Fonoaudiologia e a gestão da linguagem na área da comunicação suplementar e alternativa: da formação à prática

Abstract

This thesis has the general objective to investigate the role of the Speech, Language and Hearing Science Therapist in Augmentative and Alternative Communication with children with cerebral palsy and the conversational standard l in Speech, Language and Hearing Science in dyad sessions. It also aims at developing a conversational evaluation Speech, Language and Hearing protocol to guide evaluation and Speech, Language and Hearing intervention in Augmentative and Alternative Communication directed to this population. For these objectives, three studies were developed with different methods. All the Speech, Language and Hearing Science professionals of study one had the initiative to compensate for the lack of training in their undergraduate Augmentative and Alternative Communication course in different ways. Regarding the inclusion of different conversational partners all Speech, Language and Hearing Science professionals are in favor of this practice. However, they report the family, school and other therapists as resistant to that. Study two shows communicative means used by children and partners, namely oral means, oral assisted, gestural, vocal and pictographic ones. The speech acts of the speaker were predominantly the directive type ones and the children´s speech acts came in the form of adjacent pairs. The conversational analysis Speech, Language and Hearing Science protocol developed from the previous study of the final version of this present study is made up of fifty-four items and it is divided into three parts: (a) communicative means, acts of speech, theme maintenance and dialogue turns common to the dyads; (b) acts of child speech, the Augmentative and Alternative Communication resource use, thematic maintenance and dialogue turn and (c) speech acts of the speaker. There is a need to insert theoretical subjects, clinical observation and practical classes with the intervention in language with Augmentative and Alternative Communication theme in the pedagogical political projects of Speech, Language and Hearing Science courses. Speech, Language and Hearing therapists insert different interlocutors in intervention with Augmentative and Alternative Communication and guide themselves in implicit or explicit linguistic principles according to their written speech, in theoretical reference specific to Augmentative and Alternative Communication area, in global neuromotor elements and, finally, on functionality principles and general well being. Regarding the communicative means used by children and partners, the verbal means, assisted verbal, gestural, vocal, assisted non-verbal one with loose figures were produced. However, they are asymmetrical in use hampering a multimodal communication system. The speech acts of children are more effective and functional in the form of adjacent pairs (protest, inquiries and requests) because they are more dependent linguistically on conversational partners. The conversational clinical assessment protocol for children with cerebral palsy and their partners developed in study three can be used to evaluate the means, the communicative acts and adjacentpairs observed in conversational context, leading the initial language evaluation process to the introduction, maintenance and generalization of Augmentative and Alternative Communication use with different interlocutors and environments. This way, there might be a more delineated evaluative criterion of linguistic competence by considering the language in use with different interlocutors, encouraging the creation of programs that enhance the communication skills and, consequently, the quality of life of children with cerebral palsy and thus, their families.