The Palin Parent Rating Scales
Transcript of The Palin Parent Rating Scales
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The Palin Parent Rating Scales
Sharon MillardSteve Davis
Frances Cook
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Overview• Background to development of the parent
rating scales • The Delphi Study• The exploratory factor analysis• Normative Scores• The Palin Parent Rating Scales (Palin
PRS)
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A measure that would take into account:
– The variability of stammering– The impact of stammering on the child– The impact of stammering on the parent- The broader aims of therapy– Whether change is clinically significant– Clients’ reports and evaluations of outcome
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The Delphi StudyAim:‘obtain a group’s opinion or judgment on a
topic’ (Goodman 1987, p730)
Principle:“entails gathering information, opinions and
ideas from a panel of experts using a specific sequence” (Mead and Moseley, 2001)
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Six Stages of a Delphi Study
• Selection of the expert panel • Formulation of the question• Generation of statements• Reduction and categorisation• Rating • Analysis
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The Questionnaire• 26 items remained• Series of 10 cm visual analogue scales• Marked 0 and 10 at each end
Use:• Obtain score by measuring along the line• Group scores into categories: stuttering
severity; impact on child; impact on parent; parents’ knowledge and confidence
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Limitations of scoring and interpretation
• No evidence to support the categorisation of the individual scales into the four areas
• Each scale receives the same weighting in the final score(s)
• No information about whether each contributes to the overall questionnaire
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Aims
To use exploratory factor analysis to establish the constructs underlying responses to the parent rating scales.
To establish reliability of the parent rating scales
To produce standardized scores for the factor constructs
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Method
• Questionnaires completed at initial assessment
• 259 Parents (146 mothers, 113 fathers)– Children aged 2;6 – 14;6 – Male : female 3:1
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Exploratory Factor Analysis
• Indicated that certain items were redundant – final scale contains 19 items
• Revealed three components– Impact on the child– Severity of stammering and impact on the parents– Parents’ knowledge and confidence in managing the
stammering
Items loading on Factor 1 (impact on child)
• Does your child speak less because of the stammering?
• How frustrated is your child with his speech?• How upset is your child by his stammering?• How anxious is your child about his speech?• How confident is your child in speaking situations?• How happy is your child generally?• How well can your child express how he feels?
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Items loading on Factor 2 (severity and impact on parents)
• How worried are you about your child’s stammering?
• How much is your child struggling?• How anxious are you about your child’s future
because of the stammering?• How often does your child stammer?• How much of an impact does the stammering
have on your family?• How severe is your child’s stammering• Does your child have fluent times?
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Items loading on Factor 3(parent’s knowledge and confidence)
• How confident are you in your knowledge of how to:– Respond when your child is stammering– encourage fluency in your child– Deal with your child’s concern / awareness of
stammering– Encourage confidence in your child
• Do you understand what influences your child’s stammering?
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Reliability• Cronbach’s alpha
– Measures the internal consistency of the scale
– Items should measure the same thing so should correlate with each other
– alpha increases when correlations between items increase
– Alpha of .7 and above considered as reliable
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ReliabilityAlpha for complete scale - .882
– For impact on child component - .865– For impact on parent/severity - .863– For parents knowledge and confidence - .838– Alpha for parents of younger children (n=166)
- .862– Alpha for parents of older children (n=93) -
.905
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The resulting Palin PRS• Consists of a series of 19 visual analogue
rating scales• There are 3 component factors:
– Impact on the child– Severity of stammering and impact on the
parents– Parents’ knowledge and confidence in
managing the stammering
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Palin PRS
How worried are you about your child’s stammering?
0 10as worried as not at all
I possibly could be
How worried is your child about his stammering?
0 10as worried as not at all
he possibly could be
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Normalizing and scaling the factor scores
• First step is to produce weighted factor scores for each of the three factors:– Each scale item differs in the amount it contributes to the
factor– Weighted factor scores take this into account– Factor loading (amount scale contributes) is multiplied to
the scale score to produce factor score
• Weighted factor scores then normalized to Z-scores based on mean and standard deviation and transformed to T-scores for ease of interpretation.
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Normalizing and scaling the factor scores
• Normalised scores converted to stanine scores:– Produces score from 1 to 9– Allows for easy interpretation of factor scores– To assist in identification of areas that may be of
concern– To assist in monitoring change following intervention
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Scale Categories for Factor 1 –impact on the child
Total Normed Score
Stanine Score Percentile Category
25-31 1 1-4Very Low
32-42 2-3 5-23Low
43-58 4-6 24-77Moderate
59-65 7-8 78-95High
66+ 9 96-99Very High
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Scale Categories for Factor 2 –severity and impact on parents
Total Normed Score Stanine Score Percentile Category
28-33 1 1-4 Very Low
34-42 2-3 5-23 Low
43-57 4-6 24-77 Moderate
58-67 7-8 78-95 High
68+ 9 96-99 Very High
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Scale Categories for Factor 3 –parent’s knowledge and confidence
Total Normed Score
Stanine Score Percentile Category
25-32 1 1-4 Very Low
33-42 2-3 5-23 Low
43-58 4-6 24-77 Moderate
59-65 7-8 78-95 High
66+ 9 96-99 Very High
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Next steps
• Demonstrate use as an outcome measurement tool
• Programme for use• Dissemination
Acknowledgements
• The Association for Research into Stammering in Childhood (ARSC)
• Islington PCT (Whittington Health)
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Contact [email protected]
The Michael Palin Centre for Stammering ChildrenWhittington Health13-15 Pine StreetLondon EC1R 0JHTel: 020 3316 8100