Emergência dos esquemas simbólicos em crianças com sÃndrome de Down, prematuras muito baixo peso e crianças com desenvolvimento tÃpico
Emergence of symbolic schemes in children with Down syndrome, very-low-birth-weight preterm, and typically developing children
Lenice de Fátima da Silva; FabÃola Custódio Flabiano; Karina Elena Bernardis Bühler; Suelly Cecilia Olivan Limongi
Resumo
Objetivo: verificar a emergência dos esquemas simbólicos simples e combinados e seus respectivos subtipos em 20 crianças prematuras muito baixo peso, 20 crianças com sÃndrome de Down e 20 crianças com desenvolvimento tÃpico.
Métodos: todos os sujeitos foram acompanhados mensalmente durante seis meses, a partir da avaliação inicial em que estavam localizados no final da quinta fase do perÃodo sensório-motor. Para tanto, foi utilizado o Protocolo para Observação do Desenvolvimento Cognitivo e da Linguagem Expressiva – versão revisada (PODCLE-r). Os dados foram analisados de forma quantitativa e qualitativa.
Resultados: os resultados revelaram que os esquemas simbólicos simples e combinados emergiram de forma semelhante para todos os grupos, embora se tenha observado ritmo de desenvolvimento mais lento para as crianças prematuras muito baixo peso e crianças com sÃndrome de Down, quando comparadas à s crianças com desenvolvimento tÃpico. A análise qualitativa, referente à diversidade e complexidade dos esquemas simbólicos produzidos, mostrou que as crianças prematuras muito baixo peso apresentaram pior desempenho quando comparadas à s crianças com sÃndrome de Down e à s com desenvolvimento tÃpico, apresentando também dificuldades especÃficas quanto ao uso de esquemas simbólicos aplicados a objetos não-figurativos, ou seja, quanto à construção da representação por meio de significantes arbitrários.
Conclusão: estes dados reforçam a importância de se acompanhar a emergência e o desenvolvimento dos esquemas simbólicos simples e combinados nessas crianças, com o objetivo de monitorar e estimular esse desenvolvimento, com vistas a minimizar os efeitos da defasagem cognitiva e a favorecer o desenvolvimento da linguagem.
Palavras-chave
Abstract
Purpose: to check the emergence of isolated and combined symbolic schemes as well as their respective subtypes in 20 very-low-birth-weight (VLBW) preterm children, 20 children with Down syndrome (DS), and 20 typically developing (TD) children.
Methods: all subjects were followed up monthly during a six-month period, starting from the initial assessment, when they were placed at the fifth phase of the sensorimotor period, using the Protocol for Expressive Language and Cognitive Development Observation – reviewed version (PELCDO-r). Data were analyzed both quantitatively and qualitatively.
Results: results revealed that isolated and combined symbolic schemes emerged in a similar way in all groups, although DS and VLBW preterm children showed slower rhythm of development when compared to TD children. The qualitative analysis, concerning the analysis of symbolic schemes' diversity and complexity showed that VLBW preterm children showed poorer performance when compared to children with DS and TD children, also showing specific difficulties as for the use of symbolic schemes applied to non-figurative objects, that is, concerning the representation's construction by means of an arbitrary significant.
Conclusion: these data reinforce the importance of following the emergence and development of isolated and combined symbolic schemes in these children, with the objective of monitoring and stimulating their development, aiming to minimize the effects of cognitive deficits and favor language development.
Keywords
Referencias
1. Piaget J. A formação do sÃmbolo na criança. 3. ed. Rio de Janeiro: Guanabara Koogan; 1978.
2. Sinclair H, Berthoud I, Gerard J, Veneziano E. Constructivisme et psycholinguistique génétique. Arch Psychol. 1985; 53:37-60.
3. McCune L. A normative study of representational play at the transition to language. Dev Psychol. 1995; 31:198-206.
4. Lyytinen P, Laakso ML, Poikkeus AM, Rita N. The development and predictive relations of play and language across the second year. Scand J Psychol. 1999; 40(3):177-86.
5. Johnson KE, Younger BA, Furrer SD. Infant's symbolic comprehension of actions modeled with toy replicas. Dev Sci. 2005; 8(4):299-314. http://dx.doi.org/10.1111/j.1467-7687.2005.00416.x
6. McEwen F, Happé F, Bolton P, Rijsdyk F, Ronald A, Dworzynski K, et al. Origins of individual differences in imitation: links with language, pretend play, and socially insightful behavior in two-year-old twins. Child Dev. 2007; 78(2):474-92.
7. Brownell CA. Combinatorial skills: converging developments over the second year. Child Dev. 1988; 59(3):675-85.
8. Lewis V, Boucher J, Lupton L, Watson S. Relationships between symbolic play, functional play, verbal and non-verbal ability in young children. Int J Lang Commun Disord. 2000; 35(1):117-27.
9. Newland LA, Roggman LA, Boyce LK. The development of social toy play and language in infancy. Infant Behav Dev. 2001; 24(1):1-25. http://dx.doi.org/10.1016/S0163-6383(01)00067-4
10. Hsieh HC. Effects of ordinary and adaptive toys on pre-school children with developmental disabilities. Res Dev Disabil. 2008; 29(5):459-66.
11. Vicari S. Motor development and neuropsychological patterns in persons with Down syndrome. Behav Genet. 2006; 36(3):355-64. http://dx.doi.org/10.1007/s101519-006-9057-8
12. Abbeduto L, Warren SF, Conners FA. Language development in Down syndrome: from the prelinguistic period to the acquisition of literacy. Mental Retard Dev Disabil Res Rev. 2007; 13(3):247-61. http://dx.doi.org/10.1002/mrdd.20158
13. Roberts JE, Price J, Malkin C. Language and communication development in Down syndrome. Mental Retard Dev Disabil Res Rev. 2007; 13(1):26-35. http://dx.doi.org/10.1002/mrdd.20136
14. Silverman W. Down syndrome: cognitive phenotype. Mental Retard Dev Disabil Res Rev. 2007; 13(3):228-36. http://dx.doi.org/10.1002/mrdd.20156
15. Hill PM, McCune-Nicolich L. Pretend play and patterns of cognition in Down's syndrome children. Child Dev. 1981; 52(2):611-7.
16. Motti F, Cicchetti D, Sroufe LA. From infant affect expression to symbolic play: the coherence of development in Down syndrome children. Child Dev. 1983; 54(5):1168-75.
17. Limongi SCO, Mendes AE, Carvalho AMA, Val DC, Andrade RV. A relação comunicação não verbal-verbal na sÃndrome de Down. Rev Soc Bras Fonoaudiol. 2006; 11(3):135-41.
18. O'Toole C, Chiat S. Symbolic functioning and language development in children with Down syndrome. Int J Lang Commun Disord. 2006; 41(2):155-71. http://dx.doi.org/10.1080/13682820500221600
19. Andrade RV, Limongi SCO. A emergência da comunicação expressiva na criança com sÃndrome de Down. Pró-Fono. 2007; 19(4):387-92.
20. Constantinou JC, Adamson-Macedo EN, Mirmiran M, Ariagno RL, Fleisher BE. Neurobehavioral assessment predicts differential outcome between VLBW and ELBW preterm infants. J Perinatol. 2005; 25(12):788-93.
21. Hack M, Klein NK, Taylor HG. Long-term developmental outcomes of low birth weight infants. Future Child. 1995; 5(1):176-96.
22. Rugolo LMSS. Crescimento e desenvolvimento a longo prazo do prematuro extremo. J Pediatr. 2005; 81(Supl1):S101-S10.
23. Seitz J, Jenni OG, Molinari L, Caflisch J, Largo RH, Latal Hajnal B. Correlations between motor performance and cognitive functions in children born < 1250 g at school age. Neuropediatrics. 2006; 37(1):6-12.
24. Sansavini A, Guarini A, Alessandroni R, Faldella G, Giovanelli G, Salvioli G. Early relations between lexical and grammatical development in very immature Italian preterms. J Child Lang. 2006; 33(1):199-216.
25. Anderson PJ, Doyle LW. Cognitive and educational deficits in children born extremely preterm. Semin Perinatol. 2008; 32(1):51-8.
26. Wolke D, Samara M, Bracewell M, Marlow N. Specific language difficulties and school achievement in children born at 25 weeks of gestation or less. J Pediatr. 2008; 152(2):256-62.
27. Caravale B, Tozzi C, Albino G, Vicari S. Cognitive development in low risk preterm infants at 3-4 years of life. Arch Dis Child Fetal Neonatal Ed. 2005; 90(6):474-9. http://dx.doi.org/10.1136/adc.2004.070284
28. Mikkola K, Ritari N, Tommiska V, Salokorpi T, Lehtonen L, Tammela O, et al. Neurodevelopmental outcome at 5 years of age of a national cohort of extremely low birth weight infants who were born in 1996-1997. Pediatrics. 2005; 116(6):1391-1400. http://dx.doi.org/10.1542/peds.2005-0171
29. Rodrigues MCC, Mello RR, Fonseca SC. Learning difficulties in schoolchildren born with very low birth weight. J Pediatr. 2006; 82(1):6-14.
30. Sansavini A, Guarini A, Alessandroni R, Faldella G, Giovanelli G, Salvioli G. Are early grammatical and phonological working memory abilities affected by preterm birth? J Commun Disord. 2007; 40(3):239-56.
31. Bühler KEB, Flabiano FC, Mendes AE, Limongi SCO. Construção da permanência do objeto em crianças nascidas pré-termo muito baixo peso. Rev. CEFAC. 2007; 9(3):300-7. http://dx.doi.org/10.1590/S1516-18462007000300003
32. Aylward GP. Neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr. 2005; 26(6):427-40.
33. Kessel-Feddema B, Sondaar M, Kleine M, Verhaak C, Baar A. Concordance between school outcomes and developmental follow-up results of very preterm and/or low birth weight children at the age of 5 years. Eur J Pediatr. 2007; 166(7):693-9. http://dx.doi.org/10.1007/s00431-006-0309-7
34. Ozbek A, Miral S, Eminagaoglu N, Ozkan H. Development and behavior of non-handicapped preterm children from a developing country. Pediatr Int. 2005; 47(5):532-40. http://dx.doi.org/10.1111/j.1442-200x.2005.02108.x
35. Bühler KEB, Limongi SCO, Diniz EMA. Language and cognition in very low birth weight preterm infants with PELDCO application. Arq Neuropsiquiatr. 2009; 67(2a):242-9.
36. Flabiano FC, Bühler KEB, Limongi SCO, Befi-Lopes DM. Protocolo para observação do desenvolvimento cognitivo e de linguagem expressiva – versão revisada (PODCLE-r): proposta de complementação. Rev Soc Bras Fonoaudiol. 2009; 14(1):26-35.
37. Johnston F, Stansfield J. Expressive pragmatic skills in pre-school children with and without Down's syndrome: parental perceptions. J Intellect Disabil Res. 2007; 41(1):19-29. http://dx.doi.org/10.1111/j.1365-2788.1997.tb00673.x
Submitted date:
20/07/2009
Accepted date:
06/11/2009
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