Análise funcional da atenção compartilhada adulto-criança pequena com deficiência visual

Abstract

Shared attention (SA) is considered a milestone in child development. One of the most mentioned components in the literature for children starting SA is eye contact. The study of SA in young children with visual impairment is scarce and limited, suggesting the following questions: What are the behavioral dimensions of shared attention in the interaction between an adult and a young child with visual impairment? Is it possible to define theoretically and empirically what are the components of shared attention when the visually impaired child is involved in the interaction? To answer these questions, three studies were developed: the first aimed to characterize the components of shared attention of young children with visual impairment found in the definitions and in the method of empirical research conducted with this population. To achieve this goal, a systematic literature review produced between the 1980s and 2017 was carried out. The methodology used attended Preferred Reporting Items for Systematic Reviews and Meta-Analyzes/PRISMA requirements and resulted in 2,919 manuscripts survey theme of shared attention, 288 occurred with targeted participants by special education and 28 of them shared attention with visual impairment children. The result of the analysis of indicated studies addressed predominantly themes: definition of Shared Attention (N = 15); Limits of Shared Attention (N = 8); Maternal Interaction (N = 4) and Perspective Taking (N = 3). The main components highlighted in publications were touch/touch and communication when related to caregiver's interaction with the child. Many components descriptions of shared care found in publications about children with visual impairments brought difficult to identify and characterize the behavioral dimensions, especially components function indicated by studies. Therefore, Study 2 sought to empirically identify the behavioral components performance of initiating and responding to children with low vision in episodes of shared attention with an adult during free play. The study included 27 dyads (small and responsible child) recruited from an Educational Assistance Center Specialized in Visual Disability in Curitiba - PR. The instruments used were: Participants Protocol Characterization by Parents/Guardians; Brazil Criterion Questionnaire; Operationalized Portage Inventory; Transcription Protocols and Functional Analysis Protocol for Episodes of Shared Attention and analysis software adapted to OpenPose Realtime Multi-Person 2D Pose. The dyads were filmed in play situations for up to 10 minutes. The video recordings were edited with excerpts suppression from the beginning to the end recordings, totaling three minutes editing for each dyad. Videos descriptions and analyzes were carried out by completing the Transcription Protocols and Functional Analysis Protocol of Shared Attention Episodes. After observing and categorizing the SA behaviors in free inspection, video recordings were submitted to OpenPose programming treatment, in order to observe points of convergence between the guardian and the child in relation to the object and presented behaviors. The results indicated with the analysis using contingency of three, we have how much the OpenPose program was effective in identifying the SA behaviors of young children with low vision. Initiate a behavior SA most observed by those responsible were speech, hand movements and directives; for children and responding behaviors to SA were vocalization, conversation, responding orally and looking towards the source of the sound. The results presented by participants were in accordance with literature, as well as the result indicating that children were less likely to initiate shared attention. It is concluded that children components who shared attention with visual impairment are similar to those described for children in general. Additional research may help to refine the analysis procedures to advance the characterization of the phenomenon. In order to verify which components of initiating and responding to shared attention are presented by the child with low vision in a situation of structured activity, Study 3 was carried out: the participants in this study were 14 children selected from the 27 who undertook Study 2. The selection criterion was the child not to have completed four years and to be enrolled in the specialized institution. The instrument used was an unsystematic adaptation of Early Social Communication Skills - ESCS. The task materials that referred to shared attention were adapted/replaced by others with sound and light so that the children could access and carry out the activity. Original objective tasks proposed by the scale were preserved. Tasks were organized with reference to triple contingency. Results indicated that children with visual impairment had more behavior classes of responding to shared attention than of initiating shared attention. The ESCS behavioral observation protocol provided effective measures to identify SA components, as well as to verify children performance with low vision in tasks that evaluated the IAC and the RAC. Material adaptation and specific insertion components for SA behavior identification in children with DV were essential to obtain results. The thesis was concluded by stating that three studies contributed to describe shared care components with visual impairment children. Despite the effort to analytically break down aspects of shared care between the visually impaired child and their caregiver, it is necessary to invest in studies that detail and expand the findings of these studies. The lack of consensus in literature on shared care components, associated with conceptual problems and data collection methodological compatibility and analysis, limited discussion scope about this research results. Realization of other modalities of functional analysis, supplementary and complementary to those carried out here, may indicate new directions for consolidating behavioral components identification that establish the bases of shared attention in children with visual impairment.