Predicting Communicative Participation in Adults Across Communication Disorders

Purpose: The purpose of this study was to explore the extent to which communicative participation differs across diagnoses and if there are common predictor variables for communicative participation across diagnoses. Method: Survey data on self-report variables including communicative participation were collected from 141 community-dwelling adults with communication disorders due to Parkinson's disease, cerebrovascular accident, spasmodic dysphonia, or vocal fold immobility (VFI). Analysis of covariance was used to determine communicative participation differences between diagnoses, with age, sex, and hearing status as covariates. Sequential entry linear regression was used to examine associations between communicative participation and variables representing a range of psychosocial constructs across diagnoses. Results: The VFI group had the least favorable communicative participation differing significantly from Parkinson's disease and spasmodic dysphonia groups. Self-rated speech/ voice severity, self-rated effort, mental health, perceived social support, and resilience contributed to variance in communicative participation when pooled across diagnoses. The relationship between communicative participation and the variables of effort and resilience differed significantly when diagnosis was considered. Conclusions: The findings suggest that communicative participation restrictions may vary across some diagnoses but not others. People with VFI appear to differ from other diagnosis groups in the extent of participation restrictions. Effort and resilience may play different roles in contributing to communicative participation in different disorders, but constructs such as social support, severity, and mental health appear to have consistent relationships with communicative participation across diagnoses. The findings can help clinicians identify psychosocial factors beyond the impairment that impact clients' communication in daily situations.