Scoping review of the Communication Function Classification System (CFCS)

Introduction: The Communication Function Classification System (2011) classifies communication into 1 of 5 distinct levels based on sending/receiving messages with familiar/unfamiliar partners. The level is based on all communication methods including aided and unaided augmentative and alternative communication (AAC). Originally developed for use with cerebral palsy, the CFCS has since been used with other populations.

Research Question: Since the initial publication, how has the CFCS been used in clinical and research applications?

Methods: For this scoping review, a cited reference search for ‘Hidecker, M*, 2011’ was conducted.

Results: This method identified 572 articles citing the CFCS. Of the 572, about 40% mentioned the CFCS in background information and about 54% used the CFCS for research purposes. Of the articles that used the CFCS for research purposes, 86% used the CFCS level as a participant description, but only 22% reported participants` AAC methods of communication.

Discussion/Conclusions: Since its 2011 publication, the CFCS has been translated into more than 28 languages. Many use the CFCS as part of a classification family including the GMFCS for functional mobility (1997), the MACS for functional hand use (2006), and the EDACS for functional eating and swallowing (2014). In the studies identified, authors report CFCS levels, but not the AAC methods used. Reporting AAC use status is potentially important to understanding AAC service delivery patterns. In cerebral palsy studies as well as other disability areas, an underestimation of the number of patients that require AAC is likely. If an individual with a communication disorder is not at a CFCS level I, AAC should be considered as a service option.