{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:10:54Z","timestamp":1793196654959,"version":"4.5.0"},"reference-count":50,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Communicative participation is restricted in many conditions associated with dysarthria. This position paper defines and describes the construct of communicative participation. In it, the emergence of this construct is reviewed, along with the predictors of and variables associated with communicative participation in the dysarthrias. In doing so, the features that make communicative participation unique and distinct from other measures of dysarthria are highlighted, through emphasizing how communicative participation cannot be predicted solely from other components of the World Health Organization\u2019s International Classification of Functioning, Disability and Health (ICF), including levels of impairment or activity limitations. Next, the empirical literature related to the measurement of communicative participation and how this research relates to dysarthria management is presented. Finally, the development of robust clinical measures of communicative participation and approaches to management is described from the point of view of the clinician. We argue that communicative participation should be a primary focus of treatment planning and intervention to provide patient-centered, holistic, and value-based clinical interventions which are responsive to the needs of individuals living with dysarthria.<\/jats:p>","DOI":"10.3390\/brainsci12040420","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T14:55:35Z","timestamp":1647960935000},"page":"420","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Communicative Participation in Dysarthria: Perspectives for Management"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0319-028X","authenticated-orcid":false,"given":"Allyson D.","family":"Page","sequence":"first","affiliation":[{"name":"School of Communication Sciences and Disorders, Western University, London, ON N6G 1H1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn M.","family":"Yorkston","sequence":"additional","affiliation":[{"name":"Department of Rehabilitative Medicine, University of Washington, Seattle, WA 98105-6246, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1055\/s-0037-1602840","article-title":"Incorporating the Principles of Self-Management into Treatment of Dysarthria Associated with Parkinson\u2019s disease","volume":"38","author":"Yorkston","year":"2017","journal-title":"Semin. Speech Lang."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1044\/1058-0360(2006\/030)","article-title":"Measuring communicative participation: A review of self-report instruments in speech-language pathology","volume":"15","author":"Eadie","year":"2006","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1044\/jshr.1202.246","article-title":"Differential diagnostic patterns of dysarthria","volume":"12","author":"Darley","year":"1969","journal-title":"J. Speech Lang Hear Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1044\/jshr.1203.462","article-title":"Clusters of deviant speech dimensions in the dysarthrias","volume":"12","author":"Darley","year":"1969","journal-title":"J Speech Lang Hear. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/S0010-9452(67)80009-1","article-title":"Suggestions for physiological research in dysarthria","volume":"3","author":"Hardy","year":"1967","journal-title":"Cortex"},{"key":"ref_6","first-page":"502","article-title":"Dysarthria in adults: Physiologic approach to rehabilitation","volume":"60","author":"Netsell","year":"1979","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1044\/jshd.4703.334a","article-title":"A physiological approach to the dysarthrias","volume":"47","author":"Rosenbek","year":"1982","journal-title":"J. Speech Hear. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1055\/s-2008-1064294","article-title":"Treating the dysarthric talker","volume":"5","author":"Rosenbek","year":"1984","journal-title":"Semin. Speech Lang."},{"key":"ref_9","unstructured":"Netsell, R., and Rosenbek, J.C. (1985). Treating the Dysarthrias. Speech and Language Evaluation in Neurology: Adult Disorders, Grune & Stratton."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1044\/jshd.4803.315","article-title":"Speech production with flaccid paralysis of the rib cage, diaphragm, and abdomen","volume":"48","author":"Hixon","year":"1983","journal-title":"J. Speech Hear. Disord."},{"key":"ref_11","unstructured":"World Health Organization (2001). International Classification of Functioning, Disability and Health (ICF), WHO."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1044\/1058-0360(2008\/07-0010)","article-title":"The Communicative Effectiveness Survey: Preliminary Evidence of Construct Validity","volume":"17","author":"Donovan","year":"2008","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1044\/1058-0360(2001\/013)","article-title":"Communication in context: A qualitative study of the experiences of individuals with multiple sclerosis","volume":"10","author":"Yorkston","year":"2001","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000111799","article-title":"Living with Dysarthria: Evaluation of a Self-Report Questionnaire","volume":"60","author":"Hartelius","year":"2008","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_15","unstructured":"Yorkston, K., Beukelman, D., Strand, E.A., and Bell, K.R. (1998). Optimizing communicative effectiveness: Bringing it together. Management of Motor Speech Disorders in Children and Adults, Pro-Ed."},{"key":"ref_16","unstructured":"Till, J.A., Yorkston, K.M., and Beukelman, D.R. (1994). Dysarthria from the viewpoint of individuals with dysarthria. Motor Speech Disorders: Advances in Assessment and Treatment, Brookes."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jcomdis.2015.06.012","article-title":"Examining the relationship between speech intensity and self-rated communicative effectiveness in individuals with Parkinson\u2019s disease and hypophonia","volume":"56","author":"Dykstra","year":"2015","journal-title":"J. Commun. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jcomdis.2003.09.002","article-title":"Communication effectiveness of individuals with amyotrophic lateral sclerosis","volume":"37","author":"Ball","year":"2004","journal-title":"J. Commun. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.3109\/02699052.2010.511590","article-title":"Speech intelligibility and perceptions of communication effectiveness by speakers with dysarthria following traumatic brain injury and their communication partners","volume":"24","author":"McAuliffe","year":"2010","journal-title":"Brain Inj."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1044\/jshd.5401.113","article-title":"The communicative effectiveness index: Development and psychometric evaluation of a functional communication measure for adult aphasia","volume":"54","author":"Lomas","year":"1989","journal-title":"J. Speech Hear. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1044\/2021_JSLHR-21-00306","article-title":"From speech acoustics to communicative participation in dysarthria: Toward a causal framework","volume":"65","author":"Borrie","year":"2022","journal-title":"J. Speech Hear. Disord."},{"key":"ref_22","first-page":"101","article-title":"Communicative participation in people with amyotrophic lateral sclerosis","volume":"73","author":"Hartelius","year":"2020","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_23","first-page":"334","article-title":"Examining speech intelligibility and self- ratings of communicative effectiveness in speakers with oromandibular dystonia receiving botulinum toxin therapy","volume":"39","author":"Dykstra","year":"2015","journal-title":"Can. J. Speech-Lang Pathol. Audiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S0021-9924(02)00064-3","article-title":"Work integration issues go beyond the nature of the communication disorder","volume":"35","author":"Garcia","year":"2002","journal-title":"J. Commun. Disord."},{"key":"ref_25","unstructured":"Yorkston, K.M., Beukelman, D.R., and Tice, R. (2011). Speech Intelligibility Test, Institute for Rehabilitation Science and Engineering at Madonna Rehabilitation Hospital."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1044\/1092-4388(2012\/12-0140)","article-title":"The Communicative Participation Item Bank (CPIB): Item bank calibration and development of a disorder generic short form","volume":"56","author":"Baylor","year":"2013","journal-title":"J. Speech Lang Hear. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1080\/17549507.2016.1193900","article-title":"Variables associated with communicative participation in Parkinson\u2019s disease and its relationship to measures of health-related quality-of-life","volume":"19","author":"McAuliffe","year":"2017","journal-title":"Int. J. Speech Lang Pathol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1044\/2017_JSLHR-S-16-0206","article-title":"Factors associated with communicative participation in amyotrophic lateral sclerosis","volume":"60","author":"Yorkston","year":"2017","journal-title":"J. Speech Lang Hear. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jcomdis.2014.05.005","article-title":"Communicative participation restrictions in multiple sclerosis: Associated variables and correlation with social functioning","volume":"52","author":"Yorkston","year":"2014","journal-title":"J. Commun. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1044\/1058-0360(2009\/08-0087)","article-title":"Variables associated with communicative participation in people with multiple sclerosis: A regression analysis","volume":"19","author":"Baylor","year":"2010","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1044\/2020_AJSLP-20-00100","article-title":"Predicting Communicative Participation in Adults Across Communication Disorders","volume":"30","author":"Jin","year":"2021","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ijnurstu.2005.11.026","article-title":"From Husserl to van Manne. A review of different phenomenological approaches","volume":"44","author":"Dowling","year":"2007","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1093\/ageing\/afj053","article-title":"Life with communication changes in Parkinson\u2019s disease","volume":"35","author":"Miller","year":"2006","journal-title":"Age Ageing"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jcomdis.2006.10.006","article-title":"Satisfaction with communicative participation as defined by adults with multiple sclerosis: A qualitative study","volume":"40","author":"Yorkston","year":"2007","journal-title":"J. Commun. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1044\/2018_AJSLP-MSC18-18-0092","article-title":"The Consequences of Oromandibular Dystonia on Communicative Participation: A Qualitative Study of the Insider\u2019s Experiences","volume":"28","author":"Page","year":"2019","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3109\/09638288.2010.511685","article-title":"Living with acquired dysarthria: The speaker\u2019s perspective","volume":"33","author":"Walshe","year":"2011","journal-title":"Disabil. Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1044\/1058-0360(2011\/10-0084)","article-title":"A qualitative study of interference with communicative participation across communication disorders in adults","volume":"20","author":"Baylor","year":"2011","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1111\/1460-6984.12668","article-title":"Perceptions regarding communicative participation in individuals receiving botulinum toxin injections for laryngeal dystonia","volume":"56","author":"Yorkston","year":"2021","journal-title":"Int. J. Lang Commun Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1044\/2020_AJSLP-20-00124","article-title":"Exploring the Psychosocial Impact of Botulinum Toxin Type A Injections for Individuals with Oromandibular Dystonia: A Qualitative Study of Patients\u2019 Experiences","volume":"30","author":"Page","year":"2021","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1001\/jamaoto.2018.0677","article-title":"\u201cI\u2019ll Have What He\u2019s Having\u2026\u201d and Other Restrictions in Communicative Participation","volume":"144","author":"Baylor","year":"2018","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1044\/2017_AJSLP-16-0087","article-title":"Speech versus speaking: The experiences of people with Parkinson\u2019s disease and implications for intervention","volume":"26","author":"Yorkston","year":"2017","journal-title":"Am J Speech Lang Pathol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1044\/1092-4388(2009\/07-0275)","article-title":"Developing the communicative participation item bank: Rasch analysis results from a spasmodic dysphonia sample","volume":"52","author":"Baylor","year":"2009","journal-title":"J. Speech Lang Hear. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1080\/02687038.2016.1225274","article-title":"Validating the Communicative Participation Item Bank (CPIB) for use with people with aphasia: An analysis of Differential Item Function (DIF)","volume":"31","author":"Baylor","year":"2017","journal-title":"Aphasiology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1002\/lary.28897","article-title":"Validation of the Communicative Participation Item Bank as an Outcome Measure for Spasmodic Dysphonia","volume":"131","author":"Yiu","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1001\/jamaoto.2021.2358","article-title":"Sensitivity of the Communicative Participation Item Bank for Measuring Patient-Reported Outcomes After Treatment of Unilateral Vocal Fold Immobility","volume":"147","author":"Baylor","year":"2021","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_46","unstructured":"(2022, February 14). CPIB Resource ePortfolio. Available online: https:\/\/sites.google.com\/uw.edu\/cpib."},{"key":"ref_47","first-page":"191","article-title":"Levels of Speech Usage: A self-report scale for describing how people use speech","volume":"16","author":"Baylor","year":"2008","journal-title":"J. Med. Speech Lang Pathol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0022-510X(99)00210-5","article-title":"The ALSFRS-R: A revised ALS functional rating scale that incorporates assessments of respiratory function","volume":"169","author":"Cedarbaum","year":"1999","journal-title":"J. Neurol. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1044\/2020_AJSLP-19-00043","article-title":"Achieving Participation-Focused Intervention Through Shared Decision Making: Proposal of an Age-and Disorder-Generic Framework","volume":"29","author":"Baylor","year":"2020","journal-title":"Am. J. Speech Lang Pathol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.apmr.2015.08.424","article-title":"Proposed Criteria for Appraising Goal Attainment Scales Used as Outcome Measures in Rehabilitation Research","volume":"97","author":"Evans","year":"2016","journal-title":"Arch. Phys. Med. Rehabil."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/4\/420\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:41:10Z","timestamp":1760136070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/4\/420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,22]]},"references-count":50,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["brainsci12040420"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12040420","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,22]]}}}