Objective: To use the Five Minute Speech Sample (FMSS) to assess Expressed Emotion
(EE) in various samples of children with asthma in order to clarify (1) developmental and
validity issues for the EE construct and (2) the use of the FMSS technique, specifically, in
children with chronic medical illness.
Method: Data were collected on a sample of 84 adolescents with severe, chronic asthma
who had failed outpatient management. In addition, a sample of 30 children with asthma,
ages 6–9, were recruited from an outpatient pediatric clinic. A comparison sample of 15
children without any chronic illness, ages 6–9, were recruited by notices posted in the
community. The primary caregiver of each child was assessed using the FMSS.
Results: FMSS interviews were reliability coded in all samples. Rates of high Criticism
(FMSS CRIT), Emotional Overinvolvement (FMSS EOI), and EE were comparable to rates
previously reported in child and adolescent samples. Although the validity for ratings of
FMSS CRIT was well supported, the validity of FMSS EOI ratings and the overall EE
construct were more problematic.
Conclusions: The FMSS is a useful and largely valid measure in children with asthma.
Ratings of FMSS CRIT were found to have strong validity. There was little problem shifting
the context of FMSS administration from chronic mental to chronic medical illness, but a
variety of developmental considerations arose, especially regarding FMSS EOI ratings.
Although we raise concerns about viewing EE as a valid construct, it may remain a useful