ABSTRACT
By analyzing the problems existing in the practice of doctor -patient communication , respectively discusses the speech act theory before the implementation of the implementation of doctor -patient communication oral English training , implementation , and after implementation of the positive role: instant help medical students to master a large number of medical English vocabulary;In view of the students come from different areas , instant help correct the pronunciation and intonation;Benefit based on speech act theory to guide the student to carry on the different roles played in English oral practice helps students to adopt direct and indirect speech act theory and the method of the oral English practice for communication;To improve medical students′professional recognition;To strengthen the medical students′sense of mission .
ABSTRACT
El estudio que se informa describe el análisis psicométrico de la validación y confiabilidad de los instrumentos que conforman la Batería ICRA-A (Investigación de la Competencia Comunicativa para la Realización de Actos de Habla - Abraham & Brenca, 2002, 2005, 2007, 2009a, 2013), la cual fue diseñada para evaluar sistemáticamente el aspecto pragmático del lenguaje infantil en el marco de la evaluación neurolingüística. La batería está conformada por cuatro instrumentos: (1) Análisis y Registro de Actos de Habla, (2) Observación Pragmática del Juego, (3) Cuestionario para Padres y (4) Guía para Padres. Fueron evaluados 155 niños, 100 de ellos tenían compromisos del lenguaje no verbal y/o verbal, y 55, con desarrollo típico del lenguaje. Se realizó el análisis de la validez de constructo utilizando Análisis Factorial con Componentes Principales y Rotación Varimax, la confiabilidad entre jueces, aplicando Coeficiente de Correlación Intraclase con acuerdo absoluto y la consistencia interna, mediante el coeficiente de Alpha de Cronbach. Se determinaron percentiles y valores de corte empleando la Curva ROC, como así también valores de especificidad, sensibilidad, predictibilidad y razón de probabilidad. La validez de constructo para el instrumento 1 fue igual a 65.5% y para el instrumento 2, igual a 73.7 % y la correlación intraclase fue igual a .90 y .89 respectivamente. Los resultados de la Curva ROC fueron: .92 para el instrumento 1 y .89 para el 2. Para el instrumento 1, el valor de sensibilidad fue igual a 81%, el de especificidad 90.9%, de seguridad (VP + 94.2%; VP - 72.5%) y de predictibilidad (CP + 8.47; CP - .21). Los instrumentos 3 y 4 brindan información preponderantemente cualitativa, ya que registran la percepción que tiene cada uno de los padres sobre la competencia comunicativa del niño. Los resultados obtenidos muestran la fortaleza de la Batería ICRA-A para evaluar el aspecto pragmático del lenguaje infantil en la clínica fonoaudiológica.
In this paper we describe the psychometric analysis of the validation and reliability of the instruments which constitute ICRA-A Battery (Communicative Competence for Speech Acts Production Research - Abraham & Brenca, 2002, 2005, 2007, 2009a, 2013). It was designed for systematic assessment of child language pragmatic aspect, with a progression criterion, within the framework of neurolinguistic evaluation, in River Plate Spanish speeking children. In this way, it allows to register and analyze pragmatic development rigorously, with variables control, what is added to the analysis made in the other dimensions (phonological, lexical-semantic and morphosyntactic), so permitting to get a whole profile of the child linguistic competence. ICRA-A Battery is applied to little children who show pragmatic impairment. It is also useful with older children with a lower communicative or intellectual range. It is composed of four instruments. (1) Speech Acts Analysis and Register: it allows to evaluate in a quantitative and a qualitative mood pre and paralinguistic manifestations of the seven speech acts basic in children language development. (2) Playing Pragmatic Observation: information can be obtained about communicative competence, fundamentally non verbal, taking into consideration shared referenciality, protodeclaring and protoimperative conducts, prelinguistic functions, basic speech acts precursors, ludic interaction type and mode, analyzed into six communicative dimensions. (3) Parents Questionnaire: useful to get information on the perception each parent has about his / her child communicative competence. (4) Parents Guide: to give parents guidance on their child communicative behavior in three daily routines within the familiar context. ICRA-A Battery includes created ad hoc concrete and figurative material, as well as Register and Results forms. It is incorporated into the ICRA Method, which, from a systematic and progressive fashion, allows to formulate the pragmatic objectives of treatment plan and intervention strategies. One hundred and fifty five children were assessed: 100 with verbal and/or non verbal language impairment, and 55 with normal language development. Construct validity analysis was made through Factorial Analysis with Principal Components and Varimax Rotation. For reliability between judges we applied Intraclass Correlation Coefficient with absolute agreement; and internal consistency through Cronbach Alpha - Coefficient. Percentiles and cut values were determined through ROC Curve, and so specificity, sensibility, predictability values and probability ratio. Construct validity for instrument 1 was of 65.5%; for 2, of 73.7%; intraclass correlation was of .90 and .89, respectively. ROC Curve results were of .92 for instrument 1 and .89 for 2. For instrument 1, sensitivity value was of 81%, specificity of 90.9%,security (VP + 94.2%; VP - 72.5%); predictability (CP + 8.47; CP - .21). Instruments 3 and 4 give a preponderantly qualitative information, as they register the perception that each parent has on their child communicative competence. These results show the Battery ICRA-A fortitude to evaluate the child language pragmatic aspect in phono-audiological work. Speech acts systematic study is a relevant tool in phonoaudiological treatment to obtain greater precision in language analysis of children with communicative competence development difficulties, in differential diagnosis and consequent treatment. The psychometric results that have been achieved show ICRA-A Battery fortitude for its use in the phonological work with neurolinguistic orientation.
ABSTRACT
Las afasias son una patología del lenguaje y éste es un sistema de mediación cultural lógica, situado netamente por encima de lo meramente natural. Arranca de la función simbólica, que establece la distinción y el nexo entre significante y significado. Se establece, a grandes rasgos, una clasificación neurolingüística de las afasias, rechazando las expresiones inadecuadas de sensitiva o sensorial y motora. Se insiste particularmente aquí sobre la cuestión de la "repetición" en la semiología afásica, tanto en lo que se refiere a su pérdida como a su "exaltación". Ello conduce a una revisión de la mal llamada afasia "de conducción" y del "transcorticalismo".
Aphasias are language pathologies, therefore the acquaintance of its structure is required for proper understanding. Language is a cultural interaction system, logical, set much above common natural. It separates the symbolic function, which establishes the distinction between significant and signification. We establish a neurolinguistic classification of aphasias, refuting improper expressions. We broach the wrongly called "conduction aphasia". We detach the unit of speech act and we distinguish the existence of a joint project that sheds light on all sentences brought forth. The complex texture of the "transcorticalism" qualify is analyzed. Aphasia field and some forms of its unfolding are questions aborded under the light of basic neurolinguistic concepts. We detach the unit of speech act and we distinguish the existence of a common project that sheds light on all sentences brought forth.