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41 Test-Retest Reliability of the POSHA–S/Child in 4- to 11-Year-Old Schoolchil

41 Test-Retest Reliability of the POSHA–S/Child in 4- to 11-Year-Old Schoolchildren Canadian Journal of Speech-Language Pathology and Audiology (CJSLPA) RELIABILITY OF THE POSHA–S/CHILD Volume 42, No. 1, 2018 KEYWORDS CHILDREN STUTTERING ATTITUDES RELIABILITY POSHA–S/CHILD Abstract The Public Opinion Survey of Human Attributes–Stuttering/Child (POSHA–S/Child) was developed to measure attitudes of young nonstuttering children toward stuttering. Initial studies with the instrument have shown promise in its ability to do so. The purpose of this study was to estimate the test-retest reliability of the POSHA–S/Child. From one school in the Mid-Atlantic region of the USA, 99 children from 7 academic levels (preschool through the 5th grade) were administered the POSHA–S/Child orally and face-to-face twice (test and retest), 1 to 2 weeks apart. Answers to questions related to stuttering of “no”, “I don’t know”, or “yes” were converted to a 1–3 scale. Correlations between test and retest ratings ranged between .51 and .75 or from moderate to high, with older children being generally more consistent in their ratings than younger children. Absolute agreement between test and retest ratings ranged from 76% to 87%. We concluded that test-retest reliability of the POSHA–S/Child is satisfactory. Kenneth O. St. Louis Mary E. Weidner Test-Retest Reliability of the POSHA–S/Child in 4- to 11-Year-Old Schoolchildren La fiabilité test-retest du sondage POSHA–S/Child chez des élèves âgés de 4 à 11 ans Kenneth O. St. Louis West Virginia University, Morgantown, WV, USA Mary E. Weidner Marshall University, Huntington, WV, USA 42 pages 41-54 Revue canadienne d’orthophonie et d’audiologie (RCOA) RELIABILITY OF THE POSHA–S/CHILD ISSN 1913-2018 | www.cjslpa.ca Abrégé Le sondage Public Opinion Survey of Human Attributes–Stuttering/Child (POSHA–S/Child) a été élaboré pour mesurer l’attitude de jeunes enfants non bègues envers le bégaiement. Les premières études ayant été effectuées avec cet instrument ont par ailleurs montré des résultats prometteurs. L’objectif de la présente étude était d’estimer la fiabilité test-retest du POSHA–S/Child. Pour ce faire, le POSHA–S/Child a été administré en personne et à l’oral à 99 enfants répartis dans sept niveaux académiques différents (de la maternelle à la 5e année); ces derniers fréquentaient une école de la région Mid-Atlantique des États-Unis. Le sondage a été administré à deux reprises (test et retest), avec une ou deux semaines d’intervalle entre les deux administrations. Les réponses « non », « ne sait pas » ou « oui » aux questions portant sur le bégaiement ont été converties sur une échelle s’étendant de 1 à 3. Les corrélations entre les cotations du test et du retest variaient entre 0,51 et 0,75 (modérées à élevées). La cotation des enfants plus âgés était généralement plus constante que celle des enfants plus jeunes. Le taux d’accord absolu entre les cotations du test et du retest s’étalait entre 76% et 87%. Il a donc été conclu que le POSHA–S/Child avait une fiabilité test-retest satisfaisante. 43 Test-Retest Reliability of the POSHA–S/Child in 4- to 11-Year-Old Schoolchildren Canadian Journal of Speech-Language Pathology and Audiology (CJSLPA) RELIABILITY OF THE POSHA–S/CHILD Volume 42, No. 1, 2018 The Public Opinion Survey of Human Attributes– Stuttering (POSHA–S), a paper-and-pencil or online measure of public attitudes toward stuttering, has been widely used around the world. This emerged in response to the need for a standard instrument of public attitudes that would be comparable across studies (St. Louis, 2005, 2011). The POSHA–S contains a demographic section, a general section that compares stuttering to four other human attributes (intelligent, left handed, obese, and mentally ill), and a detailed stuttering section. Forty-five item ratings are combined into 11 components, and the components are combined into three subscores (Beliefs about People Who Stutter, Self Reactions to People Who Stutter, and Obesity/Mental Illness). The mean of the two stuttering subscores is the Overall Stuttering Score. For the sake of ease of interpretation, all ratings are converted to a scale from -100 to +100, with 0 being neutral. Also, values for some items are inverted so that, uniformly, higher scores reflect more positive attitudes and vice versa. The instrument’s sociometric properties have been carefully evaluated. Test-retest reliability, concurrent validity, and construct validity of an experimental prototype, containing 1–9 ratings, were reported, respectively, by St. Louis, Lubker, Yaruss, and Aliveto (2009) and St. Louis, Reichel, Yaruss, and Lubker (2009) to be satisfactory. To enhance user-friendliness, the 1–9 ratings in the final version of the POSHA–S were changed to 1–5 scales or to “yes”, “no”, and “not sure” choices. Test-retest reliability of the final POSHA–S utilizing 1–3 and 1–5 ratings was also reported to be satisfactory (St. Louis, 2012b). The instrument’s discriminative validity and construct validity were further documented (St. Louis, Williams, Ware, Guendouzi, & Reichel, 2014), and acceptable internal consistency of the instrument was reported by Al-Khaledi, Lincoln, McCabe, Packman, and Alshatti (2009) and by St. Louis (2012b). Finally, the construct validity of the POSHA–S is supported by positive changes after attempts to improve negative public attitudes in several investigations (Abdalla & St. Louis, 2014; Flynn & St. Louis, 2011; Junuzović-Žunić et al., 2015; Węsierska & St. Louis, 2014). Other studies documented the instrument’s readability (St. Louis, Lubker, Yaruss, Adkins, & Pill, 2008), translatability (St. Louis & Roberts, 2010; St. Louis, Sønsterud et al., 2016; Valente, St. Louis, Leahy, Hall, & Jesus, 2017), equivalence in paper versus online administration (St. Louis, 2012a), and use with and without a definition of stuttering provided (St. Louis, Sønsterud et al., 2016). It should be noted that the POSHA–S has been used successfully not only with adults but with adolescents and children as young as 12 years old (i.e., sixth grade; Flynn & St. Louis, 2011; Kuhn & St. Louis, 2015; Özdemir, St. Louis, & Topbaş, 2011). The need has been recognized to evaluate public attitudes toward stuttering in younger children as well. For example, the Peer Attitudes Toward Children who Stutter Scale (PATCS) (Langevin & Hagler, 2004) is a survey instrument that has been used to examine stuttering attitudes of older school-aged children. The Communication Attitude Test for Preschool and Kindergarten Children (KiddyCAT; Vanryckeghem & Brutten, 2007) is another questionnaire that has been used to examine young children’s perceptions of their own communication skills. These well-researched instruments do not cover the entire age range from preschool through elementary school and, more importantly for our purpose, are not directly comparable to the POSHA–S. Accordingly, Weidner and St. Louis (2014) developed a parallel version of the POSHA–S for children from 3 to 11 years old, known as the POSHA–S/Child. Such a measure would foster comparative studies of various age groups to better understand the development of negative attitudes toward stuttering as well as intervention studies using a standard instrument to document changes in children after programs designed to improve their stuttering attitudes. The POSHA–S administration was changed from written to oral because, except in rare cases, young children cannot read. The demographic section is filled out by a parent, and separately, yes/no questions are asked orally of the child. Items are as similar as possible to those in the adult version; thus, summary subscores for stuttering—i.e., Beliefs and Self Reactions—and an Overall Stuttering Score (OSS) are generated for both. In scoring the POSHA–S/Child, an “I don’t know” response is recorded if the child says or indicates that he or she does not know or, after the examiner repeats the question, the child does not respond. The rationale for this “I don’t know” option is that the instrument’s authors judged that many 3- to 5-year-olds could not be expected to respond accurately to a three-choice option. Scoring of these three choices is the same as for the POSHA–S. Because it cannot be assumed that a child would know what stuttering is, the POSHA–S/Child begins with a 1.5-minute video of two child avatars (or computer-generated cartoon characters), a boy and a girl, talking about themselves and playing. Each stutters moderately to severely, but the stuttering is not acknowledged in the video. Thereafter the examiner points out that the children stuttered, identifying bouncy (repetitious), stretchy (prolonged), and stopped (blocked) speech. The examiner then asks subsequent yes/no questions aimed to measure children’s beliefs about stuttering and people who stutter (e.g., “Do you think children who stutter… are nervous? Are shy? Can talk 44 pages 41-54 Revue canadienne d’orthophonie et d’audiologie (RCOA) RELIABILITY OF THE POSHA–S/CHILD ISSN 1913-2018 | www.cjslpa.ca well? Can make friends?”), as well as their self reactions to people who stutter (e.g., “If you were talking to a person who stutters would you… finish the person’s words? Tell the person to ‘slow down?’ Laugh?”).Two recent investigations utilized the POSHA–S/Child, wherein American preschoolers were compared with American kindergarten children (Weidner, St. Louis, Burgess, & LeMasters, 2015) and with preschoolers from Turkey (in Turkish; Weidner, St. Louis, Nakıscı, & Özdemir, 2017). Preschoolers’ attitudes were more negative than those of kindergarten children, but essentially equivalent in the two countries. These studies provide preliminary evidence that the POSHA–S/ Child appears to be robust with respect to a translation to an entirely different language and sensitive to attitudes in widely different cultures. Weidner administered a slightly modified version of the POSHA–S/Child before and after an intervention uploads/Litterature/cjslpa-vol-42-no-1-2018-ms-1132-41-54.pdf