Validation of a booklet on language developmental milestones in childhood

Rev. CEFAC. 2020;22(2):e16219 http://dx.doi.org/10.1590/1982-0216/202022216219 Original articles Validation of a booklet on language developmental milestones in childhood Débora de Souza Alexandre1 https://orcid.org/0000-0002-4251-0231 Matheus Francoy Alpes1 https://orcid.org/0000-0001-9617-7668 Ana Claudia Mirândola Barbosa Reis1 https://orcid.org/0000-0002-5800-6566 Patrícia Pupin Mandrá¹ https://orcid.org/0000-0002-2926-0354 ¹ Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto – FMRP-USP, Departamento de Ciências da Saúde, Ribeirão Preto, São Paulo, Brasil. Research support source: Programa Unificado de Bolsas – Universidade de São Paulo (PUB - USP) and Santander Bank. Conflict of interests: Nonexistent ABSTRACT Purpose: to develop and validate the content of printed educative material (booklet) on the typical oral language development. Methods: methodological development research with content validation. The material was produced following a literature review, in which the available publications approaching this theme were analyzed. The descriptors used were “child language”, “child development”, “language development”, and “language development disorders”. A total of 37 judges (specialists in the field and target audience) participated, divided into groups: speech-language-hearing therapists (LJG), educators (EJG), and relatives (RJG). They answered a 5-point Likert-scale instrument. The absolute percentage agreement (APA) and content validity index (CVI) were applied, whose respective minimum values of 75% and 0.78 were adopted. Results: the booklet encompassed the aspects of phonology, semantics, syntax, narrative and hearing, citing what is expected for each age. At the end of each topic, suggestions on how to stimulate the child’s language were made. The mean VCI scores were: LJG=81.3%, EJG=93.51%, and RJG=89.4%. Conclusion: the booklet reached a high content and design validity index and will aid health education initiatives, allowing its content to be spread among families and professionals involved in child development. Keywords: Validation Studies; Language Development; Educative Technology; Health Education; Speech, Language and Hearing Sciences Received on: November 10, 2019 Accepted on: March 31, 2020 Corresponding address: Matheus Francoy Alpes Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto USP Avenida Bandeirantes, 3900 CEP: 14049-900 - Ribeirão Preto, São Paulo, Brasil E-mail: 1/14 2/14 | Alexandre DS, Alpes MF, Reis ACMB, Mandrá PP INTRODUCTION Health education initiatives can lead to the development of new knowledge, as well as changes in behavior and lifestyle1, including the motivation to seek health professionals to get more information and learn about possible treatments2. This process involves the communication between institutions/professionals and the citizens3,4, and, in this context, the printed educative technologies – as posters, books, booklets, handouts and/or pamphlets – are widely used resources3,5-9. Printed technology supports and reinforces oral information and/or discussions, serves to offer instructive guidelines in cases of future doubts, and aids in decision-making3-6, besides increasing the target audience’s autonomy10, making it part of the mediation between professionals and the population in the educative process4-12. The development of printed educative material must follow certain principles: a) be scientifically based11-14; b) have a meta-educational approach to the intended audience15; c) be both readable and understandable to the intended audience13,14,16; d) be evaluated by judges regarding its content, language, structure, design/ layout, illustrations, and general composition13,14. The printed material must be attractive and easy to read; therefore, the vocabulary used must be coherent with the message and target audience16. The content must be validated first by specialized judges with expertise in the field and then by the public audience16-18. In the field of neuroscience, language acquisition is one of the classic examples of a critical or sensitive period of development. Studies refer to different temporal windows for learning different language levels. Hence, one learns phonology from birth to the end of the first year of life; syntactical development occurs between the 18th and 36th month of life; and vocabulary has an important lexical boom at the age of 18 months, though acquisition goes on throughout the whole life19. Being exposed to language in one’s first year of life influences the brain’s neural circuits still in the preverbal period, and the development of vocabulary in the first years of life is associated with future academic success20. The extension of oral vocabulary at 24 months of age is a predictive factor of the child’s academic performance (reading and mathematics) in preschool age21. Following up child language development from birth is extremely important, as the period from 0 to 36 months is essential to linguistic development, and any Rev. CEFAC. 2020;22(2):e16219 | doi: 10.1590/1982-0216/202022216219 exposure to risk and/or protection factors can directly affect this process15. Many relatives are uncertain about their children’s language development and how to deal with these situations. Many times, they seek a pediatrician’s or educator’s instruction, although the ideal is that they be referred for a language-expert speech-languagehearing therapist. A booklet scientifically developed and validated is a very relevant option of an educative instrument to inform the different public – as health professionals, educators, relatives, and other people who have direct contact with the children – about the language developmental milestones. Its importance lies in widely spreading this content to encourage the recognition of delays and the early referral to the speech-languagehearing assessment and intervention processes, thus contributing to the prognosis of different cases. During practice in different scenarios of supervised internship, in different levels of complexity (as in primary schools, family health care units, and speech-languagehearing diagnosis and intervention specialized centers), many relatives, in the anamnesis, commonly reported having been instructed to wait until the child was five or six years old (the period when language development is completed) to seek help. Thus, considering these facts and the information exposed in the previous paragraphs, the first research question arose: “Is there any scientifically validated printed material to inform about language development from birth to the six years old?”. After analyzing the institutional guidelines and informative material from the Municipal and State Departments of Education and Health and the Ministry of Health, no such educative technology was found. Hence, the process of developing the first version of the material was started, which brought about the s (...truncated)