1. Test-Retest Reliability of The Family Paradigm Assessment Scale (F-PAS)
Ariel Adams1
BJ Arnold2
Renee Smith2
Brittany Reed2
1Department of Hearing, Speech, and Language Sciences
Gallaudet University
2Department of Speech-Language Pathology
University of Central Arkansas

2. Resources transformed for goals.
Control
How do important things get done?
Time
How is it used?
Family
Members may act as one entity, in small groups, individually, according to their
Space
How are physical and personal space used?
Affect
How are caring & support expressed?
Energy
How much effort to get things done?
Family-centered evidence-based practice (EBP) is an approach to intervention in which the clinician considers the research, her clinical experiences, and the family’s values and preferences while making clinical decisions.
Speech-language pathology and audiology professionals can look to family science for models and tools to help families discuss their values and encourage family-centered EBP. …
Meaning
What do you value?
family paradigm
Material
How are possessions viewed?
Content
How do you determined what is real?

3. There are four paradigms: Closed Random Open Synchronous
Family Paradigm = family’s view of the world.
Each family's behavior is guided by its paradigm(s).
There are four paradigms: Closed Random Open Synchronous
Family Paradigms describe the family’s view of the world – or how they prefer to use their resources to meet their goals.
Paradigms guide the way families do everything. Each one represents different decision-making processes that a family might use.
The four paradigms are closed, random, open, and synchronous.

4. Stability through continuity & tradition
Family Paradigm = family’s view of the world.
Each family's behavior is guided by its paradigm(s).
There are four paradigms: Closed Random Open Synchronous
Stability through continuity & tradition
Families that are particularly closed-paradigmatic prefer stability through continuity and tradition.
they stick to a schedule and do the things they have always done

5. Free exploration through intuition & innovation
Family Paradigm = family’s view of the world.
Each family's behavior is guided by its paradigm(s).
There are four paradigms: Closed Random Open Synchronous
Free exploration through intuition & innovation
Families of the random paradigm prefer free exploration through intuition and innovation.
act in spontaneous and individual ways to reach individual goals.

6. Adaptation through consensus
Family Paradigm = family’s view of the world.
Each family's behavior is guided by its paradigm(s).
There are four paradigms: Closed Random Open Synchronous
Adaptation through consensus
Families of the open paradigm prefer adaptation through consensus.
make their decisions as a group and change if the group sees fit.

7. Harmony through identification
Family Paradigm = family’s view of the world.
Each family's behavior is guided by its paradigm(s).
There are four paradigms: Closed Random Open Synchronous
Harmony through identification
Families of the synchronous paradigm prefer harmony through identification.
know and understand what they do and why without a need to communicate with each other because the “just know.”

8. Some families use multiple paradigms
Family Paradigm = family’s view of the world.
Each family's behavior is guided by its paradigm(s).
There are four paradigms: Closed  Random  Open  Synchronous 
Some families use multiple paradigms
It is important to remember that families can have members that use different paradigms, or use a combination of paradigms as a family.

9. The Family Paradigm Assessment Scale (F-PAS)
(Imig, 1998)
Used to identify paradigms
Paper and pencil instrument
10 multi-part questions using a 0-10 rating scale
1 question per resource
1 question to rank resources
1 question per goal
1 question to rank goals
Current and Ideal
The tool designed to identify paradigms is called the Family Paradigm Assessment Scale.
It is a paper and pencil instrument used to help identify individual paradigms. It consists of 10 two part questions using a zero to ten rating scale. An answer of 0 indicates that the participant’s family would never use that strategy, and an answer of 10 indicates that the participant’s family uses that strategy the most. Each question calls for two answers, one for how the family currently operates and one for how they would ideally operate.

10. The Family Paradigm Assessment Scale (F-PAS)
Cluster Scores
Calculated from the F-PAS
Range from 0-5
0 – family never uses this paradigm
5 – family uses this paradigm most often
Define cluster scores
Reporting on C&I overall – future analysis for rest

11. Research Aim
To measure test-retest reliability of the F-PAS overall cluster scores.
The aim of my research project was to measure the test-retest reliability of the Family Paradigm Assessment Scale.

12. Participants (N=51) Gender: Age: Race/ethnicity: Education level:
34 females, 17 males
Age:
Mean Age 30 years
Range from
Race/ethnicity:
2% American Indian
18% African American
81% Caucasian
Education level:
2% High school graduate
39% Some college
31% College graduate
18% Some graduate school
10% Advanced degree
Family roles:
26 spouses
11 parents
3 grandparents
20 offsprings
23 siblings
Years in family:
53% entire life
29% five years or more
10% less than five years
8% less than one year

13. Procedures Recruitment: flyers, word of mouth
Each participant completed the F-PAS twice, demographics, no major change,
Data entered into Excel spreadsheet which calculated F-PAS cluster scores
Test-Retest Reliability of the overall F-PAS cluster scores for each paradigm was calculated using weighted kappas (k) with 95% confidence intervals (CI)
<0.00 poor
slight
fair
moderate
substantial
almost perfect
(Byrt, 1996)
Recruiting was really the hardest part: I sent out and posted flyers, I told my friends, told them to tell their friends, etc.
Participants completed the F-PAS once and then again two weeks later.
They also filled out a demographics form and reported any major change in the two week period. (death in a family or loss of job that might explain any major difference in results)
The scores were then calculated and compared using weighted kappas with 95% confidence intervals
A weighted kappa score was determined for each of the four paradigms.
A kappa is a way of measuring reliability using a full credit system. The scores are either the same, or they are not.
A weighted Kappa is a little bit more complicated in that it measures reliability using a “partial credit” system for having similar scores. So if they have a 5 on the initial test and a 4 on the retest, it would get a score of like, .8 whereas in a Kappa system it would get 0, because it did not match exactly.

14. Current Closed Paradigm
Retest 5 4 3 2 1
Test 11 15
In this chart, the rows represent the first f-pas cluster scores (the test)
And the columns represent the second f-pas cluster scores (the retest)
The numbers in each box represent the number of participants with that score. (for instance, we have 3 in the 5-4 box – this means that three people had the current-closed paradigm score of 5 on the first f-pas and 4 on the first f-pas.)
Numbers on the yellow line are considered to have perfect reliability. those near but outside the yellow boxes, have better reliability than those in the outside 5-0 or 0-5 boxes. (in the top right or bottom left corners)
k = % CI (.30,.70)
Moderate

15. Current Random Paradigm
Retest 5 4 3 2 1
Test 18 16
k = % CI (.09,.52) Fair

16. Current Open Paradigm 21 10 6 8 Retest 5 4 3 2 1 Test
Test 21 10 6 8
k = % CI (.03,.50) Fair

17. Current Synchronous Paradigm
Retest 5 4 3 2 1
Test 16
k = % CI (.38,.69)
Moderate

18. Ideal Closed Paradigm 9 7 11 8 Retest 5 4 3 2 1 Test
Test 9 7 11 8
k = % CI (.33,.70) Moderate

19. Ideal Random Paradigm 16 6 8 Retest 5 4 3 2 1 Test
Test 16 6 8
k = % CI (.05,.49) Fair

20. Ideal Open Paradigm 33 8 Retest 5 4 3 2 1 Test
Test 33 8
k = % CI (.24,.71) Moderate

21. Ideal Synchronous Paradigm
Retest 5 4 3 2 1
Test 14 9
k = % CI (.16,.56) Fair

22. Overall Findings Current-Closed Paradigm Current-Random Paradigm
Moderate reliability
Current-Random Paradigm
Fair reliability
Current-Open Paradigm
Current-Synchronous Paradigm
Ideal-Closed Paradigm
Moderate reliability
Ideal Random Paradigm
Fair reliability
Ideal- Open Paradigm
Ideal- Synchronous Paradigm
Overall test-retest reliability

23. Clinical Implications
Test-retest reliability OK for clinical use
Clinicians can use the F-PAS to:
Determine paradigms of clients and their families
Provide services that best fit client/family
Improve family-centered practices
Help families better understand how intervention affects their family functioning
Fair to moderate test-retest reliability is not a clinical issue because the results can be validated through discussion.
Can be used by clinicians to determine paradigms of the families they are working with.
This will help them to provide services best fitting each client and therefore improve the overall quality of therapy
It can also help families understand how intervention affects their family functioning.

24. Future Research Analyze reliability of individual cluster scores
Need to evaluate ways to improve reliability
Wording of questions
Data collection method
Use family paradigm model of resources and goals in researching family-centered practices
Although the Family paradigm assessment scale can be used in clinic, Test-retest reliability should be improved for research purposes.
We need to evaluate new ways to improve reliability. These could include the wording of the questions and the data collection method used – possibly making the F-PAS more “user friendly.”
Once that is done, the F-PAS can be used in researching family-centered practices

25. What we learned… There are no short cuts
Nothing is as easy as it appears to be
Double check EVERYTHING
Everybody needs a team
Research is fun
“Welcome to research”
No short cuts – everything must be done the right way – and that usually means the long way.
Nothing is easy – recruitment sounds easy
Double check everything – proofread before you send things out (with a typo) data entry (much easier to fix now than find it later) THE LITTLE DETAIL MATTER
Team – helped recruit – even moreso when I was in a bind, help with abstract (which I had never written before) peer-editing group, moral support system
Research is fun – fun to learn, interesting to see how everything fits together. I’ve read many many research articles for classes and never really understood what they meant until I understood the research process. I learned so much information that I didn’t know before.
And when all else fails, “welcome to research”

26. Acknowledgements Those who participated
Faculty mentor: Dr. Mary Jo Cooley Hidecker
F-PAS creator: Dr. David R. Imig
Research team members: BJ Arnold, Morgan Poole, Brittany Reed, Megan Scott, Sara Shaw, Renée Smith, Tammy Soileau and Kara Taylor
UCA Sponsored Programs Office (SPO)
This research was funded by the Arkansas Department of Higher Education and the University of Central Arkansas Speech-Language Pathology Department

27. For more information:
Byrt, T. (1996). How good is that agreement? Epidemiology, 7(5), 561. Constantine, L. L. (1986). Family paradigms: The practice of theory in family therapy. New York: Guilford. Constantine, L. L. (1993). The structure of family paradigms: An analytical model of family variation. Journal of Marital and Family Therapy, 19(1), Hidecker, M. J. C. (2004). An exploratory study of the associative relationships between family paradigms and augmentative and alternative communication satisfaction in families with young Children. Unpublished Thesis (Ph. D.), Michigan State University. Dept. of Audiology and Speech Sciences, Hidecker, M. J. C., Jones, R. S., Imig, D. R., & Villarruel, F. A. (2009). Using family paradigms to improve evidence-based practice. American Journal of Speech Language Pathology, 18(3), Imig, D. R. (1993). Family stress: Paradigms and perceptions. Family Science Review, 6, Imig, D. R. (2000). A conversation about interpersonal relationships, family systems and paradigms. Venice, CA: ETEXT.net Electronic Textbook Publishing. Imig, D. R. (2005). Family paradigms, interpersonal relationships, and family systems. Venice, CA: ETEXT.net Electronic Textbook Publishing. Imig, D. R., Pate, S. M., Mitchell, M. M., David, D. A., Pegorraro, C., Barton, E. R., et al. (1996). Paradigmatic family systems theory: Applications and praxis. Paper presented at the 58th Annual Conference Education & Enrichment Section, Kansas City, MO. Imig, D. R., & Phillips, R. G. (1992). Family theory: The family regime assessment scale (FRAS). Family Science Review, 5, Kantor, D., & Lehr, W. (1975). Inside the family (1st ed.). San Francisco: Jossey-Bass.
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28. The Family Paradigm Assessment Scale (F-PAS)
Cluster Scores
Two cluster scores for each paradigm
Current & Ideal overall
Current & Ideal time
Current & Ideal space
Current & Ideal energy
Current & Ideal material
Current & Ideal control
Current & Ideal affect
Current & Ideal meaning
Current & Ideal content
Calculated from the F-PAS
Range from 0-5
0 – family never uses this paradigm
5 – family uses this paradigm most often
Define cluster scores
Reporting on C&I overall – future analysis for rest