistic adolescents coped, depending on how competent they felt and how much anxiety they experienced during social activities. We included 133 individuals (82 autistic, 51 neurotypical) between the ages of 10 and 16 years. Participants carried a mobile device that prompted them seven times a day for 7 days to record what they were doing, how competent they felt and how much anxiety they experienced. We used the Coping Inventory to understand how well participants coped with environmental challenges and met their needs for growth. Autistic adolescents were more likely than neurotypical peers to feel anxious while doing activities with adults. Autistic adolescents who had more difficulty coping with challenges were more likely to feel anxious when doing leisure activities with peers. Interestingly, autistic adolescents who coped better with challenges tended to feel less competent in social situations. However, those better able to meet their needs for growth tended to perceive their social competence positively. These findings can help practitioners develop strategies and programs to reduce the negative social experiences of autistic adolescents by helping them cope better., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background/Objectives : The Dysphagia Handicap Index (DHI) is commonly used in oropharyngeal dysphagia (OD) research as a self-report measure of functional health status and health-related quality of life. The DHI was developed and validated using classic test theory. The aim of this study was to use item response theory (Rasch analysis) to evaluate the psychometric properties of the DHI. Methods : Prospective, consecutive patient data were collected at dysphagia or otorhinolaryngology clinics. The sample included 256 adults (53.1% male; mean age 65.2) at risk of OD. The measure's response scale, person and item fit characteristics, differential item functioning, and dimensionality were evaluated. Results : The rating scale was ordered but showed a potential gap in the rating category labels for the overall measure. The overall person (0.91) and item (0.97) reliability was excellent. The overall measure reliably separated persons into at least three distinct groups (person separation index = 3.23) based on swallowing abilities, but the subscales showed inadequate separation. All infit mean squares were in the acceptable range except for the underfitting for item 22 (F). More misfitting was evident in the Z-Standard statistics. Differential item functioning results indicated good performance at an item level for the overall measure; however, contrary to expectation, an OD diagnosis presented only with marginal DIF. The dimensionality of the DHI showed two dimensions in contrast to the three dimensions suggested by the original authors. Conclusions : The DHI failed to reproduce the original three subscales. Caution is needed using the DHI subscales; only the DHI total score should be used. A redevelopment of the DHI is needed; however, given the complexities involved in addressing these issues, the development of a new measure that ensures good content validity may be preferred.

Background: Researchers have examined sub-groups that may exist among young people transitioning from out-of-home care (OHC) using various theoretical models. However, this population group has not been examined for trajectories of homelessness risk., Objectives: To examine whether different subtypes of homelessness risk exist among young people transitioning from care and whether these trajectories of homelessness are associated with mental health and substance use disorders., Participants and Setting: A retrospective population-based cohort study was conducted from a population of 1018 young people (aged 15-18 years) who transitioned from out-of-home in 2013 to 2014 in the state of Victoria, Australia, with follow-up to 2018., Methods: Latent Class Growth Analysis was conducted using linked data from homelessness data collections, child protection, mental health information systems, alcohol and drug use, and youth justice information systems., Results: Three sub-groups of young people were identified. The 'moving on' group (88 %) had the lowest levels of homelessness, with the slope of this trajectory remaining almost stable. The 'survivors' (7 %) group started off with a high risk of homelessness, followed by a sharp decrease in homelessness risk over time. The 'complex' (5 %) group started off with a low risk of homelessness but faced sharp increases in the risk of homelessness over time., Conclusions: Our study demonstrates that subgroups of young people transitioning from care exist with distinct longitudinal trajectories of homelessness, and these classes are associated with different risk factors. Early intervention and different approaches to tackling homelessness should be considered for these three distinct groups before transitioning from care and during the first few years after leaving care., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We aimed to develop a culturally appropriate psychometrically robust measure for assessing interprofessional socialization for health practitioners and students in Indonesia. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used as guidelines. Our study was organized in three phases (a) translation, (b) cross-cultural validation by evaluating the content validity and internal structure of the translated instrument (i.e. structural validity, internal consistency reliability, and measurement invariances), and (c) hypotheses testing for construct validity. A total of 266 health practitioners and 206 students from various professional backgrounds participated. The Indonesian ISVS-19 was confirmed unidimensional. Content validity evaluation confirmed the inclusion of relevant, understandable items and was comprehensive. Factor analysis supported removal of two items. Configural, metric, and scalar tests confirmed the invariance of the 1-Factor 19-Items model in practitioner and student cohorts. Age was a differentiating factor in both cohorts; length of work was only significant for practitioners, and educational background was significant for students (80% of assumptions were accepted, fulfilling COSMIN requirement for construct validity). The Indonesian ISVS-19 has good psychometric properties regarding content validity, internal structure, and construct validity and, therefore, is a psychometrically robust measure for assessing interprofessional socialization for health practitioners and students in Indonesia.

Rationale: Children with neurodevelopmental disorders such as attention-deficit hyperactivity disorder (ADHD), autism, developmental language disorder (DLD), intellectual disability (ID), and social (pragmatic) communication disorder (SPCD) experience difficulties with social functioning due to differences in their social, emotional and cognitive skills. Previous systematic reviews have focussed on specific aspects of social functioning rather than broader peer functioning and friendships., Objective: To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that measured friendship outcomes for children with ADHD, autism, DLD, ID, and SPCD., Method: Following PRISMA guidelines, we searched five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Two independent researchers screened all abstracts and disagreements were discussed with a third researcher to reach consensus. The methodological quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomised Trials., Results: Twelve studies involving 15 interventions were included. Studies included 683 children with a neurodevelopmental disorder and 190 typically-developing children and diagnosed with either autism or ADHD. Within-group meta-analysis showed that the pooled intervention effects for friendship across all interventions were small to moderate (z = 2.761, p = 0.006, g = 0.485). The pooled intervention effect between intervention and comparison groups was not significant (z = 1.206, p = 0.400, g = 0.215)., Conclusion: Findings provide evidence that some individual interventions are effective in improving social functioning and fostering more meaningful friendships between children with neurodevelopmental disorders and their peers. Effective interventions involved educators, targeted child characteristics known to moderate peer functioning, actively involved peers, and incorporated techniques to facilitate positive peer perceptions and strategies to support peers. Future research should evaluate the effectiveness of friendship interventions for children with DLD, ID and SPCD, more comprehensively assess peer functioning, include child self-report measures of friendship, and longitudinally evaluate downstream effects on friendship., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Cordier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: Child maltreatment (CM) is a global public health and social problem, resulting in serious long-term health and socioeconomic consequences. As parents are the most common perpetrators of CM, parenting interventions are appropriate strategies to prevent CM. However, research on parenting interventions on CM has been hampered by lack of consensus on what measures are most responsive to detect a reduction in parental maltreating behaviours after parenting intervention. This systematic review aimed to evaluate the responsiveness of all current parent- or caregiver-reported CM measures. Methods: A systematic search was conducted in CINAHL, Embase, ERIC, PsycINFO, PubMed and Sociological Abstracts. The quality of studies and responsiveness of the measures were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for systematic reviews of patient-reported outcome measures. Only measures developed and published in English were included. Studies reporting data on responsiveness of the included measures were selected. Results: Sixty-nine articles reported on responsiveness of 15 identified measures. The study quality was overall adequate. The responsiveness of the measures was overall insufficient or not reported; high-quality evidence on responsiveness was limited. Conclusions: Only the Physical Abuse subscale of the ISPCAN Child Abuse Screening Tool for use in Trials (ICAST-Trial) can be recommended as most responsive for use in parenting interventions, with high-quality evidence supporting sufficient responsiveness. All other overall scales or subscales of the 15 included measures were identified as promising based on current data on responsiveness. Additional psychometric evidence is required before they can be recommended.

The provision of quality healthcare relies on scales and measures with robust evidence of their psychometric properties. Using measurement instruments with poor reliability, validity, or feasibility, or those that are not appropriate for the target diagnostic group or construct/dimension under consideration, may be unfavorable for patients, unproductive, and hinder empirical advancement. Resources from the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) group can assist in identifying and developing psychometrically sound measures. The COSMIN initiative is the only international, research-based practice taxonomy and methodological guidelines for measurement in healthcare. This manuscript aims to provide an accessible introduction to theories, principles and practices of psychometrics, instrument properties, and scale development, with applied examples from the COSMIN recommendations. It describes why measurement in healthcare is critical to good practice, explains the concepts of the latent variable and hypothetical construct and their importance in healthcare assessments, explores issues of flawed measurement and briefly explains key theories relevant to psychometrics. The paper also outlines a ten-step process to develop and validate a new measurement instrument, with examples drawn from a recently developed visuoperceptual measure for analysis of disordered swallowing to demonstrate key concepts and provides a guide for understanding properties of and terminology related to measurement instruments. This manuscript serves as a resource for healthcare clinicians, educators, and researchers who seek to develop and validate new measurement instruments or improve the properties of existing ones. It highlights the importance of using psychometrically sound measurement instruments to ensure high-quality healthcare assessments., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Swan, Speyer, Scharitzer, Farneti, Brown, Woisard and Cordier.)

Background: Children with attention-deficit hyperactivity disorder (ADHD) experience substantial difficulty maintaining meaningful friendships, which has implications for social functioning and mental health. No systematic review has investigated their friendship difficulties., Objectives: To systematically review and methodologically appraise the quality of existing studies reporting on friendships of children with ADHD. To compare their friendships to typically-developing children, and examine associations between friendship and children's social-emotional wellbeing and mental health., Method: Six databases were searched. The methodological quality of studies was assessed using the QualSyst appraisal tool and the Appraisal tool for Cross-Sectional Studies. Aspects of friendships measured were charted, along with comparisons between children with ADHD and typically-developing children and the associations between friendships and social-emotional wellbeing and mental health., Results: Twenty-three cross-sectional studies and one longitudinal follow-up study were included. Studies included 1509 participants with ADHD, with 1197 typically-developing participants used as a companion in 19 of the 24 studies. Friendship quantity was the most investigated aspect of friendship. Children and youth with ADHD had significantly fewer friends, lower quality friendships and poorer friendship interactions. There were mixed findings from studies investigating the role or impact of friendship on social-emotional wellbeing and mental health. Twenty-two had strong methodological quality., Conclusion: Limited longitudinal studies, small sample sizes and variability in measurement restrict the interpretations of friendship over time and the causal impact of friendship on social and emotional outcomes. Further research should investigate the role and impact of friendships on the social-emotional wellbeing of children and youth with ADHD., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Spender et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Ongoing health issues influence the postseparation lives of survivors of intimate partner violence (IPV). This study identified associations between health following IPV and demographic, housing, employment, and social participation factors. Survivors of IPV in Australia were surveyed. Logistic regression assessed factors of interest with physical and mental health conditions. Six hundred and fifty-eight women participated. Physical health issues were associated with reduced skills and confidence in employment. A mental health diagnosis was associated with women not working as desired and lower incomes. Screening for health impacts and longer-term responses to women could reduce the long shadow of IPV impacts., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Visuoperceptual evaluation of fiberoptic endoscopic evaluation of swallowing (FEES) is a commonly used assessment in dysphagia or swallowing disorders. Currently, no international consensus exists regarding which visuoperceptual measures to use for the analysis of FEES recordings. Moreover, existing visuoperceptual FEES measures are limited by poor and incomplete psychometric data, identifying an urgent need for developing a visuoperceptual measure to interpret FEES recordings. Following the COSMIN group's (COnsensus-based Standards for the selection of health Measurement INstruments) psychometric taxonomy and guidelines, this study aimed to establish the content validity of a new visuoperceptual FEES (V-FEES) measure in adults with oropharyngeal dysphagia. Using the Delphi technique, international consensus was achieved among dysphagia experts across 21 countries, resulting in a new prototype measure for V-FEES, comprising 30 items, 8 function testing items (i.e., specific tasks performed by patients while observing and rating items), and 36 unique operationalisations (i.e., defining items into measurable factors that could be measured empirically using visuoperceptual observation). This study supports good content validity for V-FEES, including participants' feedback on the relevance, comprehensiveness, and comprehensibility of the included items. Future studies will continue the instrument development process and determine the remaining psychometric properties using both the classic test theory (CTT) and item response theory (IRT) models.

Aim: To determine the quality and utility of proxy-reported sensory measures for children and adolescents with neurodevelopmental disorders (such as autism spectrum disorder, attention-deficit/hyperactivity disorder, movement disorders, and intellectual disability)., Method: We systematically searched 11 databases. We applied the updated Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist and criteria for good measurement properties to evaluate instrument development and psychometric properties. Findings were summarized using a COSMIN adaptation of Grading of Recommendations, Assessment, Development and Evaluations., Results: From 11 databases, 6748 articles were screened. Ninety-one full-length articles were reviewed after removing excluded studies and manual searches conducted by two reviewers. Data were extracted for 12 measures from 20 articles. Of the 12 measures, only three provided sufficient data to evaluate content validity and psychometric measurement properties. The Participation and Sensory Environment Questionnaire-Home (PSEQ-H) was the only measure that satisfied moderate content validity and moderate-to-high quality for measurement properties. These properties included: structural validity, hypothesis testing for construct validity, internal consistency, reliability, and measurement error., Interpretation: One measure, the PSEQ-H, met eight criteria for good measurement properties. To facilitate evidence-informed clinical decision-making, all psychometric properties of all 12 sensory-based, proxy-reported measures were presented. The importance of consumer engagement in measure development and the need for ongoing evaluation of measures against contemporaneous standards is recommended., What This Paper Adds: Three measures provided studies on content validity and psychometric measurement properties. The Participation and Sensory Environment Questionnaire-Home had moderate quality for content validity studies and high-to-moderate quality evidence for psychometric properties. The Participation and Sensory Environment Questionnaire was the only measure that included consumer involvement through qualitative interviews and pilot testing. Consumer involvement in measure development is important for content validity. Ongoing evaluation of measures against contemporaneous standards is recommended., (© 2022 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.)

This systematic review on non-instrumental clinical assessment in adult oropharyngeal dysphagia (OD) provides an overview of published measures with reported reliability and validity. In alignment with PRISMA, four databases (CINAHL, Embase, PsycINFO, and PubMed) were searched, resulting in a total of 16 measures and 32 psychometric studies included. The included measures assessed any aspect of swallowing, consisted of at least one specific subscale relating to swallowing, were developed by clinical observation, targeted adults, and were developed in English. The included psychometric studies focused on adults, reported on measures for OD-related conditions, described non-instrumental clinical assessments, reported on validity or reliability, and were published in English. Methodological quality was assessed using the standard quality assessment QualSyst. Most measures targeted only restricted subdomains within the conceptual framework of non-instrumental clinical assessments. Across the 16 measures, hypothesis testing and reliability were the most reported psychometrics, whilst structural validity and content validity were the least reported. Overall, data on the reliability and validity of the included measures proved incomplete and frequently did not meet current psychometric standards. Future research should focus on the development of comprehensive non-instrumental clinical assessments for adults with OD using contemporary psychometric research methods.

Introduction: This study examined speech-language pathologist (SLP)'s use of standardized language measures when assessing school-aged children., Method: A total of 335 SLPs provided information in a web-based survey regarding the standardized language measures they use for school-aged children. SLPs were asked to identify the domains targeted, purposes of use, and reasons for which regularly used standardized measures were chosen for use., Results: Findings indicated that SLPs collectively use many standardized measures, although only a small number are used regularly. SLPs reported using standardized measures to assess domains that measures are not ideally designed for and for purposes that the measures are not ideally suited to assessing. SLPs reported selecting diagnostic measures based on psychometric properties but not for screening measures. Reasons for choice varied depending on the particular measure., Conclusion: Overall, findings indicated that SLPs need to place greater focus on evidence-based practice recommendations when selecting standardized measures for use with school-aged children. Implications for clinical practice and future directions are discussed., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Background: Self-management of type 1 diabetes mellitus (T1DM) can be challenging for people with intellectual disability. Often, parents provide health support due to lack of appropriate services outside the home. The study aim was to identify barriers and facilitators to T1DM self-management for young adults with intellectual disability and the implications for health promotion., Methods: Five male participants with intellectual disability, aged 17-26 years, and seven parents were interviewed between October 2017 and February 2019. Interview data were descriptively analysed., Findings: Two categories for barriers and facilitators were identified: 1) Diabetes self-management is complex (carbohydrate counting, blood glucose level monitoring, insulin therapy); 2) support for diabetes care (reliance on parents and carers, the National Disability Insurance Scheme, mainstream diabetes service support)., Conclusions: Parents are critical for the support of people with intellectual disability and T1DM in the absence of disability staff with appropriate health skills.

To examine the effectiveness of a play-based intervention for improving social play skills of typically-developing playmates of children with ADHD. Children (5-11 years) were randomised to an intervention (n = 15) or waitlisted control group (n = 14). The Test of Playfulness was scored by a blinded rater. Between-group statistics compared the change of the intervention (10-week intervention) and waitlisted control (10-week wait) groups. Change in the intervention group following intervention was significantly greater than the change in the waitlisted control group. When combining data from the groups, playmates' (n = 29) mean ToP scores improved significantly following intervention, with a large effect pre- to post-intervention and pre-intervention to follow-up. Typically-developing playmates of children with ADHD benefited from participation in a peer-mediated intervention., Competing Interests: The authors have declared that no competing interests exist.

Introduction . Patient self-evaluation is an important aspect in the assessment of dysphagia and comprises both Functional Health Status (FHS) and Health-Related Quality of Life (HR-QoL). As many measures combine both FHS and HR-QoL, disease-related functioning cannot be distinguished from disease-related quality of life as experienced by the patient. Moreover, current patient self-reported measures are limited by poor and incomplete data on psychometric properties. Objective . This study aimed to establish content validity for the development of two new self-reported measures on FHS and HR-QoL in adults with oropharyngeal dysphagia (OD), in line with the psychometric taxonomy and guidelines from the COSMIN group ( CO nsensus-based S tandards for the selection of health M easurement IN struments). Methods . Using the Delphi technique, international expert consensus was achieved; participants and patients with dysphagia evaluated relevance, comprehensiveness, and comprehensibility of definitions of relevant constructs (i.e., dysphagia, FHS and HR-QoL) and potential items. Results . A total of 66 Delphi participants from 45 countries achieved consensus across two rounds. The Delphi study resulted in two prototype measures, the Functional health status measure of Oropharyngeal Dysphagia (FOD) and the health-related Quality of life measure of Oropharyngeal Dysphagia (QOD), consisting of 37 and 25 items, respectively. Minimal revisions were required based on feedback by patients. Conclusions . This study provides evidence of good content validity for both newly developed prototype measures FOD and QOD. Future studies will continue the process of refining the measures, and evaluate the remaining psychometric properties using both Classic Test Theory (CTT) and Item Response Theory (IRT) models., Competing Interests: The authors declare no conflict of interest.

Objectives: The study examined the relationship between mental health, homelessness and housing instability among young people aged 15-18 years old who transitioned from out-of-home in 2013 to 2014 in the state of Victoria, Australia with follow-up to 2018. We determined the various mental health disorders and other predictors that were associated with different levels of homelessness risk, including identifying the impact of dual diagnosis of mental health and substance use disorder on homelessness., Methodology: Using retrospective de-identified linked administrative data from various government departments we identified various dimensions of homelessness which were mapped from the European Topology of Homelessness (ETHOS) framework and associated mental health variables which were determined from the WHO ICD-10 codes. We used ordered logistic regression and Poisson regression analysis to estimate the impact of homelessness and housing instability respectively., Results: A total homelessness prevalence of 60% was determined in the care-leaving population. After adjustment, high risk of homelessness was associated with dual diagnosis of mental health and substance use disorder, intentional self-harm, anxiety, psychotic disorders, assault and maltreatment, history of involvement with the justice system, substance use prior to leaving care, residential and home-based OHC placement and a history of staying in public housing., Conclusions: There is clearly a need for policy makers and service providers to work together to find effective housing pathways and integrated health services for this heterogeneous group of vulnerable young people with complex health and social needs. Future research should determine longitudinally the bidirectional relationship between mental health disorders and homelessness., Competing Interests: The authors have declared that no competing interests exist.

Limited interventions exist that support student's school participation. This paper describes a theoretical model of school participation and the iterative process that led to the development of an intervention that aims to improve the school participation of students on the autism spectrum and their typically developing peers. Literature on autism, school participation and intervention research were integrated to develop a theoretical model. Focus groups, a Delphi study, online surveys, and reference group consultation helped to develop and refine the intervention. A novel school-based intervention was developed. The impetus to develop interventions with a strong theoretical rationale is discussed., (© 2021. The Author(s).)

Our systematic review and meta-analysis of pharyngeal electrical stimulation (PES) and neuromuscular electrical stimulation (NMES) in patients with oropharyngeal dysphagia (OD) is the first paper (Part I) [...].

In My Shoes is a peer supported, teacher-led, school-based intervention that aims to improve the school participation and connectedness of students on the autism spectrum. The aim of this study was to explore the feasibility, fidelity, and preliminary effectiveness of In My Shoes in mainstream elementary schools. Ten Grade 3 and 4 students on the autism spectrum and 200 of their typically developing peers across eight classrooms and six schools participated. The following aspects of feasibility were explored: recruitment capability and sample characteristics, data collection procedures and outcome measures, appropriateness, implementation, and practicality of the intervention. Fidelity was explored by evaluating the delivery of intervention components against set criteria. Preliminary effectiveness was investigated by evaluating changes in intervention outcomes pre-post intervention using a range of outcome measures. Study findings are encouraging, suggesting In My Shoes is a feasible and appropriate intervention, and shows promise in improving the self-report school engagement of all student participants, as well the classroom participation and subjective school experiences of students on the autism spectrum. Useful insights into ways the intervention and the design of future research can be improved are discussed., Competing Interests: The authors have declared that no competing interests exist.

This White Paper by the European Society for Swallowing Disorders (ESSD) reports on the current state of screening and non-instrumental assessment for dysphagia in adults. An overview is provided on the measures that are available, and how to select screening tools and assessments. Emphasis is placed on different types of screening, patient-reported measures, assessment of anatomy and physiology of the swallowing act, and clinical swallowing evaluation. Many screening and non-instrumental assessments are available for evaluating dysphagia in adults; however, their use may not be warranted due to poor diagnostic performance or lacking robust psychometric properties. This white paper provides recommendations on how to select best evidence-based screening tools and non-instrumental assessments for use in clinical practice targeting different constructs, target populations and respondents, based on criteria for diagnostic performance, psychometric properties (reliability, validity, and responsiveness), and feasibility. In addition, gaps in research that need to be addressed in future studies are discussed. The following recommendations are made: (1) discontinue the use of non-validated dysphagia screening tools and assessments; (2) implement screening using tools that have optimal diagnostic performance in selected populations that are at risk of dysphagia, such as stroke patients, frail older persons, patients with progressive neurological diseases, persons with cerebral palsy, and patients with head and neck cancer; (3) implement measures that demonstrate robust psychometric properties; and (4) provide quality training in dysphagia screening and assessment to all clinicians involved in the care and management of persons with dysphagia., (© 2021. The Author(s).)