Mudanças fonológicas em sujeitos com diferentes graus de severidade do desvio fonológico tratados pelo modelo de oposições máximas modificado

Abstract

This study aimed at analyzing and comparing the phonological changes that occur in the different degrees of phonological disorder severity in individuaIs treated with the Modified Maximum Opposition Model (Bagetti,Mota & Keske-Soares, in press) as well as verifYingthe way of approaching the distinctive features in the target sounds (contrast or reinforcement) which lead to major phonological changes. The phonological disorder (PD) diagnosis was carried out by means of phonological and complementary assessments. The subjects' speech data were analyzed through the performance of the Child's Phonological Assessment (CPA) proposed by Yavas, Hemandorena & Lamprecht (1991). After the phonological assessment, the percentage of correct consonants (PCC) proposed by Shriberg & Kwiatkowski (1982) was calculated and the subjects were then classified in the degrees of severity of the phonological disorder: severe (SD), moderate-severe (MSD), mild-moderate (MMD) and mild disorder (MD). The studied group was composed by seven subjects, four males and three females aged from 3:10 to 6:9. For the treatment, the Modified Maximum Opposition Model (Bagetti, Mota & Keske-Soares, in press), which is based on the Maximum Opposition Model (Gierut, 1992), wasused. After 20 therapeutic sessions, the CPA was performed again, the PCC was calculated and the phonological changes referent to the PCC were analyzed, as well as the number of sounds acquired during the therapy and generalizations (to items not used in the treatment, to another position of the word, within a class of sounds and to other classes of sounds). The phonological changes were analyzed before and after the treatment, considering and not considering the way ofpresenting the stimulus (contrast or reinforcement). It was analyzed whether there was a statistically significant difference (Wilcoxon Non-Parametric Test, p<0.05). A comparison of the phonological changes among the different degrees of severity of the PD was performed considering and not considering the form of presenting the stimulus. After, the phonological changes within each degree of PD severity were analyzed, one subject treated by contrast approach and the other by reinforcement approach. The phonological changes among the groups treated by both approaches were also analyzed, as well as whether there was a statistically significant difference among them (Kruskal-Wallis Test, p<0.05). It was verified that in the total group there was a statistically significant increasing of the PCC (p<0.0 17), of the number of acquired phonemes (p<O.O17) and of the generalizations to items not used during the treatment (p=O.OO5), to another position of the word, (p=O.OO7), within a class of sounds (p=O.OO6)and to other classes of sounds (p=O.OOO9) after therapy. The group of subjects treated by the contrast approach showed an increase in the PCC and in the number of the phonemes acquired, but such increment was not statistically significant (p=O.067). They presented a statistically significant evolution in relation to the generalizations to items not used in the treatment (p=0.027), to another position ofthe word (p=O.042),within a class ofsounds (p=O.OI7)and to other classes ofsounds (p=O.017).The major phonological changes in the different degrees of phonological disorder severity without considering the form of presenting the stimulus and the subjects treated by the contrast approach occurred in the groups with intermediate phonological disorder severity (MSD and MMD) when compared to the group with a more severe (SD) or less severe (MD) degree. Among the subjects with different degrees of PD severity treated by the reinforcement approach, the major phonological changes were observed in the subject with SD followed by the MMD and the MD. In the comparative analysis within each degree, it was verified that in the severe and medium degrees, the subjects treated by the reinforcement approach presented the major phonological changes and in the medium-moderate degree and the subject treated by the contrast approach presented the major changes. In relation to the comparative analysis between the total group treated by both approaches, it was observed that both groups presented changes in their phonological systems and there was no statistically significant difference between them.