Avaliação das habilidades de compreensão e expressão em criança com paralisia cerebral através do uso da comunicação alternativa: contribuições para uma Investigação Transcultural

Abstract

Language and communication are certainly the most remarkable and significant acquisitions in the process of human evolution. Speech is just one of the forms of language, although it is the most used by humans. About one in every two hundred people is unable to communicate through speech due to neurological, physical, emotional and cognitive problems as it is the case of people with cerebral palsy, autism, mental retardation and cognitive disorders. In such cases it may be necessary to use alternative communication. Alternative Communication is defined as any form of communication other than speech and used in contexts of face to face communication involving the use of hand gestures, facial and body expressions, graphic symbols, alphabetical language, synthesized or digitized voice among others. The objective of the present work is to describe and analyze the communicative patterns of two children with twelve years of age, Tereza with cerebral palsy without oral communication capacity who makes use of the alternative system of communication and Alicia, with normal development and who makes use of speech (subject control). This study is part of a project resulting from a cross-cultural study project, whose aim is to describe how the understanding and expression of certain types of graphical statements occurs in children and young people in different age groups and different countries, and how these statements are understood by their partners - parents, teachers and peers. The communication system used by child with cerebral palsy consisted of photographs and the PCS system (Picture Communication System) in the format of a book for communication. In order to collect data the following instruments were used: semi-structured interviews with the parents and Tereza´s teacher, Tereza and Alicia; assessment of the communication and education system accomplished by parents and by Tereza´s teacher; standardized assessment of intelligence rating and of language receptiveness applied to both children; motor skills evaluation tests applied to Tereza, communicative tasks applied to both children (comprehension and production tasks). The assessed data showed greater skill and knowledge of the Tereza´s mother in the use of the alternative communication system, as well as in fostering the development of alternative language for the special child. Tereza s teacher involvement related to the use of alternative communication in the classroom was very limited. The collected data also presented difficulties in comprehensive and expressive language by Tereza which seems to be related to lack of experience and thus poor and seldom use of alternative language by the peers of the child, as well as the difference between the organizational syntax of graphical and oral language. The results showed, therefore, the difficulties presented by Tereza on the communicative tasks, but also showed the need of systematic training on the use of alternative communication systems directed at these special young people and their peers.