Design and Evaluation of Psychometric Properties of the Questionnaire "Assessment of Social / Emotional / Behavioral Disorders in Children with Preschool Stuttering (for Parents)

Abstract

Objective: Stuttering is beyond mere superficial speech behaviors, considering that negative feelings and emotions of a person with stuttering, especially children, towards their speech is an undeniable part of stuttering disorder. Therefore, in the first place, we need a suitable and valid tool to identify, study and measure these negative effects, and then to take action to eliminate or reduce them. Regarding the increasing clinical and research need of the country for valid and reliable tools in the field of stuttering, this study evaluates design and validation. Methods: This article is a methodological and validation study that was conducted in 3 steps in spring and summer of 2018 in Isfahan. The subjects included parents of preschool children with stuttering, aged 3 to 5 years and 11 months, who had referred to speech therapy clinics in Isfahan. The 60 subjects in this study included parents of preschool children with stuttering who were literate. The age of children was in the age range of 3 to 5 years and 11 months and included 36 boys and 24 girls who referred to speech therapy clinics in Isfahan. In the first stage, which defined the concept of social, emotional and stuttering behavior disorders, 10 parents of pre-school children with stuttering participated, and unstructured, in-depth and open-ended interviews were used to collect information. Afterwards, according to the information extracted from the interviews, the opinions and recommendations of experts in the field of psychology and speech therapy, and based on the concept of social / emotional / behavioral disorders, the main constructs of the questionnaire included "uncompromising / hyperactive behavior", "social skills" "communication skills", "aggression", "fear" and "separation anxiety" were completed. In the second stage, in order to determine the face validity, 10 experts were interviewed face to face. In order to determine the content validity, 15 experts (different from the experts of the previous stage) were asked to examine each item according to the three-step spectrum. Content validity was calculated based on the content validity ratio index, and the total content validity index (Lawshe) Confirmatory factor analysis examined construct validity and in the last stage the internal consistency of the questionnaire was calculated by Cronbach's alpha, and its stability was calculated by test-retest method using intra-cluster correlation index. Results: According to the results of the interviews, and the opinions of experts in the field of psychology and speech therapy, the questionnaire of the present study initially consisted of 61 design items in 6 subtests with a total of primary items from the interview. According to the experts, by integrating expressions with overlapping meanings, the items of the questionnaire were reduced to 40. In the face validity stage, items in the questionnaire the level of difficulty (difficulty in understanding phrases and words), the degree of appropriateness (appropriateness and good relationship of phrases with the dimensions of the questionnaire), and ambiguity (the possibility of misunderstandings of phrases or the existence of inadequacies in word meanings) were examined, and necessary corrections were made. An attempt was made to use the correct method of writing and logical wording to write the questionnaire phrases as well. The research team re-read the phrases several times, and the opinions of experts were applied and then reviewed by two experts in the field of Persian literature and finally approved. The content validity of the questionnaire based on the content validity ratio index and the content validity index of the entire questionnaire (Lawshe) were 0.76 and 0.90, respectively. Internal consistency of the questionnaire, based on Cronbach's alpha coefficient equal to 0.89 and the criterion of intra-cluster correlation index was more than 0.7 and significant (P <0.001). In the validity index of the construct, according to the output of AMOS software, the calculated value ofX2 is equal to 631/25. The presence of a low X2 indicates a good fit of the model (P value = 0.000). Conclusion: Considering that stuttering affects social relationships, emotions and behaviors of a person with stuttering, and that the most important age group in order to control and prevent these disorders is childhood and preschool, the present questionnaire can be recognized and used as a reliable tool, because this questionnaire has acceptable validity and reliability.