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His first co-edited book, Constructing In competence: Disabling Evaluations in Clinical and Social Interaction , appeared in , and his second, Diagnosis as Cultural Practice , was published in He has published numerous articles, served as a guest editor for topical issues of selected journals, and presented his work in national and international venues. Kovarsky , D.

Otherness in the clinical borderlands. Clinical discourse as cultural borderlands.

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The Discursive Construction of Language Disorders

American Journal of Speech-Language Pathology , Language, Speech, and Hearing Services in Schools 28 3 , , Secondly, within this review, a central aim was to comprehensively evaluate the quality of psychometric properties reported across these assessments. To guide this aim, we used the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes [ 55 ]. The PRISMA statement checklist contains a total of 27 item areas that are deemed essential for the transparent reporting of systematic reviews [ 56 ].

Eligibility criteria for studies in this review included research articles or published manuals on the psychometric properties of instruments designed to measure the social skills and behaviours of the general population. We adopted the following, widely used definition of social skills to guide our review, which comprises both skills and behavioural elements that result in positive social interactions, encompassing: 1 cooperation, 2 verbal and non-verbal communication, 3 engagement and participation, 4 empathy, and 5 self-regulation and adaptive behaviours in situations where interpersonal interaction occurs [ 16 , 57 ].

Within this search, instruments measuring these skills and behaviours in both children and adults were included. For instruments to be included in this review, their main components or subscales needed to meet the definition we adopted of social skills. Instruments or published articles written in languages other than English were not eligible. As we were interested in evaluating the quality of psychometric properties of contemporary measures being used in recent research, instruments were excluded if they were published before For the purpose of this review, instruments that had an update of their psychometric properties in the last 20 years at the time of the search were regarded as contemporary.

Instruments were further excluded if they were developed for a specific target population e. Articles were excluded if no psychometric properties were reported. Conference abstracts, reviews, case reports, student dissertations and editorials were also excluded. The HAPI database provides access to information on instruments relevant to health related disciplines, including the fields of social sciences, organisational behaviour, and library and information sciences.

Search strategies included both free text words and subject headings see Table 1 , and comprised all journal articles up to May The second author conducted the searches because of her expertise in conducting systematic reviews. It combines bibliographic records with full-text professional and lay-audience literature in the behavioural and social sciences. To be comprehensive, we also searched the websites of three major publishers of assessments in social sciences Pearson, Acer and Western Psychological Services to identify potential assessment not identified in earlier search strategies.

A total of 2, abstracts were retrieved, including duplicates. A total of duplicates across the four databases were removed. The electronic search strategy used for each database, including: subject heading, free text and limitations are reported in Table 1. Reference lists of the included articles were searched for additional literature.

The HAPI database identified 22 instruments that potentially met the inclusion criteria; thus warranting further scrutiny. Search of grey literature identified an additional 25 records; thus a total of 47 records were identified.

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Adapted from Moher et al. Two independent abstract reviewers rated the abstracts on the following inclusion criteria: abstracts had to describe an instrument or outcome measure; address its psychometric measurement properties; and assess social skills and behaviours. At this level, the abstracts of the articles and descriptions of the assessment were located to ensure the instrument met the adopted definition of social skills [ 16 , 57 ].


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To capture the data contained within the included studies and manuals 45 we used the Cochrane Handbook for Systematic Reviews section 7. Data were extracted under the following headings: study design, purpose of the study, study population, age of the population, and instrument characteristics. The psychometric quality of the included instruments were then analysed using the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes [ 61 ].

The COSMIN checklist [ 55 ] is a standardised tool for assessing the methodological quality of studies on measurement properties and consists of nine domains: internal consistency, reliability relative measures: including test-retest reliability, inter-rater reliability and intra-rater reliability , measurement error absolute measures , content validity including face validity , structural validity, hypotheses testing, cross-cultural validity, and criterion validity.

Responsiveness as a psychometric property was not evaluated in this review. Interpretability is not considered to be a psychometric property under the COSMIN framework and was therefore not described in this review. Each domain of the COSMIN checklist includes 5 to 18 items focussing on different aspects of study design and statistical analyses. Terwee et al. As this rating system appears to be so severe that it inhibits differentiation between more subtle psychometric qualities of instruments [ 63 ], a revised scoring was introduced. Given that some COSMIN items only have excellent and good as an option for rating, we calculated the total score for each psychometric property using the following formula to most accurately capture the quality of the psychometric properties:.

All data items for each instrument were obtained. The results were synthesised and grouped as follows: 1 development and validation of the instrument, 2 the psychometric properties of the instruments, and 3 the instrument characteristics. After the removal of duplicate abstracts across the four databases, a total of 1, studies were screened for inclusion in this review.


  • The Discursive Construction of Language Disorders;
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Of these studies, full-text articles on 53 measures were assessed for eligibility see Fig 1. Of these 53 measures, 13 measures met the inclusion criteria and 40 were excluded for the following reasons: 24 were published before , 6 were diagnostic specific, and 10 did not meet the definition of social skills adopted for the purpose of this review. See Table 3 for an overview of the 40 social skills instruments and the reasons for exclusion.

Through additional searches another 9 manuals were located. Thus, the psychometric properties were obtained for a total of 13 social skills measures which were accessed using 36 articles and 9 manuals. Information on the development and validation of the 13 included social skills measures is reported in Table 4.

Of the 13 measures, 12 were developed using children up to 12 years of age; with 6 of these measures also using an adolescent sample 13—18 years. No measure was developed using an adult population alone older than 18 years and only 1 measure i. The characteristics of the included measures are reported in Table 5. Of the 13 measures, 6 were published within the last 5 years since Regarding the measure type, 9 measures used self-, parent- or teacher-report; with 3 of these measures using only teacher-report.

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Of the remaining measures, 3 were observation-based and only 1 used a semi-structured interview see Table 5. Regarding the response options within the measures, 12 reported the use of Likert scales and only the ESI reported the use of a criterion-referenced rating scale. Of the 12 measures using a Likert response scale, 11 reported the use of a 3 to 5 point scale, and the Peer Social Maturity Scale PSMS reported the use of a 7-point scale. Additionally, the Interaction Rating Scale IRS reported the use of a dichotomous yes or no rating system for its scale.

The quality ratings of the psychometric properties of all 13 measures, which were evaluated against the COSMIN quality criteria, are summarised in Table 6. The overall means and standard deviations of each psychometric property across all social skills measures were also calculated.

S tructural validity was most frequently reported; the mean rating across 12 measures was The least reported psychometric property was criterion validity ; 3 measures had a mean rating of Overall, 11 measures had evidence for internal consistency ; the mean rating across these measures was The mean rating of the 11 measures reporting on reliability and hypothesis testing was The mean rating of the 6 measures that reported on measurement error was Content validity was reported by 8 measures; mean rating Cross-cultural validity was reported by 4 measures; mean rating In this systematic review, we identified and evaluated the quality of psychometric properties of instruments that measure social skills and behaviours developed after We identified 13 instruments that evaluated a component of social skills and behaviours that fit the definition we used in the review.

The vast majority of instruments 11 were developed mainly for school aged children and adolescents, with two instruments solely developed for children 2—5 years i. Alongside the validity evidence, reliability findings also need to be reported.

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This systematic review of social skills and behaviour instruments using the COSMIN framework provided a comprehensive summary of this. Application of the COSMIN checklist based taxonomy provided the framework for a critical evaluation of the quality and extent of psychometric evidence of the 45 research articles and manuals on the 13 social skills and behaviour instruments. Based on the COSMIN taxonomy, the social skills and behaviour instrument with the most robust psychometric properties to date was the SSBS-2, given that all eight psychometric properties were evaluated and it had an overall rating of excellent.

Five of the measures had overall excellent ratings, but have evaluated only five psychometric properties ESI [ The IRS is the measure with the least evidence of having sound psychometric properties; having rated only two psychometric properties and achieving an overall fair rating The COSMIN checklist provides information about the instruments' properties with reliability testing for internal consistency. While these aspects of reliability were not reported for a number of instruments, the current review showed good to excellent reliability for the majority of the instruments.

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However, only six of the thirteen instruments reported on measurement error. When selecting appropriate outcome measures for a study, consideration of the measurement error of the instruments is important as a small measurement error will allow the instrument to detect smaller treatment effects and allow for stronger conclusions to be drawn. Thus, clinical trials will require smaller sample sizes if the measurement error is small in relation to its minimal important change MIC , compared with instruments where the opposite applies [ ].