Eliza Porto* Suelly Cecilia Olivian Limongi Irlaine Guedes dos Santos*** Amostra de filmagem e andlise da pragmatica na sindrome de Down***#* Filmed sample size and pragmatic analysis in Down syndrome Fernanda Dreux Miranda Fernandes**** Fonoandologle oor Distabios Pigg da Inficca pla nice pure suespoadinc: Kus igen, SL Cidade Univers {poncelraayatoo.com by, Diparamesis de Fee, Fomeadologi Tepi Ocipcion *s+seademis em Fonoagi pls ‘ssssFonoauislogs.Profeuor step, Fosoullog © Terps ‘capac a Faculdade de Medes ‘rerepesgis Reals na Facade 4 Main da Universi de Sis -Aign Subst Ava por Pas ‘Acs pata Pabliago ea 29.05.2007 Refreni t atri co Abstract Background: assessing language development is 2 complex tsk that requites practical and theorticl knowledge about the investigated issues. Its also important to take into aecount data gathering and analysis methodology, in order to achieve consistent and reliable results that mirror the subject reality. Aim: considering the purpose of obtaining the maximum data in minimum time, without jcopatdizing their quality and effesiveness, ur aim isto identify the beter sample’ size and moment ff videotaped interaction to study the pragmatic siltes of chizen with Down syndrome. Method: the communicative profile of 25 children with Down syndrome aged between 2 and 7 years were dstermined a8 proposed by Fernandes (2004). Data obtained through samples of 15 and 30 minutes were analyzed and compared, The situation auslyzed provided inteaetion between the child and a specch-and language-therapist in play situations. To determine the statistical significance of data the tests Friedman, Wilcoxon and confidence interval were applied with a significance level of 0.05 (5%) Conclusion: there were no significant difernces elated to he obtained samples with diferent videotaped ‘dration for pragmatic analysis of the communication of children with Down syndrome, Key Words: Language: Down Syndrome; Communication; Language Thecapy. Resumo ‘Tema: aval 0 detenvolvimento ds Hinguagem & uma tarefa eomplexa que exige conkecimentos tebrieos e prices a respeito dos aspectos que se desea investiga, consderando-se 8 metodologa a ser Utlizada ma coleta¢ ma anise dos dados, a fim de terem obtidor resultados consstentse ¢ coniévis, {ue refliam a realidade do sujito. Objctivo:considerandose @ obtengio do maior aimeo de dadas em tenor tempo possive, sem preiuizo da qualidade ¢ efetvidade dox dads obidos, nosso objetivo € idenficar © momento € tempo de flmagem de situagio de interagio, mais adequados para realizar a tndlse de pragmitica de ciangas com indrome de Dow, Método: fo tragado 0 peril comunictivo de 25 criangas com sindrome de Down, de dois a sete anos de idade,utilizando-se a proposta de avaliagao elaboreds por Femandes (2004), comparando-se os dados oblidos na anilie de amostras de imagem, A situagio snaisada foi a de terapeuta ¢ ‘brincadciralidica. Para veritiar a signiicincia dos dados, fi ‘statistics, ulizando os testes de Friedman e Wileoxon e a tenia de Intervalo de Confianga, com nivel de signifieanca igual 1.005 (5%) Conelusio: nfo foram encontradas diferengas sigailiativas relacionadas as amosiras obidas com diferentes duragdes de flmagem para a anlise da pragmitica da comunicagio de erangas tom siadrome de Down. Palaveas-Chave: Linjuagem; Sindrome de Down; Comunicagio; Terapia de Linguager PORTO, F., LIMONGI, S. C. 0.; SANTOS, 1. G; FERNANDES, FD. M. Filmed sample size and pragmatic analysis in Down Dg syndrome (o ina ile: Amostra de filmagem e anélise da pragmatica na sindrome de Down), Pro Clenifiea, Barueti (SP), v.19, n. 2, p. 159-166, a ‘Foro Revista de Atwalizacao jun. 2007 189Introduction Assessing language development is a complex task that requires practical and theoretical knowledge about the investigated issues. Itis also important to take into account data gathering and analysis methodology, in order to achieve consistent and reliable results that mirror the subject's reality. Owens (1996) states that itis difficult 16 obtain data about language development. Frequently series of procedures is required to guarantee their objective description, validity and reliability. The author points out that the researcher's purpose and theoretical presuppositions influence the kind of data gathering procedure is used, Data about language development are usually collected in two ways: a sample of spontaneous {alk or natural observation and a structured test or experimentally manipulated situation (Owens, 1996), The assessment of functional aspects of Ianguage, as defined the pragmatic analysis is defined (Fernandes, 1996) allows the speech-and- language pathologist to determine when and how the child used his/hers communicative abilities. Several methods, criteria and techniques have been used to collect and analyze data about the use of language by children. Since the decade of 1980 many protocols, questionnaires and scales for observing the child's communicative attitude have been proposed (Baixauli-Fortea et al, 2004). Adams (2002) produced a review about the types of pragmatic assessment and described the available protocols, such as: a developmentally ordained list of emerging of different communicative intents; comprehensive checklist of verification of pragmatic behavior, the Children Communicative Checklist; the assessment of language pragmatic knowledge and the assessment of specific details based on observation analysis, The author observes that among these assessment protocols and methods some are validated and reliable and others aren't. This way, the future of pragmatic evaluation may be not in the multiplication of coding sets but in allowing the research that is now being produced to become more accessible and to guarantee their validation and reliability by the use of appropriate statistical methods. Owens (1996) comments that electronic methods are essential to the microanalysis, The videotape recording, although more intrusiv better than just the audiotape recording because it allows the observation of the verbal and non verbal 0 clements of the situation, Iverson et al 2003), studying the gestual communication of children ‘with Down syndrome, opted to use the videotaped recording of a spontaneous situation to later transcribe all the gestures and intelligible words produced by the subjects. The authors used 30 ‘minutes recordings in this study Analyzing the research about specific populations as children with Down syndrome it can be observed that many different research methods are used 0 assess the functional use of language. Laws and Bishop (2004a) used as a procedure to obtain data about a population that included children with Down syndromea checklist that could be answered by children's parents or teachers, Laws and Bishop (2004b) and ‘Andrade(2006) state that children with Down syndrome, among other deficits, presen language disorder in varying degrees and with different profiles of week and unaffected points. The gesture, as @ non-linguistic clement, is used to ‘communication and serves asa transition to spoken language (Capone and McGregor, 2004; Andrade, 2006; Flabiano and Limongi, 2006). Considering the of the communicative profile of individuals with diagnostics within the autistic spectrum Femandes (2003) used the videotapes ofa specific situation and a specific protocol. This situation included objects as a toy with movement, a transparent recipient difficult to open, books, bubbles, balloons, food items the children liked and disliked ‘The duration ofthe child-adult interaction wasn't mentioned. Cardoso and Femandes (2003) also studied children of the autistic spectrum with the purpose to verify the children's performance and evolution refering tothe use of interpersonal and non-interpersonal communicative functions. Todo it they used games and toys, videotape recorder, tapes and protocals. The communicative situations were determined and the communicative contexts varied according to the individual and group activities proposed by the adult or chosen by the subjects, In what refers othe time of videotaping, 15 and 30 minutes of interaction were revorded o posterior analysis Andrade (2002) conducted a research that aimed to verify iftwo groups of children, with and without genetic antecedents to stuttering were different in other aspects of language development, including pragmatics. To assess pragmatics the sample was filmed and analyzed according to the pragmatic test proposed byFemandes (2004), ‘Mufioz-Céspedes and Melle (2004) report the assessment of pragmatic abilities in individuals with brain damage (BD). The authors suggest the use of a filmed sample that allows a detailed and precise analysis of language and is also useful to ‘document the patient's improvements. The authors also mention that the interest in the study about pragmatic competence in patients with BD by researchers from different fields has increased the number of assessment tests and protocols Crespo-Fguilaz etal 2003) assessed language of dysphasic children. The authors chose the Children's Communication Checklist to assess the pragmatic aspects of language. As there are different gathering methods, there are also many aspects that interfere with the obtained data (Owens, 1996). Considering the context, including linguistic and non-linguistic ‘elements, is essential when analyzing pragmatics. Any sound or gestured interpreted by the adult is ‘considered as language (Fernandes, 1996). Already in 1978 Kreckel commented on the analysis of filmed social interactions, The author referred that this kind of analysis provides greater detailing of behavior. His study reports that the presence of a videotaping camera may cause behavior distortions, eliminating inadequate behavior and increasing the adequate ones. But the author ‘emphasizes that only the behaviors that are really ‘part of the individual's repertoire can be increased or avoided. That is, a person can't produce behaviors that aren't in his/her repertoire. The pragmatic analysis demands the consideration of context. And considering it, the filmed data gathering seems to be the most adequate method because it allows the analysis of all pragmatic aspects of an individual's lamguage. Determining standard assessment criteria to data analysis is important to obtaining consistent results, Besides considering the communicative act as the smallest unit of analysis - starting when the adult-child,child-adult or child-object interaction starts and ends when there is @ change in attention focus or tum (Fernandes, 1996) - itis important to determine the size of the sample to be used in the analysis. Frequently 30 minutes data recordings are used (Fernandes, 2004). Aiming to obtain the largeramount of data in the shortest possible time, without jeopardizing the quality and effectiveness of data, our objective is to identify the moment and the duration of filmed sample that are more useful to the pragmatic analysis of the ‘communication of children with Down syndrome in interaction situations. Method The present research was approved by the Research and Ethies Committe of the Hospital das Clinicas ofthe School of Medicine - University of Sao Paulo (FMUSP) with protocol number 838/05 and an adult responsible for each child signed the consent form, Participants were 25 children with Down syndrome, chronological age between two and seven years, 15 boys and 10 girls All subjects were attending speech-and-language therapy at the Research laboratory of speech-and-language pathology in syndromes and moter-sensorial disorders of the Physiotherapy, Speech and language pathology and occupational therapy department of FMUSP. ct data video VHS cameras and tapes were used to record interaction between each child and his/her speech and language therapist in play situations, The material included a box of toys with small doll aplastic box witha piece of cloth and a "lego" part a basket, kitchen items miniatures (ans, plate, glasses, knives, forks, spoons, jar), animal miniatures (cat, horse, chicken, lion), food miniatures (eggs, cucumber, banana, cookie, applc), a ball, a toy ruck, telephone, wood block (several shapes and colors). To the transcription of data the protocol of Functional Communicative Profile (Femandes, 2004) was used Each child was filmed during 30 minutes imeracting wth hisyher language therapist, playing with the material previously determined by the researcher, After the recording, the transcription ‘identified: number of communicative acts, number of communicative ats per minute, communicative mean used in each communicative act (gestul, vocal or verbal) and communicative function of each communicative act produced by adult and child during the 30 minutes, During the transcription the beginning and end ofthe first, ‘medium and last 15 minutes of interaction were marked. The interactivity of each communicative act was considered to the analysis of the communicative functions, This way, the communicative acts were divided in more icractive communicative acts and less interactive communicative acts, according tothe classification proposed by Fernandes (2005), After the data were registered, the analysis considered the values obtained in the total 30 minutes and the ones referring to the initial 15 minutes, the medium 15 minutes (starting after the first five minutes) and the final 15 minutes of Jeraction beoween child and therapist afterwards To col 161these data were compared. The data related to 30, and 15 minutes were called "time" and the ones related to initial, medium and final were called "moments". An statistical analysis, using the Fiedman and the Wilcoxon tess and the confidence interval, with significance level of 0.05 (5%), was made to verify the significance of data. Results Itcan be observed in Table | to 5 and in Table 7 that there were no significant differences in the resulls obtained in the different times and moments of analysis, Table 6 refers to the vocal mean used by the subjects and it shows a significant difference between moments. The box I shows only the p> values of all two-by-two comparisons of the ‘Table | Propontion of communicative cuune "OMMUNICATI 30a 15"__Medium ‘verge a6 a8 Mean a0 a70 270 Standard Deva 5 35 52 a 700) we 3a @ #9) 54 @ © 2 3s Tnfirortirebold S984 —=39.90 20.08 Supeiortveshold A409 2 ae pale oat ‘moments, It can be observed that the difference between the moments occurs between the initial and the medium 15 minutes, Itecan be observed in Tables 8 to 11 and 13 to 14 that there were no significant differences between the results obtained from the therapists in the different times and moments of analysis. Only in Table 12 that refers to the verbal communicative ‘mean, it ean be observed a significant difference between moments. This way, box 2 shows only the p-values of all two-by-two comparisons of the ‘moments, Is can be verified exactly where if the difference between the moments, Itcan than be verified thatthe final 15 minutes are different from the other segments and the 30 minutes data are different from the initial 15 nutes. i produced by the subjects Table 2~ Proportion of les interactive communicative fanetons produced by the subjects Chili Tail 1 Medium 2s 412 39 25 3 Tnfevortirebold 24632477 Soperiorthrshold S098 —_—S597 62 TTESS INTERACTIVE FUNCTIONS, 1S Falls 386 260 1d Ba 33 a2Table 3 Proportion of more interactive communicative fnctons produce by the subjects MORE INTERACTIVE FUNCTIONS Children 30 intial 15" ‘Medium 15" Final 1S avenge on eee a8 7135 Mean 74707630 75.00 73.90 Standard Deviation 119 33 9 1 ai es Se @ oo @ 79 755 we 779 N 3 3 35 3 Tnferorthreboid 6606 ——~ 64.08 BR 6698 Superior thesbold’ 1587 75:28 7a 7568 prvale 0556 Table 4 Number of communicative ats produced bythe subjects per minute Chiles ‘COMMUNICATIVE ACTS PER MINUT 30a Medium 15°F 5 Avene ea_a96 si oo Mean 490450 290 460 Standard Deviaion 73 Te 15 1 ai ae 39 39 @ a oS 60 N 2s 3 3 Inferorthrebold ——=3S2 ~~ 35 BF Supeiorthesbold 928 S39 sa Bas pralue 0505 Tble Proportion of verbal communicative ats produce by the subjets children 30 Initial 15" Medium 15" Final 15 avenge 2.76 29 28s Mean 0 50 740 Standard Devon 279 365 29 ai 09 1 Ts a @ BS 308 30 ws N a 5 Tnfeortiesbold 1299 —«122 Tas Bs Supeiorthesbold 5484 _—=S324 sat Bas peal 3 VERBAL COMMUNICATIVE MEAN 163Table 6 Proportion of vocal communicative acts produce by the subjects ‘VOCAL COMMUNICATIVE MEAN Children VOCAL COMMUNICATIVE MEAN _ 30 Intel 1" Medium 15° Final 1S Average 2660208 28s 26 oT Standard Deviation 173) ins 189 a 38 rz] 38 @ 36 323 398 a0) N a 2 3 3 Tnferortivemoi ——‘1982_—«17.29 2099 ae Supriorthrshold S038 ——=S08 368 3628 pralue Done atnially igniican pve Box 1 p-values ‘Voss communiative mean M7 Tnital iS __Medhum 15 Tail 15 oars Medium 15 0.0908 005 Final 15 oR e101 one Hatisially iifican pale tt pele ner the significance init “Tuble 7 — Proportion of gestusl communicative ate produced bythe subjects (GESTUAL COMMUNICATIVE MEAN Children 0 _Taiia1__Medium ‘Final 1 ‘Average my 7238 99 7189 Mean a0 #0 7040 7470 Standard Deviawon 217 22 Ba Bi a Sia 300 160) 2 e 04 735 02 a3 Tnferiortirebold «GGT —~—«S 8 ez Sopeiortirabold —-8072_——~S1A 28 WO pralue oa Tble€ Proportion of communicative ats produced by the theapisis COMMUNICATIVE ACTS Adu Taal Median 19 Fil SundadDovinion Sa = 32 G Super shold 60.6610 3991 ea Prahe vali‘Teble 9 Proportion of ss-interactve communicative function produced bythe therapists Avene Mean Standard Deviation ai @ N Inferior threshold ‘Superior tesbold povale TLESS INTERACTIVE FUNCTIONS, Tia 15 289 240 30 00 46 06 ‘Medium 285 10 or a 35 30 0236 Final 1S 222 7 10 Table 10 Proportion of more-nteractive communicative functions produced by the therapists ‘Avene ‘Mean ‘Standard Deviation ai a Inferior thrsbold ‘Sopeior threshold Prva 0 9830 22 368 389 3s 3685 9839 MORE INTERACTIVE FUNCTIONS Teal 15 37.60 30 34 100.8 35 3598 Re ‘Medium 15 oe oO we 1000 3s 95.2 RA Final 3187 380 20 369 wy. 35 oes Table 11 Number of communicative aes produced by the therapists er minute ‘COMMUNICATIVE ACTS PER MINUTE ‘cate Tait 15 __Medium 15-—_—_‘Fnal 15 Avenge 666 692 Mean 600 a0 ‘Standard Deviation 12 15 ai ay 3B 37 a 73 7 79 79 N 25 2 2 2s Iniviorthrebold 623610 35 24 ‘Superior threshold 7S 2 ® 728 pve ome Ac 1 Dow 165Table 12 Proportion of verbal communicative sss produced by the therapists ‘VERBAL COMMUNICATIVE MEAN nats 30___tnal 1) Medium 157 Final 15 Average Baa 95:08 3508 3 Mean 3540 95.50 9530 oS Standard Deviation 35 5 8 2 m6 aS 34 370 9k 383 360) 3 35 25 25 inetd oO —=O wise vias Superior ®weshold 958 96.70 96.62 ny Pralue =o" raistcallygaiican pe Box? _povalues Verbal communicative mean 30" Thiel 1 Medium 1 Tail 1S oa Median 15 021s to Final 15 0.009" O05 Oa + Haaly sion pao Table 13 = Proportion of veal communicative acs produced by the therapists VOCAL COMMUNICATIVE MEAN Aduts 30 ine) Mediom 15° Canal ‘Average 5a 198 206 26 Mean’ 180 140 150 240) ‘Standard Deviation 174 19 2 35 @ 1 00 00 10 @ 32 3s 2 30 N 25 25 25 25 Inferior renbold 1.01 126 Tie 130 Supeviorteshold 126527 296 “408 pve ow Table 14 — Proportion of gertual communicative ats produced by the therapists (GESTUAL COMMUNICATIVE MAN Adults 30 Ini Mediom 15° Final ‘Average aoe ass ae Meso 1402610 2630 o Standard Deviation 136 BS Be a 200) 17s 180 aa Ba 33 N 25 25 25 25 Inferior reshold DATE=. Bat 3622 Superior tirethold 3545 ___—=S8.07 32 3SDiscussion The purpose of this study was to identify the best amount of time and specific moment to perform the pragmatic analysis of the communication of children with Down syndrome. The aim isto obtain, the largest amount of data in the shortest time possible without jeopardizing their quality and reliability Data was obtained during spontancous play situations, as it's been done in other studies (Andrade, 2006, Flabiano and Limongi, 2006). tis, also consistent with the literature that proposes to reinforce the adult-child relationship (Owens, 1996). The interaction between child and therapist was videotaped allowing the detailed analysis of the communicative behavior expressed by the child as well as the adult. This procedure of data gathering and recording was proposed by Kreckel (1978) in his study. Authors as Andrade (2002), Femandes (2003), Cardoso and Fernandes (2003) and Mufioz-Céspedes also used video cameras to record samples to the assessment of language functions in different populations. Crespo-Eguilaz et al, (2003) and Laws and Bishop (2004) used questionnaires and checklists, intheir research, Important data as communicative context and non-linguistic elements (as gestures and face and body expressions) that should be considered as language in the functional study of communication (Femandes, 1996) may be lost by the use of checklists and questionnaires. Considering that the population studied present @ delay in the language acquisition and development process (Law and Bishop, 2004b) and that many of them do not use the verbal mean of communication, the use of the vocal mean is, extremely important to the language development, process (Andrade, 2006; Flabiano and Limongi, 2006). This way, considering just the item "vocal communicative mean’, it can be stated that the time and moment of better performance were the final 15 minutes. The analysis of the therapist's pragmatic performance while interacting with the child has shown that the only significant difference is also related to the communicative means. The values obtained for the use of the verbal communicative ‘mean during the final 15 minutes were different of the other time and moments. The final 15 minutes constitute the moment with the smallest average proportion of use of the verbal mean by the adult (93.09%), Considering individual differences is essential when assessing the functional use of language. The behavior must be considered, as well as the communicative context that includes linguistic and non-linguistic components, as suggested by Fernandes (1996). The assessment method proposed by Fernandes (2004) includes items that constitute the individual communicative profile. Considering that there was no significant difference of time and moment in most of the analyzed data, any of them can be used to analyze the communicative profile of the studied population, Conclusion ‘The aim of this study was to verify the better time and moment to collect data about the pragmatic aspects of the communication of children with Down syndrome. No significant differences were found in the samples with 15 or 30 minutes of duration. Itis important to note that the statistical analysis was based on the average values obtained in this specific group of subjects, Therefore, these results are useful to significant samplings and group data for research use, where average values are used, It means that videotaped samples of either 15 or 30 minutes, ofthe beginning, the middle or the end of the footage can be used to analyze the communicative profile of individuals with Down syndrome, without any risk to the quality and reliability of the results. However, it can be that for any specific subject, there are significant differences on different times and different moments. This way, when considering language and communication development within the language therapy process, the individual analysis is essential to the determination of intervention proposals based on specific characteristics of each individual. It is important to stress that if in one hand the analysis of filmed samples allows the reproducibility and reliability of results, on the other hand it involves a limited picture ofthe child's communicative abilities, once the communicative context and motivational factors are limited and the interlocutors are trained specialists. 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