The Palin Parent Rating Scales

The Michael Palin Centre for Stammering Children

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The Palin Parent Rating Scales

Sharon MillardSteve Davis

Frances Cook


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Overview• Background to development of the parent

rating scales • The Delphi Study• The exploratory factor analysis• Normative Scores• The Palin Parent Rating Scales (Palin

PRS)


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A measure that would take into account:

– The variability of stammering– The impact of stammering on the child– The impact of stammering on the parent- The broader aims of therapy– Whether change is clinically significant– Clients’ reports and evaluations of outcome


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The Delphi StudyAim:‘obtain a group’s opinion or judgment on a

topic’ (Goodman 1987, p730)

Principle:“entails gathering information, opinions and

ideas from a panel of experts using a specific sequence” (Mead and Moseley, 2001)


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Six Stages of a Delphi Study

• Selection of the expert panel • Formulation of the question• Generation of statements• Reduction and categorisation• Rating • Analysis


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The Questionnaire• 26 items remained• Series of 10 cm visual analogue scales• Marked 0 and 10 at each end

Use:• Obtain score by measuring along the line• Group scores into categories: stuttering

severity; impact on child; impact on parent; parents’ knowledge and confidence


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Limitations of scoring and interpretation

• No evidence to support the categorisation of the individual scales into the four areas

• Each scale receives the same weighting in the final score(s)

• No information about whether each contributes to the overall questionnaire


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Aims

To use exploratory factor analysis to establish the constructs underlying responses to the parent rating scales.

To establish reliability of the parent rating scales

To produce standardized scores for the factor constructs


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Method

• Questionnaires completed at initial assessment

• 259 Parents (146 mothers, 113 fathers)– Children aged 2;6 – 14;6 – Male : female 3:1


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Exploratory Factor Analysis

• Indicated that certain items were redundant – final scale contains 19 items

• Revealed three components– Impact on the child– Severity of stammering and impact on the parents– Parents’ knowledge and confidence in managing the

stammering

Items loading on Factor 1 (impact on child)

• Does your child speak less because of the stammering?

• How frustrated is your child with his speech?• How upset is your child by his stammering?• How anxious is your child about his speech?• How confident is your child in speaking situations?• How happy is your child generally?• How well can your child express how he feels?


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Items loading on Factor 2 (severity and impact on parents)

• How worried are you about your child’s stammering?

• How much is your child struggling?• How anxious are you about your child’s future

because of the stammering?• How often does your child stammer?• How much of an impact does the stammering

have on your family?• How severe is your child’s stammering• Does your child have fluent times?


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Items loading on Factor 3(parent’s knowledge and confidence)

• How confident are you in your knowledge of how to:– Respond when your child is stammering– encourage fluency in your child– Deal with your child’s concern / awareness of

stammering– Encourage confidence in your child

• Do you understand what influences your child’s stammering?


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Reliability• Cronbach’s alpha

– Measures the internal consistency of the scale

– Items should measure the same thing so should correlate with each other

– alpha increases when correlations between items increase

– Alpha of .7 and above considered as reliable


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ReliabilityAlpha for complete scale - .882

– For impact on child component - .865– For impact on parent/severity - .863– For parents knowledge and confidence - .838– Alpha for parents of younger children (n=166)

- .862– Alpha for parents of older children (n=93) -

.905


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The resulting Palin PRS• Consists of a series of 19 visual analogue

rating scales• There are 3 component factors:

– Impact on the child– Severity of stammering and impact on the

parents– Parents’ knowledge and confidence in

managing the stammering


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Palin PRS

How worried are you about your child’s stammering?

0 10as worried as not at all

I possibly could be

How worried is your child about his stammering?

0 10as worried as not at all

he possibly could be


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Normalizing and scaling the factor scores

• First step is to produce weighted factor scores for each of the three factors:– Each scale item differs in the amount it contributes to the

factor– Weighted factor scores take this into account– Factor loading (amount scale contributes) is multiplied to

the scale score to produce factor score

• Weighted factor scores then normalized to Z-scores based on mean and standard deviation and transformed to T-scores for ease of interpretation.


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Normalizing and scaling the factor scores

• Normalised scores converted to stanine scores:– Produces score from 1 to 9– Allows for easy interpretation of factor scores– To assist in identification of areas that may be of

concern– To assist in monitoring change following intervention


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Scale Categories for Factor 1 –impact on the child

Total Normed Score

Stanine Score Percentile Category

25-31 1 1-4Very Low

32-42 2-3 5-23Low

43-58 4-6 24-77Moderate

59-65 7-8 78-95High

66+ 9 96-99Very High


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Scale Categories for Factor 2 –severity and impact on parents

Total Normed Score Stanine Score Percentile Category

28-33 1 1-4 Very Low

34-42 2-3 5-23 Low

43-57 4-6 24-77 Moderate

58-67 7-8 78-95 High

68+ 9 96-99 Very High


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Scale Categories for Factor 3 –parent’s knowledge and confidence

Total Normed Score

Stanine Score Percentile Category

25-32 1 1-4 Very Low

33-42 2-3 5-23 Low

43-58 4-6 24-77 Moderate

59-65 7-8 78-95 High

66+ 9 96-99 Very High


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Next steps

• Demonstrate use as an outcome measurement tool

• Programme for use• Dissemination

Acknowledgements

• The Association for Research into Stammering in Childhood (ARSC)

• Islington PCT (Whittington Health)


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Contact [email protected]

[email protected]

The Michael Palin Centre for Stammering ChildrenWhittington Health13-15 Pine StreetLondon EC1R 0JHTel: 020 3316 8100

mailto:[email protected]�

mailto:[email protected]�

Documents

The Palin Parent Rating Scales