Tradução e adaptação transcultural de um instrumento para rastreio das características da apraxia de fala na trissomia do cromossomo 21

Abstract

Trisomy of Chromosome 21 (T 21) is a genetic condition that promotes repercussions at different levels, including linguistic-communicative impairments. Considering the complexity of this condition and seeking to assist in the clinical context, several studies have been developed to understand and diagnose the speech disorders present in people with T 21. In this field, the discussions involving in Childhood Apraxia of Speech (CAS), a speech motor disorder of neurological origin, which is difficult to diagnose, compromising the planning and programming of movements underlying speech. In this context, this study seeks to contribute to the differential diagnosis of this pathology, performing a translation and adaptation of the questionnaire “Down Syndrome Speech Intelligibility Survey” into Brazilian Portuguese. The methodology involved carrying out the necessary steps for cross-cultural adaptation: translation of the instrument from the source language to the target language, synthesis of the translated versions, evaluation of the synthesis by expert judges, evaluation of the instrument by the target audience, reverse translation and study -pilot. The results obtained after the translation and synthesis of the translations, with the analysis by the expert judges, indicated that a significant majority of the instrument's items were considered very relevant, very viable and adequate, presenting content validity; in the analysis by the target population, important suggestions for changes by parents were pointed out, allowing modifications to be made for a better understanding of the instrument; from the reverse translation, some inconsistencies of the translated and adapted version were identified in relation to the content proposed in the original instrument, and the necessary adjustments were made; in the pilot study, it was identified the need to adapt some questions (inserting examples to facilitate understanding), to exclude one of the items, which had similar content to the other, and to insert previous guidelines for completion, resulting in the final version of the instrument. The translation and adaptation process conducted is discussed in the light of international guidelines and existing literature in the area, highlighting the existing methodological diversity and the lack of consensus among researchers. Furthermore, the applicability of the translated and adapted instrument is discussed, demonstrating its potential for identifying cases with suspected CAS, considering the pertinence of the characteristics addressed therein, in correspondence with the existing scientific evidence in the area. Thus, the contributions of the translated and adapted instrument are highlighted, to help with screening, pointing out which individuals have clinical signs and need a specific diagnostic evaluation. In this perspective, the research is relevant due to the scarcity of evaluative resources available in Portuguese for the analysis of the AFI and the lack of instruments specifically aimed at application with the parents of people with Trisomy 21.