Assessing Typically Developing Toddler Communication Using the CFCS and FOCUS

The Communication Function Classification System consists of five levels of communication performance with familiar and unfamiliar partners, from Level I (most functional) to Level V (least functional). In pilot data of 32 children aged 24 to 60 months, the communication performance of children older than 31 months was generally classified as CFCS Level I. However, the relationship between CFCS levels and age needs further study. The purpose of this study was to use the CFCS to determine at what age 80% of typically-developing toddlers consistently communicate at each CFCS Level and compare those results to the Focus on the Outcomes of Communication Under Six (FOCUS) items, subset scores, and total scores. Two researchers observed 37 toddlers between 12 months and 45 months of age as they interacted with familiar and unfamiliar communication partners (e.g., parents, siblings, teachers, peers). Each observation lasted approximately 30 minutes and research team members individually noted the child's CFCS classification at five-minute intervals. A parent and a teacher of each child were asked to complete a survey, including a parent-friendly version of the CFCS, a demographics form, and the FOCUS, to quantify real-world changes in these children's communication. The results for this study showed a positive correlation between a toddler's age and his or her CFCS Level. Children 12 to 24 months of age were generally classified as communicating at CFCS Level IV. Children 24 to 36 months of age were classified between Level IV and Level I. 80% of children ages 36 to 45 months were classified at CFCS Level I.