The Communicative Performance Measure （３）
Implementation of CPM
The interview using CPM proceeds in the following four steps.
＜The CPM procedure＞
Step 1: Listening to the main complaint in daily communication and specifying the main communication partner
Step 2: Rating of the level of comprehensibility and satisfaction by the person with the speech disorder and by his or her communication partners
Step 3: Detailed discussion of communication problems and setting of goals
Step 4: Rerating the level of comprehensibility and satisfaction
The first three steps are conducted during the intake interview, and the fourth step is conducted after the intervention.
If the intervention is to be continued, the procedure is repeated from step 1 or 2.
Step１
In the first step, the person with dysarthria (hereafter referred to as “PwD”) is interviewed about his or her main complaints regarding speech and communication.
The PwD is asked to list several family members and non-family members (e.g., professional staff at a daycare facility, people at work, etc.), and to select those he or she frequently converses with or those with whom he or she feels it is important to communicate.
At this point, we explain to the PwD that communication is a collaborative activity with their communication partners and that mutual understanding of the condition is essential for its success. Thereafter, we obtain the PwD’s consent to also interview their communication partners.
＜Example questions for the first step＞
・Do you have any problems in your life?
・Who do you talk to most often? (Is there someone you talk to often?)
・Are there people with whom you will need to communicate in the future, or opportunities to speak in public?
Step２
In the second step, the PwD and his or her main communication partners (hereafter referred to as “the partners”) are asked to individually reflect on a recent conversation between them (e.g., yesterday or the day before) and to rate the level of comprehensibility and satisfaction.
For comprehensibility, the clients are asked to rate the current level of comprehensibility using an 11-grade scale (10 for fully conveyed or fully understood; 0 for not conveyed at all).
The PwD is asked to rate how much of what he or she wanted to say was conveyed to the partner, and the partner is asked to rate how much of what the PwD wanted to say was conveyed to them.
Considering that the level of comprehensibility is affected by various factors, we ask the clients to rate the level of comprehensibility separately for “relatively high comprehensible situation” [comprehensibility (high)] and “relatively low comprehensible situation” [comprehensibility(low)].
For satisfaction, the clients are asked to rate the current level using an 11-grade scale (10 for very satisfied; 0 for very dissatisfied). The PwD and the partner are asked to rate the level of satisfaction the PwD feels.
＜Example questions for the second step＞
・Recall your recent communication you had with~ (the partner).
How well do you think what you wanted to say was conveyed to ~?
(To the partner) how well do you think the PwD's message was conveyed to you?
・Please rate as 10 for fully conveyed and as 0 for not conveyed at all.
How well do you think the message was conveyed to your communication partner (or you) when it was well conveyed and how well, when it was not well conveyed?
・How satisfied are you (or PwD) with the way the message was conveyed?
Step３
In the third step, based on the results of the comprehensibility and satisfaction ratings, the clients are asked to give detailed reasons for their ratings, and the people concerned work together to identify factors that affect the success or failure of communication. Thereafter, based on the thoughts and needs of the client, strategies for improvement are discussed.
Since some clients may become more aware of the current situation at this step and may modify their ratings, we ask the clients to rerate the level of comprehensibility and satisfaction at the end of this step.
Comprehensibility is defined as the extent of comprehension of the speech by a listener, as described earlier.
We thought that if the PwDs themselves, who know their own speech intentions, could also identify and rate the level of comprehensibility, it would serve as a starting point for mutual confirmation and reflection on communication and would enable them to cope with the present situations with conviction.
＜Examples of questions in the third step＞
・(For the results of the evaluation of comprehensibility and satisfaction levels) Why did you choose this score?
・Why do you think the message was not well conveyed? [How the message was conveyed, the partner's preparation (posture) while listening or communication, the situation (distance, face to face/not face, etc.), noise level, content of communication, etc.]
・Why do you think the message was well conveyed?
・What do you do when you cannot clearly convey the message?
・How do you think it can be more easily communicated?
・(After rerating the comprehensibility and satisfaction levels, if necessary) If you do not have difficulty in speaking, is there anything you would like to try?
Step４
The fourth step is the reevaluation, which is conducted after the intervention, to identify any improvements and to discuss future policies or planning with the people concerned.