Questions (FAQs)

Who can use the CFCS?

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  • Who can use the CFCS?
    • The CFCS is aimed at a wide  number of users including allied health professionals, physicians, educators, individuals with CP, and parents of individuals with CP. The authors have consistently attempted to make the CFCS readable to all in order to describe functional communication performance using a common language and have sought the input of both people with cerebral palsy and parents of such people.

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  • What is meant by “everyday communication performance” under “Purpose” on page 1 of the CFCS?
    • Everyday communication performance refers to an individual’s typical, day-to-day communication. This does not include communication abilities that only occur occasionally or with high degrees of prompting or assistance.
    • Communication is the result of establishing a shared understanding between communication partners. The ease of establishing this shared understanding will vary by partner and  setting. However, a CFCS Level I communicator is generally successful communicating with most partners and in most settings. The other CFCS  levels vary by how easily this shared understanding is established with familiar and unfamiliar communication partners.

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  • Does the CFCS make allowances for disability?
    • The CFCS is based on everyday communication performance without considering any underlying disabilities such as cognitive impairment.

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  • How do you define comfortable conversational pace?
    • Comfortable pace occurs with few communication breakdowns and little wait time between communication turns.  Conversational pace should be compared to the cultural expectations of the communicators. In United States communication research, average wait time between communication turns is a few seconds.

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    • Is comfortable pace dependent upon the method of communication such as the use of augmentative and alternative communication (AAC)?
      • Comfortable pace expectations do not change based on the communication method or methods used. For example, comfortable pace should be judged the same for individuals using spoken or speech-generating devices.
      •  Certain communication methods, especially aided AAC, may add even minutes of wait time as a person composes messages. This slower pace will likely limit the number of unfamiliar partners that will or can wait in order to complete a conversation. In addition, this slower pace may be a barrier for    employment and educational options.

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    • How is AAC considered within the CFCS?
      • The CFCS focus is on being able to participate, and not on the underlying problems that are limiting an individual’s communication. If a method of AAC is being used or developed that does not provide a time limitation barrier (such as sign language) then that person would be a level I, all other things considered.
      • If the AAC does not allow them to quickly switch between sender and receiver roles within a few seconds, then that individual is not likely to be classified at CFCS Level I. The amount of time used in AAC is a barrier for many AAC users participating in conversations.

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    • Does the CFCS consider speech intelligibility?
      • Speech intelligibility does not translate directly to communication effectiveness. Individuals with intelligible speech can be less effective communicators due to other underlying conditions including hearing and/or language disorders.  Individuals with less intelligible speech can be effective communicators  such as when they use multiple means of communicating including AAC. That is why the focus of the CFCS is on functional communicating and not just speech output measures such as intelligibility.
      • Of course, the CFCS can be complemented by tests of intelligibility or by assessments of related constructs such as comprehensibility, listener comprehension and communicative participation, all of which have been proposed as measures of communicative effectiveness. There is no widely accepted measure of intelligibility that can be used for various ages and levels of communication. Furthermore, it is clear that any such measure is sensitive not only to speaker characteristics but also to listener characteristics (especially familiarity with the speaker or with types of speech disorder) and to the communicative setting.

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    • Why isn’t there an explicit difference between impaired sending and receiving in the CFCS?
      • The CFCS views an individual’s ability to communicateas a whole. Since communication requires a  quick interchange between these two abilities, the CFCS focuses on the individual’s ability to interact in a communicative environment.

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    • The CFCS appears to address use  of language. Does it address content and form as well?
      • This depends on one’s model of language. If one considers the latest Bloom language model language, content and form are embedded in language use. Thus, an effective communicator will use the appropriate content and form to achieve the  desired use.

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      • The WHO ICF and ICF-CY may also illustrate this point. Effective communication activity and participation may hinge most directly on using language. However, language components  (e.g., use, content, and form), as well as speech and hearing components,  can be examined at a body structure and function level.

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