The Children's Communication Checklist-Second Edition (CCC-2) is a behavior rating scale developed to address the difficulties of assessing social communication in children. It was designed to be completed by a parent rater. However, since it would be helpful to know the extent to which ratings are context-dependent, this study looked at the agreement between parent and teacher ratings on the CCC-2 as well as the percent agreement on the severity of disorder. Twelve parent-teacher pairs completed the CCC-2 for children who had a documented developmental language disorder with specific impairment in social communication. Cohen's kappas, Cohen's weighted kappas, and percent agreement of severity of disorder were calculated. Kappa results ranged from less than chance agreement to fair agreement. When differentiating between scores that represent disorder and no disorder, parent and teacher percent agreement for the CCC-2 10 subscales range from 42% to 75%. Further delineation between no disorder, disorder, or severe disorder yielded percent agreement ranging from 17% to 50%. Overall percent agreement on the general communication composite was 92%. Results indicate that while parents and teachers have poor to fair agreement on the exact nature of a child's social communication strengths and weaknesses, they largely agree when a social communication problem exists. Lack of agreement likely resulted from the parent and teacher seeing the child in different contexts which required a somewhat different set of social communication abilities, or a difference in rater perception of what is within the developmental norms. These findings suggest that the best indication of a child's social communication profile may lie in a holistic assessment of performance in all the important contexts in a child's life, including school and home.

Theory of mind involves the ability to take another person’s perspective in thought, emotions and intentions.  There is today a lack of instruments to assess children’s development of Theory of Mind (ToM) in Swedish. ToM is considered by many scientists to be the basis for development of pragmatic competence. The relationship between these two abilities is complex and not fully resolved. Both abilities are important components for the development of social skills.     The purpose of this study was to compare 4 and 5-year olds ToM-ability measured with a Swedish version of Wellman and Liu’s ToM-scale, Sally Anne and Social Emotional Test with estimated pragmatic competence measured with the Children’s Communication Checklist (CCC). To make this possible the study also aims to translate and evaluate a Swedish version of Wellman and Liu’s ToM-scale. In the study 39 children in the age of 4 and 5 years old participated (20 4-year olds and 19 5-year olds).     The present study can point to the relationship between the ToM1 ability false belief and pragmatic abilities, as well as different abilities related to pragmatics (conversational rapport, use of discourse context and prosody). Correlation between prosody and other measures of ToM1 abilities was also observed. The result can be linked to previous research on the relationship between pragmatics and ToM. ToM and pragmatic are two abilities that are linked to each other. But as the result is not entirely conclusive, they may also shed more light to the complexity of these abilities and their relationship.      The result of the evaluation of Wellman and Liu’s ToM-scale shows that most of the children got a result pattern that agreed with the hypothesis of a gradual acquisition of ToM-abilties. However, Swedish 4 year olds did to a greater extent passed questions in a pattern that was not compatible with the gradual acquisition claim than American children did in a previous study. One reason for this result may be cultural differences. More research is needed on a larger selection of subjects and a wider range of age groups before any conclusions can be drawn. However, the translated scale can be used in a qualitative way, to examine which aspects of a ToM a child comprehends.

In addition to cancelations and delays of needed surgical procedures, serious or fatal complications can occur when patients with low health literacy do not comply with preoperative instructions. The purpose of this quality improvement project was to provide more insight about ways to decrease on cancelled and delayed surgical procedures in low health literacy patients' due to noncompliance with preoperative fasting instructions. The project was informed by the reach, effectiveness, adoption, implementation, and maintenance model (King, D. K., Glasgow, R. E., and Leeman-Castillo, B. (2010). The project question centered on whether health literate preoperative fasting instructions could decrease cancellations and delays of surgical procedures in low health literate patients. The project setting was conducted at a doctor's office. Interventions and changes to the preoperative instruction sheet were evaluated by using the preoperative communication checklist (POCC) which was developed for this project study. A 3-month pre-post POCC intervention design was used to evaluate changes in the numbers of cancelled and delayed surgical cases among 30 low health literate patients at a local community physician's office. The Newest Vital Sign which is a health literacy skill level assessment tool developed by Pfizer (2012), was used to assess patient health literacy. 30 (13 women and 17 men) who were aged 17-75 were enrolled. Pre-intervention, the and cancellation rate was 16.67%. Post intervention, there was a zero percent cancellation rate. This project has potential to produce positive social change by empowering patients with health literacy instructions for better understanding of what is being asked of them when having surgical procedures. This knowledge may result in better patient outcomes.

This study examines the relationship between syntactic and pragmatic language and reticence, solitary-active passive withdrawal, solitary-passive withdrawal, prosocial skills, and likeability. The Children's Communication Checklist (CCC-2), a language checklist, and Teacher Behavior Rating Scale (TBRS), a behavior checklist, were completed by three 2nd-grade teachers and three 4th-grade teachers about each of their students. Factor analysis was used to determine two composite language measures from the CCC-2 scales. The results of two hierarchal regression analyses indicated that social behaviors were significant predictors of pragmatic language, but not structural language. In particular, solitary-passive withdrawal and reticence were significant predictors of pragmatic language deficits.