Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/20232565823
Revista CEFAC
Artigos Originais

Pre-verbal and verbal pattern as predictors for the implementation of the Picture Exchange Communication System (PECS) in autistic children

Padrão pré-verbal e verbal como preditores para implementação do Picture Exchange Communication System - PECS em crianças autistas

Simoni Camilo; Fernanda Miranda da Cruz; Sheila C Caetano; Jacy Perissinoto; Ana Carina Tamanaha

http://dx.doi.org/10.1590/1982-0216/20232565823 Revista CEFAC, vol.25, n6, e5823, 2023
PDF English
PDF Português
Downloads: 1
Views: 236

Abstract

Purpose: to investigate the preverbal and verbal patterns in autism spectrum disorder, to more easily predict the need for implementation of the Picture Exchange Communication System in autistic children who are about to start speech language therapy.

Methods: a cross-sectional study with a sample consisted of 62 children aged 2 to 10 years, presented with autism spectrum disorder. The Vocal Behavior Assessment which analyzes the preverbal and verbal patterns through three parameters, that is, Mean Extension (mean verbal emission), Speech Characterization (number of atypical emissions) and Language Range (typical emissions of child development), was used. Sociodemographic data, intellectual quotient and non-adaptive behaviors were also analyzed, by using the logistic regression model.

Results: there was a high sensitivity (0.915) and specificity (0.867) for the variables Speech Characterization (p=0,000) and Mean Extension (p=0,001). The other numerical variables, such as age, time of schooling, non-adaptive behaviors and intellectual quotient of children were tested but were not identified as potential predictors for the outcome of interest of the study.

Conclusion: the indices of Speech Characterization and Mean Extension were identified as predictors for the indication of the Picture Exchange Communication System in children who are about to start speech language therapy.

Keywords

Autism Spectrum Disorder; Communication; Language; Communication Aids for Disabled; Speech, Language and Hearing Science

Resumo

Objetivo: investigar os padrões pré-verbal e verbal no Transtorno do Espectro Autista, com intuito de predizer mais facilmente a necessidade de implantação do Picture Exchange Communication System em crianças autistas que estejam prestes a iniciar a intervenção terapêutica fonoaudiológica. 

Métodos: trata-se de um estudo transversal. A amostra foi constituída por 62 crianças, de 2 a 10 anos, com Transtorno do Espectro Autista. Utilizou-se a Avaliação do Comportamento Vocal que analisa os padrões pré-verbal e verbal por meio de três parâmetros: Extensão Média (média de emissão verbal), Caracterização da Fala (quantidade de emissões atípicas) e Faixa da Linguagem (emissões típicas do desenvolvimento infantil). Foram analisados, também, dados sociodemográficos, quociente intelectual e comportamentos não-adaptativos. Utilizou-se modelo de regressão logística.

Resultados: houve alta sensibilidade (0,915) e especificidade (0,867) para as variáveis: Caracterização da Fala (p<0,001) e Extensão Média (p=0,001). As demais variáveis numéricas: idade, tempo de escolaridade, comportamentos não-adaptativos e quociente intelectual foram testadas, mas não foram identificadas como potenciais preditores para o desfecho de interesse do estudo. 

Conclusão: identificaram-se os índices de Caracterização da Fala e Extensão Média como preditores para indicação do Picture Exchange Communication System em crianças prestes a iniciar o processo de intervenção fonoaudiológica. 

Palavras-chave

Transtorno do Espectro Autista; Comunicação; Linguagem; Auxiliares de Comunicação para Pessoas com Deficiência; Fonoaudiologia

Referências

1. American Psychiatric Association. Manual Diagnóstico e Estatístico de Transtornos Mentais - DSM 5. 5 ed. Porto Alegre. Artmed, 2014.

2. La Valle C, Plesa-Skwerer D, Tager-Flusberg H. Comparing the pragmatic speech profiles of minimally verbal and verbally fluent individuals with autism spectrum disorder. J Autism Dev Disord. 2020;50(10):3699-713. https://doi.org/10.1007/s10803-020-04421-7 PMID:7483391

3. Ferreira C, Bevilacqua M, Ishihara M, Fiori A, Armonia A, Perissinoto J et al. Selection of words for implementation of the Picture Exchange Communication System - PECS in non-verbal autistic children. CoDAS. 2017,29(1):e20150285. https://doi.org/10.1590/2317-1782/20172015285 PMID:28300954.

4. Moretto G, Ishihara MK, Ribeiro M, Caetano SC, Perissinoto J, Tamanaha AC. Interference of the communicative profile of children with Autism Spectrum Disorders upon their mother´s quality of life. CoDAS. 2020;32(6):e20190170. https://doi.org/10.1590/2317-1782/20202019170 PMID: 25495867.

5. Santos PA, Bordini D, Scattolin M, Asevedo GRDC, Caetano SC, Paula CS et al. The impact of the implementation of PECS on understanding instruction in children with Autism Spectrum Disorders. CoDAS. 2021;33(2):e20200041. https://doi.org/10.1590/2317-1782/20202020041 PMID: 33978106.

6. Bondy A, Frost L. Manual de treinamento do sistema de comunicação por troca de figuras. Newark: Pyramid, 2009.

7. Ferreira C, Caetano SC, Perissinoto J, Tamanaha AC. Repercussion of the implementation of the PECS in the overload index of mothers of children with Autism Spectrum Disorder. CoDAS. 2022;34(3):e202110109. https://doi.org/10.1590/2317-1782/20212021109 PMID:35019088.

8. Olivatti DFO, Sugahara MK, Camilo S, Perissinoto J, Tamanaha AC. The relevance of family engagement in the implementation of the PECS in children with Autism Spectrum Disorder. Rev. CEFAC. 2021;23(5):e3121. https://doi.org/10.1590/1982-0216/20212353121

9. Ribeiro SB, Paula CS, Bordini D, Mari JJ, Caetano SC. Barriers to early identification of Autism in Brazil. Rev Bras Psiq. 2017;39(4):352-4. https://doi.org/10.1590/1516-4446-2016-2141 PMID:28977067.

10. Associação Brasileira de Empresas de Pesquisa. Critério de Classificação Econômica Brasil. 2021:1-6. Available at: http://www.abep.org

11. Tellegen PJ, Laros JA, Jesus GR, Karino CA. SON-R 21/2-7 [a] Manual do Teste Não Verbal de Inteligência. São Paulo: Hogrefe, 2015.

12. Weschler D. WISC III Escala de inteligência para crianças. São Paulo, Casa Psicólogo, 2002.

13. Marteleto MRF, Pedromônico MRM. Validity of Autism Behavior Checklist (ABC): preliminary study. Rev Bras Psiq. 2005;27(4):295-301. https://doi.org/10.1590/S1516-44462005000400008 PMID:16358111.

14. Krug DA, Arick JR, Almond PJ. Autism screening instrument for educational planning - ASIEP 2. Pro-ed, Austin, 1993.

15. Cruz FM, Ostermann AC, Andrade DNP, Frezza M. O trabalho técnico-metodológico e analítico com dados interacionais audiovisuais: a disponibilidades multimodais nas interações. Delta. 2019;35(4). https://doi.org/10.1590/1678-460X2019350404

16. Sugahara MK, Silva SC, Scattolin M, Cruz FM, Perissinoto J, Tamanaha AC. Exploratory study on the multimodal analysis of the joint attention. Audiol., Commun. Res. 2022;27:e2447.

17. Jurgens A, Anderson A, Moore DW. Maintenance and generalization of skills acquired through PECS training: a long-term follow-up. Dev Neurorehabil. 2019;22(5):338-47. https://doi.org/ 10.1080/17518423.2018.1503619 PMID:30067415.

18. Pereira ET, Montenegro ACA, Rosal AGC, Walter CCF. Augmentative and Alternative Communication on Autism Spectrum Disorder: impacts on communication. CoDAS. 2020;32(6):e20190167. https://doi.org/10.1590/2317-1782/20202019167 PMID: 33206773.

19. Doherty A, Bracken M, Gormley L. Teaching children with autism to initiate and respond to peer mands using Picture Exchange Communication System. Behav Anal Pract. 2018;11(4):279-88. https://doi.org/10.1007/s40617-018-00311-8 PMID:30538902.

20. Donato C, Spencer E, Arthur-Kelly M. A critical synthesis of barriers and facilitations to the use of AAC by children with ASD and their communication partners. Augment Altern Commun. 2018;34(3):242-53. https://doi.org/10.1080/07434618.2018.1493141 PMID:30231643.

21. Sievers SB, Trembath D, Westerveld M. A systematic review of predictors, moderators and mediators of augmentative and alternative communication outcomes for children with ASD. Augment Altern Commun. 2018;34(3):219-29. https://doi.org/10.1080/07434618.2018.1462849 PMID:29706101.

22. White EN, Ayres KM, Snyder SK, Cagliani RR, Ledford JR. Augmentative and alternative communication and speech production for individuals with ASD: a systematic review. J Autism Dev Disord. 2021;51(11):4199-212. https://doi.org/10.1007/s10803-021-04868-2 PMID:33511525.

23. Klin A, Micheletti M, Klalman CI, Schultz S, Constantino JN, Jones W. Affording autism in early brain development re-definition. Dev Psychopathol. 2020;32(4):1175-89. https://doi.org/10.1017/S0954579420000802 PMID: 32938507.

24. Micheletti M, McCracken C, Constantino J, Mandell D, Jones W, Klin A. Outcomes of 24 to 36 months-old children with ASD vary by ascertainment strategy: a systematic review and meta-analysis. J Child Psychol Psychiatr. 2020;61(1):4-17. https://doi.org/ 10.1111/jcpp.13057 PMID:31032937.

25. Lai MC, Anagnostou E, Wiznitzer M, Alisson C, Baron Cohen S. Evidence-based support for autistic people across the lifespan: maximizing potential, minimizing barriers, and optimizing the person-environment fit. Lancet Neurol. 2020;19(5):434-51. https://doi.org/10.1016/S1474-4422(20)30034-X PMID: 32142628.

26. Brignell A, Chenausky KV, Song H, Zhu J, Suo C, Morgan AT. Communication intervention for autism spectrum disorder in minimally verbal children. Cochrane Database Syst Rev. 2018;11(11):CD12324. https://doi.org/10.1002/14651858.CD012324.pub2 PMID:30395694.

27. Gilroy SP, Leader G, Mc Cleery JP. A pilot community-based randomized comparison of speech generating devices and the PECS for children diagnosed with autism spectrum disorder. Autism Res. 2018;11(12):1701-11. https://doi.org/10.1002/aur.2025 PMID:30475454.

28. Chenausky K, Norton A, Tager-Flusberg H, Schlaug G. Behavioral predictors of improved speech output in minimally verbal children with autism. Autism Res. 2018;11(10):1356-65. https://doi.org/10.1002/aur.2006 PMID:30230700.

29. Pecukonis M, Plesa Skwerer D, Eggleston B, Meyer S, Tager-Flusberg H. Concurrent social communication predictors of expressive language in minimally verbal children and adolescents with Autism Spectrum Disorder. J Autism Dev Disord. 2019;49(9):3767-85. https://doi.org/10.1007/s10803-019-04089-8 PMID:31187332.

30. Thabtah F, Peebles D. Early Autism Screening: a comprehensive review. Int J Environ Res Publ Heal. 2019;16(18):3502. https://doi.org/10.3390/ijerph16183502 PMID: 31546906.
 

Submetido em:
11/06/2023

Aceito em:
18/10/2023

65ba59eea953953b9d689f24 cefac Articles
Links & Downloads
1982-0216 (Eletrônico) 1516-1846 (Impresso)
Revista CEFAC ©2024 Todos os direitos reservados.

Revista CEFAC

Share this page
Page Sections