Preschoolers’ communicative participation outcomes (Cunningham et al., 2018)

<div><b>Purpose: </b>The aim of this study was to identify predictors of communicative participation outcomes for a large cohort of preschoolers with speech and language impairments.</div><div><b>Method:</b> A secondary analysis of longitudinal program evaluation data from Ontario, Canada’s Preschool Speech and Language Program was done. Data available for 46,872 children 18–67 months of age (<i>M</i> = 41.76 months, <i>SD</i> = 11.92; 68% boys, 32% girls) were previously used to predict children’s communicative participation skill development in 5 levels of function. Demographic and intervention-based variables were added to the models to identify new predictors of growth.</div><div><b>Results: </b>Three demographic and 3 intervention-based variables were statistically significant predictors of children’s communicative participation outcomes. Clinically significant predictors included participation in an early learning environment, receipt of speech-language interventions, and the amount of time spent in intervention. These variables impacted predicted outcomes differently, depending on a child’s level of communicative function.</div><div><b>Conclusions: </b>This population-based study of preschoolers with speech and language impairments identified predictors of growth in communicative participation skills—an outcome important and meaningful to families but not often explored. A broad picture emerged of factors that may influence the development of communicative participation skills and may be used to predict outcomes for preschoolers. Given the large sample size, these robust findings may be used to predict outcomes outside the Preschool Speech and Language Program as well.</div><div><br></div><div><b>Supplemental Material S1. </b>Predicted coefficients for the fixed and random effects for children in each Communication Function Classification System (CFCS) level from the original growth curves study.</div><div><br></div><div>Cunningham, B. J., Hanna, S. E., Rosenbaum, P., Thomas-Stonell, N., & Oddson, B. (2018). Factors contributing to preschoolers’ communicative participation outcomes: Findings from a population-based longitudinal cohort study in Ontario, Canada. <i>American Journal of Speech-Language Pathology, 27, </i>737–750<i>. </i>https://doi.org/10.1044/2017_AJSLP-17-0079</div

Factors predictive of time to long-term disability claim closure

<p>HR – hazard ratio; CI –confidence interval; ICD-10 – International Classification of Diseases version 10; * - Consists of Alberta, Saskatchewan, and Manitoba; ** - Consists of New Brunswick, NewFoundland, Nova Scotia and Prince Edward Island; ASO – Administrative Services Only</p><p>Factors that have a p-value of less than 0.01 are significant predictors of claim closure</p><p>An HR of greater than 1 is associated with faster claim closure; an HR of less than 1 is associated with slower claim closure</p

Factors predictive of time to short-term disability claim closure

<p>HR – hazard ratio; CI –confidence interval; ICD-10 – International Classification of Diseases version 10; * - Consists of Alberta, Saskatchewan, and Manitoba; ** - Consists of New Brunswick, NewFoundland, Nova Scotia and Prince Edward Island; ASO – Administrative Services Only</p><p>Factors that have a p-value of less than 0.01 are significant predictors of claim closure</p><p>An HR of greater than 1 is associated with faster claim closure; an HR of less than 1 is associated with slower claim closure</p

Baseline characteristics

<p><u>STD</u>- Short term disability; <u>LTD</u>– Long-term disability; <u>SD</u>– Standard deviation; <u>IQR</u>– Interquartile range;; * - Excluded from analyses; ** - merged as ‘Prairies’ for our analyses; *** - merged as ‘Maritimes’ for our analyses; N/A – not applicable due to no reserves for STD</p

Description of variables

<p><u>ICD</u>: International classification of diseases; +: associated with faster claim closure; −: associated with slower claim closure; O: associated with similar resolution; * − classifications of industry in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0067162#pone.0067162.s001" target="_blank">Table S1</a>; <u>LTD</u> – long term disability</p

Comparison between predictors associated with time to claim closure for short-term disability versus long-term disability claims

<p>Bold rows represent associations that were in the opposite directions of what we anticipated</p><p><u>STD</u>: short-term disability; <u>LTD</u>: long-term disability; +: associated with faster claim closure; -: associated with slower claim closure; O: associated with similar resolution; <u>NS*</u>: not significant but consistent with anticipated direction; <u>NS**</u>: not significant and not consistent with anticipated direction; <u>N/A</u> =  not included in the model</p

Kaplan Meier time to event curve of time to long-term disability claim closure

<p>Kaplan Meier time to event curve of time to long-term disability claim closure</p

Kaplan Meier time to event curve of time to short-term disability claim closure

<p>Kaplan Meier time to event curve of time to short-term disability claim closure</p