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· Communicative participation (CP) is a novel multidimensional construct in line with the bio-psycho-social model of health. It underlies not only functional communicative competencies (“performances”) but also formal linguistic abilities (‘capabilities’) that are known to be interrelated with certain temperamental traits and with social-emotional abilities and behavioural problems, in both typically and atypically developing children. The research aims to explore the associations between CP, temperament, and social-emotional abilities in a group of preschoolers with atypical speech-language development, given the absence of studies on this topic. In addition, the different effects that individual nonlinguistic (temperament and social-emotional skills) and linguistic factors can have on the performance component of CP will be investigated. Thirty participants were recruited according to inclusion criteria for age (between 3.6 and 6.6 years), native language (Italian), and diagnosis (Speech Sound Disorder or Developmental Language Disorder). Both direct and indirect assessments were conducted to measure CP, temperament, social-emotional abilities and behavioural problems, phonology, lexicon, and morpho-syntax. The results showed that certain temperamental traits influence the CP of children with atypical speech-language development: in fact, children with a lower social orientation and a higher inhibition to novel contexts and situations show fewer levels of CP. In addition, those with low skills in the functional use of expressive language are rated by their teachers as also having higher levels of anxiety and social withdrawal. Overall, multiple regression analysis indicated that both language skills (morpho-syntactic ability) and social orientation predict the child’s functional use of expressive language in daily life. The findings can be interpreted by considering the reciprocal influences between constitutional predispositions, children’s abilities and their functional use, and the environment.

Background. Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children. Methods. We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies. Results. Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy. Conclusions. Monitoring risk situations and employing caregivers’ reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.

Aim: Focus on the Outcome of Communication Under Six (FOCUS) is a 50-item rating scale designed to assess communicative participation in preschoolers. Satisfactory psychometric properties have been established for the English and German FOCUS versions. This preliminary study aimed to investigate internal consistency, test–retest reliability, and convergent and construct validity of the Italian adaptation of FOCUS (FOCUS-I). Method: The study included Italian-speaking children (N = 364) aged between 36 and 71 months (M = 56.1, SD = 9.8) without a major developmental impairment. Parents completed FOCUS-I, and children were assessed through a naming task and a word repetition task. To evaluate test–retest reliability, 139 parents completed FOCUS-I twice. Results: Analysis found excellent internal consistency for the overall score, with most subscales reaching acceptable internal consistency. High test–retest reliability was detected for the overall score; all subscales showed at least fair test–retest reliability. Some FOCUS-I subscales had moderate correlation with the speech measures from the word repetition task and with the expressive vocabulary from the naming task. A high correlation was found between the overall score and subscale scores. Among the 364 recruited children, those with low speech competencies (n = 46) or with low expressive vocabulary skills (n = 30) were rated lower by their parents for overall score and most subscale scores. Conclusion: FOCUS-I can be considered a reliable and valid measure of functional communicative participation for Italian-speaking preschoolers. Further research is needed for the validation of FOCUS-I in typically and atypically developing children.

Purpose: Participation-outcome measures are required in the phoniatric and speech-language pathology practice to evaluate real-life changes during interventions. In line with the bio-psycho-social model of health, ‘Focus on the Outcomes of Communication Under Six’ (FOCUS) is a validated scale by which parents rate their child’s Communicative Participation (CP). CP has been widely investigated in atypically-developing population, and it may be an innovative construct also for typically-developing children (TDC). The aim of the study is to describe the CP and its components observed in a large group of TDC, exploring whether children’s CP is influenced by their age. Method: Through a cross-sectional observational study, parents of 355 Italian-speaking TDC aged 3.0–5.11 years without developmental impairments completed the Italian FOCUS (FOCUS-I). Result: CP significantly increased with age (p

Il presente lavoro considera la salute, in accordo con quanto proposto dall’Organizzazione Mondiale della Sanità, nei termini di un complesso funzionamento bio-psico-sociale dell’individuo, che può essere descritto sia in riferimento alle possibilità di eseguire attività, sia in relazione al grado di partecipazione conseguito nelle situazioni di vita. Nella comunità scientifica è stato, inoltre, introdotto il costrutto multi-componenziale di Partecipazione Comunicativa (PC), riferito alla possibilità di un individuo di prendere parte alle situazioni quotidiane attraverso le competenze comunicativo-linguistiche. Tale costrutto è stato, prevalentemente, indagato in popolazioni pediatriche con disturbi eterogenei dello sviluppo e, pertanto, tenendo conto della scarsità dei dati disponibili, appare rilevante esaminarlo, da un lato, nei bambini con sviluppo linguistico atipico, per verificare se la presenza di difficoltà linguistiche sia associ ad una Partecipazione Comunicativa compromessa e, dall’altro, anche nei bambini con sviluppo linguistico tipico, per facilitare l’interpretazione di eventuali dissimilarità tra le due popolazioni. Nel presente elaborato viene presentata una rassegna della letteratura scientifica e, successivamente, sono riportati alcuni studi empirici realizzati per rispondere alle suddette necessità. Il primo studio indaga la PC e le componenti ad essa sottese nello sviluppo linguistico tipico, investigandone la traiettoria evolutiva e verificando l’influenza di specifici fattori individuali, quali il genere e la qualità dell’eloquio. A partire dal ruolo che quest’ultimo fattore ricopre nel grado di PC in età prescolare, il secondo studio intende verificare se i bambini caratterizzati da un eloquio compromesso presentino, rispetto ai pari, delle differenze significative in tale capacità, approfondendo il peso assunto dalla competenza articolatoria. A seguito delle evidenze riscontrate circa le differenze tra le due popolazioni osservate, nel terzo studio si approfondisce la qualità delle associazioni intercorrenti tra la PC, le competenze linguistiche formali, quelle di natura socio-emotivo-comportamentale e il temperamento, nello sviluppo linguistico tipico e in quello atipico. Nel complesso, emerge che, nel periodo prescolare, la PC presenta una traiettoria incrementale, lievemente influenzata dal genere, che risulta, in ogni caso, associata alla qualità dell’eloquio. La rilevanza dell’eloquio è confermata anche considerando i bambini con sviluppo linguistico atipico, nei quali si osservano importanti limitazioni nella PC e nelle componenti ad essa sottese. Viene altresì rilevato che la PC non è direttamente relata a competenze di natura socio-emotivo-comportamentale nonostante, nei bambini con sviluppo linguistico atipico, le difficoltà nell’utilizzo funzionale del linguaggio siano associate alla manifestazione di comportamenti disadattativi di tipo internalizzante. Alcune delle componenti funzionali della PC risultano, invece, chiaramente associate, in maniera positiva, a specifiche dimensioni temperamentali, ovvero all’estroversione, alla socievolezza e alla manifestazione di emozioni positive, contrariamente a quanto osservato nel caso in cui il bambino stesso manifesti alti livelli di inibizione comportamentale. Nelle conclusioni dell’elaborato si evidenziano le possibili ricadute applicative dei risultati ottenuti, sottolineando come l’introduzione, nella pratica clinica, di questo costrutto, nonché di validi strumenti attraverso cui misurarlo, risponda ad attuali esigenze sanitarie riferite alla fase diagnostico-valutativa, alla scelta di strategie e procedure di intervento e alle modalità di verifica dell’efficacia degli interventi stessi, indirizzati ai bambini con sviluppo linguistico atipico. This research is in line with the World Health Organization's recommendation to consider health as a complex bio-psycho-social functioning of the individual, which can be described both through an individual's specific activities and the degree of his/her participation in daily experiences. From these premises, the scientific community has recently elaborated the multi-componential construct of Communicative Participation, which refers to an individual's ability to take part in everyday life situations, specifically with communicative-linguistic skills. Previous research mainly investigated this construct in children with heterogeneous communicative-linguistic disorders. Because of the lack of existing evidence, it is still relevant to further investigate it, on the one hand, in children with atypical language development, to examine whether linguistic difficulties are associated with impaired Communicative Participation and, on the other hand, also in children with typical language development, to interpret any differences between the two populations. This manuscript includes a review of the scientific literature and three empirical studies. The first study investigates Communicative Participation and its underlying components in typical language development; it investigates this competence's developmental trajectory and verifies the influence of specific individual factors, such as gender and quality of speech, on it. Since the quality of speech plays a role in the degree of Communicative Participation in preschool age, the second study examines whether children with speech/language disorders differ from peers in this capacity, and it explores the role of articulatory skill. Results show that children with speech/language disorder are significantly different from peers in Communicative Participation. Thus, the third study investigates associations between Communicative Participation, linguistic skills, social-emotional-behavioural skills, and temperament in typical and atypical language development. Overall, the research work shows that Communicative Participation improves with age in the preschool, it seems to be slightly influenced by gender, and it is, in any case, associated with the quality of the child's speech. Speech is also relevant because children with atypical language development have significant limitations in Communicative Participation and its underlying components. Moreover, Communicative Participation is not directly related to social-emotional-behavioural skills. However, uniquely in children with atypical language development, there is an association between language use difficulties and internalizing behavioural problems. Instead, some functional components of Communicative Participation are positively associated with some temperamental dimensions, such as extraversion, sociability, and positive emotions. These traits are positively associated with the child's functional use of expressive language; on the contrary, there is a negative association between behavioural inhibition and Communicative Participation. In conclusion, the paper highlights the possible clinical implications of the results and emphasizes that it is relevant to apply the new construct of Communicative Participation in clinical practice and use valid tools to measure it. This innovation can support many needs connected to the clinical practice with children with speech/language disorders, such as deepening the first functional assessment, choosing an intervention, and selecting outcome measures.

Introduction: The Intelligibility in Context Scale (ICS) is a parent-report scale by which parents can rate their child’s functional speech intelligibility according to seven different communicative partners. Translations, linguistic adaptations, and psychometric and norming data for ICS have been achieved in different languages. Objective: To evaluate the psychometric properties of the Italian version of the ICS (ICS-I) in terms of internal consistency, test-retest reliability, criterion validity (correlation with speech measures), and construct validity, and to investigate potential differences between mothers’ and fathers’ subjective ratings in ICS-I. Methods: Italian-speaking children aged 3.0–5.11 years (n = 364), without major developmental impairment, were recruited in kindergartens. All children were independently rated by their mothers (ICS-Im) and fathers (ICS-If). A subsample of parents (n = 127) rated ICS-I twice after 3 weeks (test-retest reliability). Children were administered a naming and a word repetition task, by which speech measures were calculated: percentage of phonemes correct (PPC), percentage of consonants correct (PCC), and percentage of vowels correct (PVC). Results: High internal consistency (α = 0.92) and good test-retest reliability (rs = 0.78) were found. A high (r > 0.67) correlation between the ICS-I total scores and single-item scores was found (construct validity), except for parental perception in ICS-Im and ICS-If. Moderate correlations (rs > 0.38) between the ICS-I and the PPC and PCC tasks suggested adequate criterion validity. Mothers’ and fathers’ ratings showed an appropriate agreement in the items acquaintances and teachers, but overall parent ratings were significantly different, with higher mean scores in ICS-Im (median = 4.57) than in ICS-If (median = 4.46), Z = –2.852, p < 0.01. Conclusions: As for other previous international studies, ICS-I presents good psychometric properties, but some differences in mothers’ and fathers’ scores suggest a potential parental influence in rating a child’s intelligibility. Findings support cross-linguistic research, and further investigation could promote the application of ICS-I as an outcome measure in children with speech sound disorders.

Objectives: The Intelligibility in Context Scale (ICS) is a parent-report scale, world-wide translated and widely validated, by which parents can rate their child's functional speech intelligibility according to seven different communicative partners. The study aimed to report and discuss the normative data of the Italian version of ICS (ICS–I) in Italian-speaking preschool children, and to investigate whether the age influences the ICS-I scores (construct validity). Socio-economic status (SES) of the family were investigated and compared to parents' ratings on child's speech intelligibility. Methods: A cross-sectional observational study was conducted. Italian-speaking children aged 3–6 years (n = 355; mean age = 56.06 months; SD = 9.8 months), without major developmental impairment, were recruited in kindergartens throughout a convenience sampling. Parents completed a self-report form on their family SES (educational level and employment status of fathers and mothers). Children were independently rated by their mothers (ICS-Im) and fathers (ICS-If). Results: Results show that ICS normative data for the Italian preschool population (ICS-Im = 4.52; SD = 0.46; ICS-If = 4.47; SD = 0.49) are consistent with previous evidence found in other languages, suggesting that ICS could be a potential cross-linguistic tool to assess functional intelligibility. A statistically significant (p < 0.001) improvement in ICS-I score was found with increase of age (construct validity). No evidence of association (p > 0.05) with ICS-I was found for SES family. Conclusion: The study provides normative data of the functional intelligibility assessed by a subjective parental scale. As for other previous international studies, ICS-I normative data suggest that a preschool child without major impairment shows a high degree of speech intelligibility, even if minimal differences of intelligibility are reported for different communicative partners. The current findings support clinicians and researchers in implementing ICS-I in typical and also in atypical population with different SES background and promoting its application as a potential outcome measure in children with Speech Sound Disorders.