Assessment of children's communicative participation: a preliminary study on the validity and reliability of the Italian Focus on the Outcomes of Communication Under Six (FOCUS-I) in preschool age

Aim: Focus on the Outcome of Communication Under Six (FOCUS) is a 50-item rating scale designed to assess communicative participation in preschoolers. Satisfactory psychometric properties have been established for the English and German FOCUS versions. This preliminary study aimed to investigate internal consistency, test–retest reliability, and convergent and construct validity of the Italian adaptation of FOCUS (FOCUS-I). Method: The study included Italian-speaking children (N = 364) aged between 36 and 71 months (M = 56.1, SD = 9.8) without a major developmental impairment. Parents completed FOCUS-I, and children were assessed through a naming task and a word repetition task. To evaluate test–retest reliability, 139 parents completed FOCUS-I twice. Results: Analysis found excellent internal consistency for the overall score, with most subscales reaching acceptable internal consistency. High test–retest reliability was detected for the overall score; all subscales showed at least fair test–retest reliability. Some FOCUS-I subscales had moderate correlation with the speech measures from the word repetition task and with the expressive vocabulary from the naming task. A high correlation was found between the overall score and subscale scores. Among the 364 recruited children, those with low speech competencies (n = 46) or with low expressive vocabulary skills (n = 30) were rated lower by their parents for overall score and most subscale scores. Conclusion: FOCUS-I can be considered a reliable and valid measure of functional communicative participation for Italian-speaking preschoolers. Further research is needed for the validation of FOCUS-I in typically and atypically developing children.