Functional Communication Profile-Revised: Application and Comparison with the Functional Communicative Profile-Checklist ()
1. Introduction
Since the first descriptions of autism by (Kanner, 1943) several studies have been conducted with the purpose of identifying and describing each subject’s characteristics and propose more efficient intervention procedures.
Autism is classified as a Pervasive Developmental Disorder on the DSM 5, and is described by the American Psychiatric Association as a complex group of disorders in the areas of social communication and social cognition (APA, 2013).
The central role of language is probably one of the few agreement points in all descriptions of autism (Fernandes, 2000). The functional perspective of language use takes into account, besides the functions and communicative means, the context in which communication happens. It shows that considering the non-verbal aspects of communication is essential to its comprehensive assessment (Emerson, 2001).
The difficulties in communication occur in varying degrees, both in verbal and non-verbal ability of sharing information with others. Some children don’t develop communication abilities. Other children present an immature language, characterized by the use of jargon, echolalia, pronoun reversal, abnormal prosody, monotonous tone of voice and other disorders. The language and communication deficits tend to persist through adulthood (Gadia et al., 2004). Those individuals that acquire verbal abilities can show persistent deficits in their capacity to establish and maintain conversation. These difficulties can manifest as lack of reciprocity, difficulties to understand language subtleties, jokes and sarcasm, as well as problems to understand body language and facial expressions
Language as a communicative mean between people has systematic rules that are used to convey thoughts and cooperate in social interactions (Bess & Humes, 1998). The systematic assessment of communicative competence includes a clear understanding of the contexts where the child uses his/her linguistic abilities.
Assessment techniques must focus on the differential diagnosis and the functional communication development. Determining standard evaluation criteria is essential to the assessment of intervention proposals (Fernandes, 2003).
The speech-language pathologist must assess the association of language abilities and communicative competence of children with ASD. Language ability refers to the child’s capacity to understand and formulate spoken or written symbolic systems. Communicative competence refers to the capacity to use language as an interactive tool in different social contexts regardless of the communicative means used (Bara et al., 2001).
Used to assess communication, the Functional Communicative Profile-Revised (FCP-R) provides a sensible and organized method to the assessment of individual communicative abilities according to their age and acquired or developmental deficits (Kleiman, 2003).
The purpose of this study is to propose a reduced instrument based on the FCP-R and compare its results with those obtained with the Functional Communicative Profile-Checklist (FCP-C).
2. Methods
Participants were 50 children and adolescents with ages between 3 years 9 months and 14 years 8 months of both genders with diagnosis within the ASD. All attended speech-language therapy at a specialized service at a University clinic for at least 6 months and for no more than 2 years.
They were assessed by:
FCP-Rr—a reduced protocol based on the FCP-R (developed by the authors) that comprises the areas of Behavior, Attention, Receptive Language, Expressive Language and Social/Pragmatics. This instrument was applied during an interview with the speech-language therapists. The scoring system was adapted, with a proportion analysis, from the original suggested by Santos & Fernandes (2012). The protocol was applied as an interview with the therapists. The questions included in the reduced version were the ones considered the most appropriate to the Brazilian reality and the ones identified as the most relevant of the complete form.
FCP-C—a list of communicative functions expressed by the participants, also applied during an interview with the speech-language pathologist. It considers 20 communicative functions, their frequency-as always (A), many times (MT), rarely (R) or never (N)-and the communicative means used to express them-as Verbal (VE), Vocal (VO) and Gestual (G). The communicative functions were divided in two groups: more interpersonal and less interpersonal for the analysis of PFC-C according Cardoso & Fernandes (2003). The percentage of occurrence of communicative functions was obtained through every assigned possible occurrence (A, MT, R, N) and the communicative mean was calculated for each communicative function (only were considered the communicative functions that effectively occurred, regardless of the amount-A, MT and R) for both more and less interpersonal functions. From the percentages of occurrence, the communication interactiveness was determined by the proportion of communicative acts with interpersonal functions expressed.
The obtained data from FCP-Rr and FCP-C were characterized through descriptive analysis. This data were compared individually by t-Student test and the significant level adopted was 0.05 (5%). The correlation test was conducted in order to verify linear correlations.
The data relating to the frequency of the communicative acts with interpersonal functions obtained in FCP-C were analyzed according to their averages, separated by domain and then by degree of severity according to the FCP-Rr.
3. Conclusion
The results show that the comparison of FCP-R and PFC-C doesn’t result in equivalent data since they have different approaches. The FCP-C provides a detailed review of the use of language regarding to the occurrence, frequency and use, bringing quantitative impressions of the language characteristics of individuals with autism. However, the FCP-R only considers the occurrence of the communicative acts, regardless of the situation in which they are expressed. It is observed that the areas of formal language and interactivity are interrelated; another important factor to consider while planning therapeutic procedures.
The comparison of FCP-C and the FCP-Rr results in important information to the comprehensive understanding of children and adolescents with ASD because they use the same paradigms of variable analysis. Results indicate that disorders in receptive language interfere directly in the interpersonal communication of these subjects while only severe disorders of expressive communication have significant effects on interpersonal communication.