The use of augmentative and alternative communication in morphosyntax intervention in adolescents with Down syndrome
O uso da comunicação suplementar e/ou alternativa no trabalho com a morfossintaxe em adolescentes com Síndrome de Down
Rosangela Viana Andrade; Lenice de Fatima da Silva-Munhoz; Suelly Cecilia Olivan Limongi
Abstract
Purpose: to present and to discuss the use of augmentative and alternative communication as a therapeutic tool with the morphosyntax with adolescents with Down syndrome.
Methods: this pilot study monitored during 12 months four adolescents chronologically aged between 13 and 15 years and mentally aged between 5 and 6 years. It were analyzed the initial and the final assessments, situations of free interaction between the participant and the caregiver videotaped during 30 minutes. The speech samples were analyzed as MLU values considering morphemes and words, comparing both the two situations. All of the participants were submitted to the same procedures during the therapeutic interventions. Picture Communication Symbols (PCS) has been used and the symbols were organized according to a simple syntactic structure (substantive + verb + complement) with a gradual extension, and the elements were rated at the following order: articles, prepositions, pronouns (personals, possessives and demonstratives), and conjunctions. Each therapeutic session was recorded in specific protocol. It was used the Wilcoxon test and the p value considered was 5%.
Results: spites there were no statistical significant differences, increase in number of morphemes and words used between the both assessments was observed. This improve was represented by the worked elements, including prepositions and conjunctions beyond substantives and verbs. For personal pronouns there was tendency to significance (p = 0.068).
Conclusion: the communication system showed to be a therapeutic tool to improve the use of syntactic elements in statement structures, as articles, prepositions and conjunctions, which use for individuals with Down syndrome are difficult.
Keywords
Resumo
Objetivo: apresentar e discutir o uso de comunicação suplementar e/ou alternativa como instrumento terapêutico no trabalho com a morfossintaxe em adolescentes com síndrome de Down.
Métodos: estudo piloto que acompanhou longitudinalmente (doze meses) quatro adolescentes com idade cronológica entre 13 e 15 anos e idade mental entre cinco e seis anos. Foram consideradas as avaliações inicial e final, filmadas durante 30 minutos em situação de interação livre entre participante e cuidador. As amostras de fala foram analisadas a partir do cálculo da EME, quanto morfemas e palavras, para comparação entre as avaliações. Durante a intervenção terapêutica, todos os participantes foram submetidos ao mesmo procedimento. Foi utilizado o Picture Communication Symbols (PCS), com os símbolos ordenados seguindo uma estrutura sintática simples (substantivo + verbo + complemento), ampliada gradativamente,na seguinte ordem de elementos: artigos, preposições, pronomes (pessoais, possessivos e demonstrativos) e conjunções. Cada sessão terapêutica foi registrada em protocolo específico. Foi realizado o teste de Wilcoxon e o nível de significância adotado foi de 5%.
Resultados: apesar de não ter sido obtida diferença estatisticamente significante, houve aumento do número de morfemas e de palavras entre as duas avaliações, representados pelos elementos trabalhados, incluindo preposições e conjunções, além de substantivos e verbos. Para pronomes pessoais foi verificada tendência à significância (p=0,068).
Conclusão: o sistema de comunicação adotado mostrou-se uma ferramenta apropriada ao favorecimento do emprego de estruturas frasais com o uso de elementos com função sintática, como artigos, preposições e conjunções, de difícil utilização por indivíduos com síndrome de Down.
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Referências
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Submetido em:
12/10/2012
Aceito em:
18/05/2013
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