Validation of the neurofunctional evaluation protocol for Alternative and Augmentative Communication

Queiroz, Ítala da Piedade; Menezes, Edênia da Cunha; Santos, Ivana Maria Barboza dos; Goes, Ueslane Melo de; Givigi, Rosana Carla do Nascimento

doi:10.1590/1982-0216201820318017

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ORIGINAL ARTICLES • Rev. CEFAC 20 (3) • May-Jun 2018 • https://doi.org/10.1590/1982-0216201820318017 copy

Validation of the neurofunctional evaluation protocol for Alternative and Augmentative Communication

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to validate the neurofunctional evaluation for Alternative and Augmented Communication protocol.

Methods:

the study was carried out in four steps: instrument construction, literature review, clinical validation and evaluation of the protocol by field experts, through an interactive questionnaire which was repeatedly applied, until the last set of responses was regarded as satisfactory. In addition, clinical evaluations were performed by applying the protocol in children and adolescents with motor impairment in a clinical trial.

Results:

statistical analysis of the protocol application in the therapeutic setting showed the Kappa indices for each observer with an overall mean of 0.436 (moderate agreement), besides the agreement among experts in content evaluation.

Conclusion:

agreement between the evaluators, specialists and the protocol clinical application results allowed choosing and implementing an alternative communication resource appropriate to the neuromuscular characteristics of the patient, providing a low cost access, as well as the quick identification of the motor skills that enabled the speech-language therapy.

Keywords:
Communication; Disabled Persons; Validation Studies

	Participants	Round 1	Round 2
Implementation protocol for neurofunctional evaluation - Functional Evaluation for Alternative Communication in Motor Deficiency (ACADM) - representing the presented content	Spe 1	I Disagree	I agree
	Spe 2	Do not agree or disagree	I agree
	Spe 3	I Disagree	I agree
Does it clearly define the definition of neurofunctional assessment for the implementation of Alternative Communication?	Spe 1	I disagree	I agree
	Spe 2	Do not agree or disagree	Strongly Agree
	Spe 3	Do not agree or disagree	Do not agree or disagree
Is the purpose described consistent with the content of the protocol?	Spe 1	I disagree	Strongly agree
	Spe 2	Strongly agree	Strongly Agree
	Spe 3	I agree	Do not agree or disagree
Is the information contained in this protocol adequate for the target audience of this protocol?	Spe 1	I agree	Strongly agree
	Spe 2	Do not agree or disagree	Do not agree or disagree
	Spe 3	I agree	Do not agree or disagree
Do the general instructions reflect the most relevant information in the protocol and tell you the step-by-step how to use it?	Spe 1	I disagree	Strongly agree
	Spe 2	I agree	I agree
	Spe 3	I agree	Do not agree or disagree
Can the demonstrated results be achieved with the protocol?	Spe 1	I disagree	Strongly agree
	Spe 2	Do not agree or disagree	I agree
	Spe 3	Do not agree or disagree	I agree
Does the protocol evaluate all the important variables for the motor aspects that imply the implementation of the CAA?	Spe 1	I agree	Do not agree or disagree
	Spe 2	I agree	I agree
	Spe 3	I disagree	Do not agree or disagree

	Patient 1		Patient 2		Patient 3		Patient 4		Patient 5
Functions of Joints and Bones	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2
Mobility of cervical Joints	2	3	1	0	4	4	4	4	1	1
Stability of cervical joints	3	2	3	2	4	4	4	4	3	4
Control of Cervical Joints	2	3	3	1	4	4	4	4	3	3
Mobility of the shoulder joint	3	3	3	3	4	4	3	4	1	2
Stability of shoulder joints	3	2	3	4	4	4	4	4	2	3
Control of shoulder joints	3	2	3	3	4	4	3	4	3	3
Mobility of wrist joints	2	2	3	2	4	4	4	4	0	0
Stability of wrist joints	2	3	3	3	4	4	4	4	2	2
Control of wrist Joints	2	2	3	2	4	4	4	4	3	3
Mobility of joints of the hands	2	3	3	1	4	4	4	4	0	0
Stability of joints of the hands	2	3	3	2	4	4	4	4	2	2
Control of joints of the hand	2	3	3	3	4	4	4	4	3	2
Mobility of the joints of the feet	3	3	0	0	4	4	4	4	3	2
Stability of the joints of the feet	3	3	1	1	4	4	4	4	3	3
Control of the joints of the feet	3	3	1	1	4	4	4	4	3	2
Mobility of hip joints	3	4	3	4	4	4	4	4	3	4
Stability of hip joints	3	3	3	4	4	4	4	4	3	4
Control of hip joints	3	3	3	4	4	4	4	4	3	4
Control of voluntary cervical movement - only	2	4	3	2	3	4	4	4	2	3
Control of voluntary cervical movement - multiple	1	4	3	2	3	4	4	4	3	4
Control of voluntary cervical movement - mobility	2	4	3	0	3	4	4	4	2	1
Control of voluntary cervical movement - stability	2	3	3	2	3	4	4	4	3	4
Control of voluntary cervical movement - control	2	3	3	1	3	4	4	4	3	3
Control of voluntary hand movement - only	2	2	3	2	4	4	4	4	2	2
Control of voluntary hand movement - multiple	1	2	3	3	4	4	4	4	3	3
Control of voluntary hand movement - mobility	2	2	3	2	4	3	4	4	1	2
Control of voluntary hand movement - stability	2	3	3	2	4	4	4	4	2	2
Control of voluntary hand movement - control	2	2	3	3	4	4	4	4	2	1
Control of voluntary arm movement - only	3	3	3	3	4	4	4	4	1	2
Control of voluntary arm movement - multiple	1	2	3	3	4	4	4	4	2	3
Control of voluntary arm movement - mobility	2	3	3	3	4	4	4	4	1	2
Control of voluntary arm movement - stability	2	3	3	3	4	4	4	4	2	2
Control of voluntary arm movement - control	2	3	3	3	4	4	4	4	2	1
Control of voluntary movement of the lower limbs - only	2	4	1	1	4	4	4	4	2	2
Control of voluntary movement of the lower limbs - multiple	1	4	1	1	4	4	4	4	2	1
Control of voluntary movement of the lower limbs - mobility	2	3	1	0	4	4	4	4	2	2
Control of voluntary movement of the lower limbs - stability	2	3	1	1	4	4	4	4	3	3
Control of voluntary movement of the lower limbs - control	2	3	0	1	4	4	4	4	2	3
Control of the right side movement - only	2	3	1	2	4	4	4	4	1	1
Control of the right side movement - multiple	2	3	1	2	4	4	4	4	3	3
Control of the right side movement - mobility	2	2	1	2	4	4	4	4	1	2
Control of the right side movement - stability	2	3	1	3	4	4	4	4	2	3
Control of the right side movement - control	2	3	1	2	4	4	4	4	2	2
Mobility of bones of the shoulder blade	2	2	3	3	4	4	4	4	2	2
Stability of bones of the shoulder blade	2	4	3	4	4	4	4	4	2	3
Control of bones of the shoulder blade	2	4	3	3	4	4	4	4	2	3
Mobility of pelvic bones	4	4	3	3	4	4	4	4	3	3
Stability of pelvic bones	4	4	3	3	4	4	4	4	3	4
Control of pelvic bones	4	4	3	3	4	4	4	4	3	4
Mobility of carpal bones	4	3	2	3	4	4	3	4	0	0
Stability of carpal bones	4	4	3	3	4	4	3	4	0	0
Control of carpal bones	4	4	3	3	4	4	3	4	0	0
Mobility of tarsal bones	4	3	0	0	4	4	3	4	2	2
Stability of tarsal bones	4	4	0	0	4	4	4	4	2	3
Control of tarsal bones	4	4	0	0	4	4	4	4	2	2
General joint control - mobility	3	3	2	2	4	4	3	4	2	2
General joint control - stability	3	3	2	2	4	4	4	4	3	3
Muscle Functions	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2
Functions related to muscle strength of the head - Isotonic	0	3	3	2	4	4	0	0	3	3
Functions related to muscle strength of the head - Hypotonic	0	0	3	2	4	4	1	1	3	3
Functions related to muscle strength of the head - Hypertonia	3	4	3	0	4	4	0	0	0	0
Functions related to muscle strength of the head - Isolated	0	2	3	3	4	4	1	1	2	2
Functions related to muscle strength of the head - group	0	2	3	3	4	4	1	3	3	3
Functions related to muscle strength of the head - force	3	2	3	3	4	4	3	3	3	3
Functions related to muscle strength of the head - resistance	3	4	3	3	4	4	3	3	3	3
Functions related to muscular strength of the upper limbs - isolated	2	3	1	3	4	4	4	4	1	2
Functions related to muscular strength of the upper limbs - group	2	2	1	3	4	4	4	4	2	2
Functions related to muscular strength of the upper limbs - force	2	1	3	3	4	4	4	4	1	1
Functions related to muscular strength of the upper limbs - resistance	2	3	3	3	4	4	4	4	2	2
Functions related to muscular strength of the lower limbs - isolated	3	4	0	0	4	4	4	4	2	3
Functions related to muscular strength of the lower limbs - group	3	4	0	0	4	4	4	4	3	3
Functions related to muscular strength of the lower limbs - force	3	4	0	0	4	4	4	4	3	3
Functions related to muscular strength of the lower limbs - resistance	3	4	0	0	4	4	4	4	3	4
Functions related to muscular strength of the hands - isolated	4	2	3	1	4	4	4	4	1	1
Functions related to muscular strength of the hands - group	4	2	3	1	4	4	4	4	1	1
Functions related to muscular strength of the hands - force	2	1	3	0	4	4	4	4	1	1
Functions related to muscular strength of the hands - rigidity	2	2	3	3	4	4	4	4	1	1
Functions related to muscular strength of the feet - isolated	2	4	0	0	4	4	3	4	2	3
Functions related to muscular strength of the feet - group	3	4	0	0	4	4	4	4	3	3
Functions related to muscular strength of the feet - force	3	4	0	0	4	4	4	4	2	3
Functions related to muscular strength of the feet - resistance	2	4	0	1	4	4	3	4	2	3
Functions related to muscle strength - right side	2	1	3	3	4	4	3	4	2	2
Functions related to muscle strength - left side	3	2	2	3	4	4	3	4	3	3
Functions related to muscle strength - inferior half	2	2	1	2	4	4	3	4	3	3
Functions related to muscle strength - all the limbs	3	2	3	3	4	4	3	4	2	3
Functions related to movement	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2
Functions related to reflexes - postural reflexes	4	3	3	4	4	4	3	3	4	4
functions related to stretching tonic reflexes	3	3	3	3	4	4	2	3	1	1
Hyperreflexia	4	4	3	3	4	4	2	2	1	1
Hyporreflexia	0	0	3	0	4	4	0	0	0	0
Functions related to involuntary movements	4	3	3	2	4	4	2	4	2	1
Stereotypies and perseveration	0	4	1	0	4	4	0	0	0	0
Vision and related functions	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2	Th1	Th2
Acuity	0	0	0	0	1	0	0	0	0	0
Field	0	0	0	0	1	1	0	0	2	2
Binocular	0	0	0	0	1	1	0	0	0	0
Monocular	0	0	0	0	1	1	0	0	0	0
Eyelid	0	0	0	0	2	1	3	3	1	2
Direction	0	0	0	0	3	3	0	0	2	1

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E-mail: revistacefac@cefac.br

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[1] Mailing address: Edênia Menezes, Cidade Universitária Prof. José Aloísio de Campos - Departamento de Fonoaudiologia, Av. Marechal Rondon, s/n Jardim Rosa Elze, Zip-Code: 49100-000 - São Cristóvão, Sergipe, Brasil, E-mail: edeniamenezes@gmail.com