Translation and cultural adaptation of the Aguado Syntax Test ( AST ) into Brazilian Portuguese Tradução e adaptação cultural para o português do TSA-Test de Sintaxis de Aguado

Accepted: June 26, 2017 Study carried out at the Department of Speech-Language Pathology and Audiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo – USP Bauru (SP), Brazil. 1 Human Sciences Center of the Universidade do Sagrado Coração – USC Bauru (SP), Brazil. 2 Department of Speech-Language Pathology and Audiology of the Bauru School of Dentistry, Universidade de São Paulo – USP Bauru (SP), Brazil. Financial support: nothing to declare. Conflict of interests: nothing to declare. ABSTRACT


INTRODUCTION
The paucity of standardized clinical and assessment investigation instruments in the language development field is notable in Brazil.While countries such as the United States, Spain, France, Argentina, and Chile possess an expressive number of tests and protocols to assess language development in different age ranges, in Brazil this number is still restricted, even when considering the notorious progress made in the last decades.If the number of language assessment procedures is scarce in general, it can be said that it is almost nonexistent when the investigation process involves morphosyntax.
From a linguistic standpoint based on syntagmatic and paradigmatic axes, morphology is the study of isolated vocabulary, and syntax analyses the combination between words (1) .Thus, morphosyntax implies the knowledge of speakers regarding the intern structure of the words and combination rules of phrases (syntagmas) in clauses.As far as it is known, only the MLU -Mean Length Utterance (2) has been used in researches about morphosyntactic assessment in Brazil.MLU is a measure of language, whose main aim is to obtain data about the performance of children with typical language development in morphologic and syntactic aspects and was used in studies of children with communication disorders (3,4) .The morphosyntactic assessment of children with language alterations receives low attention in Brazil, because it is not possible to evaluate this aspect in a credible way in the Brazilian Portuguese language.Thus, investing heavily in this underprivileged area of language assessment is utterly important and this study aims to contribute to it.This study was carried out in order to perform the translation and cultural linguistic adaptation of Aguado Syntax Test into Brazilian Portuguese.

The instrument
The Aguado Syntax Test (AST) (5) is a Spanish instrument that verifies the syntactic aspects of the language in children with ages ranging from 3 to 7. It consists of two booklets, one containing data on the syntactic development in children up to 3 years of age and in children with ages ranging from 3 to 7, besides featuring instructions for the application and the standardization of the test in Spanish.The second booklet is composed by sets of figures that are used for the verification of certain grammatical structures.The application sheet contains 36 items for the verification of syntactic comprehension and 34 items for the verification of syntactic expression, each item having two possibilities of response.Therefore, the total score of the test involves 72 correct responses in the comprehension aspect and 68 in the expression aspect.
The grammatical structures assessed in both the comprehension and expression aspects involve the analysis of sentences containing: interrogative and negative sentences; the imperative mood; voices (active and passive); articles; demonstrative, possessive, indefinite, personal (subject and object), interrogative and relative pronouns; verbal voices; comparisons; prepositions; and verbal desinence as to number, mode and tense.The phrases that contain the aforementioned grammatical structures were the object of study of this work and were submitted to translation, backtranslation, and preparation for an adapted final version of the test.The manual containing the application instructions for the test was also translated into Brazilian Portuguese, however it revealed no need for cultural adaptation as it features simple instructions organized specifically to guide and control the conduct of the examiner.
The test application consists of the following: in the comprehension aspect, 36 sheets are presented containing four pictures each, where the child must show one that corresponds to the phrase said by the examiner.In the expression aspect, there are 29 sheets containing two pictures each.In each assessed item, the child listens to two phrases, one after the other, without having previous access to any of the pictures.Immediately after saying them, the examiner shows the picture that corresponds to the phrase marked with an asterisk.It is expected from the child to repeat the phrase.Then, the other picture is shown, so that the child can produce the following elocution.
From item 30 on, in the expression aspect, the graphic material ends and the examiner must lead a conversation with the child, in order to obtain responses involving compound sentences with certain verbal morphemes.In this conversation, the examiner comments about the weather during the application (cold/heat/rain).From items 30 to 34, the examiner tells the child phrases that promptly stop in two bars, ending with a tone of ellipsis, which invites the child to keep on talking.In the items in which the two bars occur in two distinct places of the phrase, the examiner will, at first, tell the child the phrase until the first two bars, to see if the child spontaneously uses the connective particle to link the ideas.If there is no expected performance, the examiner will have to repeat the stimulus-phrase until the second two bars.This is not about training the child in the verbal morphemes we intend to assess, but rather make him aware of what phrasal conclusion we expect from him.To illustrate and example, it is understood that, in general, if we start a phrase with a comment about the weather, it should end with another comment about the necessity to put on or take off some certain types of clothes.

The translation and linguistic adaptation process
For the process of translation and cultural adaptation, the methodology described by Beaton et al. (6) was adopted.In stage 1 of the translation, 2 initial translations, called T1 and T2 were performed by qualified professionals.In this phase, as part of the translation process, and in addition to the literal translation of the original content, the adaptation (cultural/linguistic) by means of translation strategies occurred, considering the technical processes of translation proposed by Barbosa (7) .Each item from the test response sheet was analyzed and adapted accordingly.Two grammatical and semantic comparisons were performed, assessing the meaning of the words in each item, in order to verify clarity aspects and issues of the instrument.At this stage, the two translations allowed for the detection of differences in interpretation of possibly ambiguous items.
In stage 2, there was a meeting between the two translators, the translation expert and the speech-language specialist (expert committee).The objective of this meeting was to compare the two distinct translated versions and discuss the changes needed for the preparation of a single version, called the synthesis version (SV), reflecting the consensus of the committee.All decisions made at this meeting were documented in detail in a report.
In stage 3, the backtranslations were performed, meaning that the text that was written in the target language was translated again to the source language.Two native back translators from Spanish speaking countries, with notable knowledge in Brazilian Portuguese, worked individually in the production of two backtranslations (BT1 and BT2) of the simplified version.The translators responsible for the backtranslation process did not have access to any other piece of information other than the text.The intention was to allow the process of backtranslation to reveal unexpected meanings and interpretations.
In stage 4, the methodologist collected information from the four translators, responsible for T1, T2, BT1, and BT2, besides listening to the speech-language specialist for guidance in relation to language development and assessment.This phase of the process aimed to promote the evaluation of the translations and back-translations, in order to verify the equivalence between the initial translations and the final version of the application sheet of the test.
Regarding to the evaluation of the cultural adaptations made, the semantic, idiomatic, experimental, and conceptual equivalences in the translation process were considered.The experts applied the grades (-1) not equivalent, (0) equivalent, and (1) very much equivalent to the test original version.Any item that received a (-1) not equivalent grade was translated again considering the experts' suggestions.The experts committee ensured that the test and the instructions for its application were understandable.

DISCUSSION
Certain verbs were used in a more neutral way in relation to the original in Spanish, as in the case of item 2 from the comprehension part "El niño juega con el balón" ("O menino joga com a bola", literally) and item 21 from the expression part "La niña lleva al niño" ("A menina leva o menino", literally).In the final translated version of the test, it was made an option to change the verbs "juega" and "lleva" for more common equivalents in Brazilian Portuguese which are "brincar" and "puxar".In the final version of the item 2, from the comprehension part, it was also made an option to insert the term "mesmo" between the definite article and the subject.These adaptations did not interfere in the grammatical performance of the item, which corresponds to the grammatical aspect "article" in the comprehension part of the original article.
Concerning the use of certain verbs, some changes were made to make the comprehension of the actions presented in the test figures easier.For instance, the verb that is in the simple conditional in Spanish in "Si no lloviera, saldría" ("Se não chovesse, sairia", literally) and in the simple future in "Aunque llueva, saldré" ("Mesmo que chova, sairei", literally), both in the item 26 from the comprehension part, were changed, respectively, into the types "eu iria sair" and "eu irei sair", because these are more common types in Brazilian Portuguese.
There were also verb tense changes, which in the original were in the present tense, into a conjugation that is closer to the continuous actions, as it is the case of item 10 from the expression part, in which the clause "El niño salta" ("o menino pula", literally) was changed into "o menino está pulando"; and the item 11 from the comprehension part, in which the clause "La leche se cae" ("O leite cai", literally) was changed into "O leite está caindo".
The difficulties in keeping the verb tenses in Brazilian Portuguese the same way they were in Spanish lies in the idea that the structures in both languages are very close and, therefore, equivalent.However, what happens is that in the syntactic level a wider gap between the languages is observed (presence/absence/addition of pronouns, direct complements, conditional clauses, etc.) (8) .Mostly, the similarities between Brazilian Portuguese and Spanish make translators erase the differences (9) .Some prepositions went through a modification and adaptation process to meet the specifications of the Brazilian Portuguese.In the item 13 of the comprehension part of the TSA, where it reads "El gato esta en el armario" ("O gato está no armário", literally) the general preposition "en" was changed to "dentro", which is something more specific in the target language, resulting in the phrase "O gato está dentro do armário".Keeping the preposition "no" in the translation could cause ambiguity, once it can be confused with the prepositions "dentro" and "sobre" in the Brazilian Portuguese.The preposition "en" in Spanish could be literally translated by "no/na/em" in Brazilian Portuguese, however the preposition "no/na" in Portuguese can mean both "sobre" and "dentro" (as in "A caixa está no armário" or "A bota está na caixa", which depending on how the picture is shown can mean that the boot is "in" or "on" the cabinet/box), thus creating ambiguity.In order to perform the disambiguation, it was used a procedure presented in the technical translation processes as "modulation".The modulation consists in replicating the original message in the translated document under a different point of view, reflecting a difference in how the languages interpret the reality (7) .
In relation to the use of demonstrative pronouns, the item 3 of the comprehension part in the original test presents the pairs "Este es mi sombrero"/ "Ese es mi sombrero" ("Este é meu chapéu" and "Esse é meu chapéu", literally) and the item 2 of the expression part presents the pairs "Ese es mi perro"/ "Este es mi perro" ("Este é meu cachorro" and "Esse é meu cachorro", literally).Nevertheless, in the Brazilian Portuguese, the translation of the demonstrative pronouns into "este" and "esse" do not accurately convey the idea desirable for the child to be able to make a distinction between the items of the test, which present the notion of distance between the object and the speaker.In order to solve this discrepancy, the demonstrative pronoun "esse" was changed for "aquele", making the purpose of the analyzed item clearer and more objective.
In the traditional grammar books, demonstrative pronouns are listed, more or less consensually, as words that indicate the position of designated objects in relation to the people who take part in the speech.In Brazilian Portuguese, the distribution of these pronouns follow three distance values: close, for objects that are close to the speaker; average, for objects that are somewhat close to the recipient and more or less close to the speaker; and distant, for the ones that are far from the speaker (10,11) .Although, while the standard Brazilian Portuguese suggests a ternary system for the demonstrative pronouns (este vs. esse vs. aquele), in spoken Brazilian Portuguese there is a binary system (este/esse vs. aquele), which is going through a phenomenon that we call "specialization of the forms".
In relation to to the possessive pronouns, the item 4 of the comprehension part presents the following pairs of phrases "Su perro"/ "Sus perros" ("Seu cachorro" e "Seus cachorros", literally).However, in the target language the use of the possessive pronouns "seu/seus" may be confusing, especially for children, because they are both connected to the personal pronouns "você" and "ele" (12) .Therefore, in order to culturally adapt the items and make them more comprehensible, the possessive pronouns "seu/seus" were changed for the possessive pronoun "dela", adapting the items respectively for "O cachorro dela"/ "Os cachorros dela".
Following guidelines from the committee of experts of this study, some nouns went through a cultural adaptation to fit into the vocabulary normally used in the target language.In the item 12 of the comprehension part, the noun "nenê" (nenê) was changed by "bebê", because this noun is more commonly used in textbooks and Brazilian school materials.
Regarding the object pronouns, the change performed was a pronominal dislocation in the item 18 of the expression part of the test.Where it reads "Los bañan/La baña" "Os banha/A banha", literally) in Spanish, the object pronoun was placed after the verb, changing the verb tense to the past ("Banhou-os/Banhou-a") to avoid cacophony ("Os banha/A banha").In the item 7 of the expression part of the test, however, there was no need of adjusting the position of the object pronoun in the phrase or even the verb tense, since this type of grammatical structure is already similar to the one spoken in the Brazilian Portuguese.
It is important to highlight that none of the adaptations changed the grammatical categories assessed by the TSA, namely, types of clauses, pronouns, prepositions, terms of comparison, voices and verbal tenses, and compound sentences.In the stage of equivalence assessment of the back-translations in face of the original version, it was observed that some changes were made in the grammatical structures of some items when the Brazilian Portuguese version was translated back to Spanish.Such changes were based in the need of obtaining semantic, idiomatic, experimental, and conceptual equivalence of the items among translations.

CONCLUSION
The cultural adaptation process of the test into the Brazilian Portuguese indicated that there was linguistic equivalence between the TSA version in Spanish and in Portuguese.The translation and cultural adaptation of the TSA test into the Brazilian Portuguese is the first step for the validation and normalization of the instrument in Brazil.

. Verb tenses from simple present to present continuous Item 10 -Expression
1 presents the most relevant adaptations made to the TSA in relation to Brazilian Portuguese and Appendix A shows the test final version in Brazilian Portuguese.The most relevant linguistic adaptations made to the TSA in the Brazilian Portuguese language Chart 1.