Efeitos do ensino de sentenças impressas por construção e por seleção sobre a compreensão e produção oral em crianças com implante coclear
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2020-03-24
Autores
Alvarez, Maria Fernanda Cazo
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Universidade Estadual Paulista (Unesp)
Resumo
A deficiência auditiva sensorioneural pré-lingual pode comprometer o desenvolvimento da linguagem oral. O implante coclear (IC) é um dispositivo auditivo que permite a essa população a detecção de sons na frequência da fala humana. A detecção de sons pode não ser suficiente para o desenvolvimento da linguagem e requer procedimentos de ensino para que se promova a aprendizagem do uso do dispositivo e o desenvolvimento das habilidades auditivas e expressivas. Pesquisas em interface entre Fonoaudiologia e Análise do Comportamento mostraram que o ensino baseado em equivalência (Equivalence-Based Instruction, EBI) envolvendo a rede de leitura pode aumentar a precisão da fala de crianças com deficiência auditiva pré-lingual que usam IC, de palavras às sentenças. Ainda, a produtividade verbal tem sido demostrada nos estudos prévios por meio da combinação do EBI que inclui o constructed response matching to sample (CRMTS) e ensino por matrizes, o que pode aumentar o controle por unidades menores e o potencial recombinativo. Nessa direção, o presente estudo avaliou os efeitos de dois procedimentos de ensino, baseado em seleção (MTS) e em construção de respostas (CRMTS), sobre a aprendizagem ou fortalecimento das relações condicionais entre sentenças ditadas e impressas, em crianças com IC; ainda, visou verificar se relações derivadas e consistentes com as relações de equivalência são observadas, e avaliar se esse EBI poderia promover o aumento da precisão da fala em tarefas de nomeação de figuras de ações e desempenhos recombinativos. Participaram duas crianças, com deficiência auditiva sensorioneural, severa a profunda e usuárias de IC. Foram usados um computador com o programa Proler®, caixas acústicas e gravador de voz. Foram utilizadas sentenças de quatro termos, divididas em dois conjuntos organizados por matrizes; as sentenças ensinadas foram as da diagonal das matrizes, enquanto as sentenças recombinadas, que correspondiam as demais células das matrizes, foram apenas avaliadas. Os estímulos foram ditados (A) e impressos (C), e figuras de cenas (B). O EBI foi organizado em etapas de testes e ensino. Os participantes passaram pelo ensino de relações condicionais entre sentenças ditadas e figuras (AB) pelo ensino por exclusão. Na sequência, os procedimentos de ensino foram contrabalanceados entre os participantes, ensino de relações condicionais entre sentenças ditadas e impressas (AC, com ensino por exclusão) para um participante, e a construção de sentenças impressas sob ditado (AE) para outro participante; para o Conjunto 2, esses procedimentos de ensino foram alternados entre os participantes. Testes intercalavam as etapas de ensino, estavam em linha de base múltipla entre conjuntos e avaliavam todas as relações de seleção de estímulos, de construção e de produção oral (leitura e nomeação). Os participantes apresentaram diferenças no repertório verbal de entrada e no ritmo de aprendizagem, porém é possível dizer que houve um fortalecimento das relações de seleção que já estavam no repertório dos participantes, bem como melhora na produção vocal, principalmente após o ensino por CRMTS. Os participantes formaram relações de equivalência, aumentaram a precisão na fala diante de figuras, e foram capazes de recombinar os componentes das sentenças ensinadas. Com isso é possível dizer que o EBI que combina matrizes e CRMTS favorece a precisão da fala de sentenças na nomeação de crianças com IC.
Pre-lingual sensorineural hearing loss can compromise the development of oral language. The cochlear implant (CI) is an auditory device that allows this population to detect sounds in the frequency of human speech. Sound detection may not be sufficient for language development and require teaching procedures to promote learning how to use the device and develop auditory and expressive skills. Research on the interface between Speech-Language Pathology and behavior analysis has shown that Equivalence-Based Instruction (EBI) involving the reading network can increase the speech accuracy of children with pre-lingual hearing loss who use CI, from words to sentences. Still, verbal productivity has been demonstrated in previous studies through the combination of EBI that includes constructed response matching to sample (CMRTS) and training by matrices, which can increase control by smaller units and the recombinative potential. In this sense, the present study evaluated the effects of two teaching procedures, based on selection (MTS) and the constructed response (CRMTS), on learning or strengthining the conditional relations between dictated and printed sentences, in children with CI, still, it aimed to verify if derived and consistent relations with the equivalence relations are observed, and to evaluate if this EBI could promote the increase of speech accuracy in tasks of naming action figures and recombinative performances. Two children participated, with sensorineural hearing loss severe to profund and CI users. A computer with the Proler program, speakers and a voice recorder were used. Two sets of fourterms were organized by matrices; the sentences taught were those of the matrix diagonal, while the recombined sentences, which correspond to the other cells of the matrices, were only evaluated. The stimuli were dictated (A) and printed (C) and scenes pictures (B). The EBI was organize in stages of probes and teaching. Participants received the teaching conditional relations between dictated sentences and pictures (AB) through teaching by exclusion. Then, the teaching procedures were contrabalanced among the participants, teaching conditional relations between dictated and printed sentences (AC with exclusion teaching) for one participant, and the construction of printed sentences under dictation (AE) for another participant; in Set 2, these teaching procedures were alternate across participants. Probes interspersed the teaching stages, were in a multiple baseline across sets and evaluated all relations of stimulus selection, construction and oral production (reading and naming). The participants showed differences in the verbal initial verbal repertoire and in the learning pace, but it is possible to say that there was a stengthening of the selection relationships that were already in the participants repertoire, as well as an improvement in vocal production especially after teaching by CRMTS. The participants formed equivalence relations, increased the accuracy in speech in front of figures, and were able to recombine the components of the sentences taught. With this it is possible to say that the EBI that combine matrices and CRMTS favors the speech accuracy of sentences in the naming of children with CI.
Pre-lingual sensorineural hearing loss can compromise the development of oral language. The cochlear implant (CI) is an auditory device that allows this population to detect sounds in the frequency of human speech. Sound detection may not be sufficient for language development and require teaching procedures to promote learning how to use the device and develop auditory and expressive skills. Research on the interface between Speech-Language Pathology and behavior analysis has shown that Equivalence-Based Instruction (EBI) involving the reading network can increase the speech accuracy of children with pre-lingual hearing loss who use CI, from words to sentences. Still, verbal productivity has been demonstrated in previous studies through the combination of EBI that includes constructed response matching to sample (CMRTS) and training by matrices, which can increase control by smaller units and the recombinative potential. In this sense, the present study evaluated the effects of two teaching procedures, based on selection (MTS) and the constructed response (CRMTS), on learning or strengthining the conditional relations between dictated and printed sentences, in children with CI, still, it aimed to verify if derived and consistent relations with the equivalence relations are observed, and to evaluate if this EBI could promote the increase of speech accuracy in tasks of naming action figures and recombinative performances. Two children participated, with sensorineural hearing loss severe to profund and CI users. A computer with the Proler program, speakers and a voice recorder were used. Two sets of fourterms were organized by matrices; the sentences taught were those of the matrix diagonal, while the recombined sentences, which correspond to the other cells of the matrices, were only evaluated. The stimuli were dictated (A) and printed (C) and scenes pictures (B). The EBI was organize in stages of probes and teaching. Participants received the teaching conditional relations between dictated sentences and pictures (AB) through teaching by exclusion. Then, the teaching procedures were contrabalanced among the participants, teaching conditional relations between dictated and printed sentences (AC with exclusion teaching) for one participant, and the construction of printed sentences under dictation (AE) for another participant; in Set 2, these teaching procedures were alternate across participants. Probes interspersed the teaching stages, were in a multiple baseline across sets and evaluated all relations of stimulus selection, construction and oral production (reading and naming). The participants showed differences in the verbal initial verbal repertoire and in the learning pace, but it is possible to say that there was a stengthening of the selection relationships that were already in the participants repertoire, as well as an improvement in vocal production especially after teaching by CRMTS. The participants formed equivalence relations, increased the accuracy in speech in front of figures, and were able to recombine the components of the sentences taught. With this it is possible to say that the EBI that combine matrices and CRMTS favors the speech accuracy of sentences in the naming of children with CI.
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Palavras-chave
Deficiência auditiva, Implante coclear, Produção oral, Sentenças, Procedimentos de ensino, Hearing impairment, Cochlear implant, Oral production, Sentences, Teaching procedures