Processamento fonológico e aspectos comportamentais antes e após intervenção fonoaudiológica em crianças com mau desempenho escolar

Abstract

Introduction: Poor school performance can be defined as a lower than expected educational performance for a given age, education or cognitive skills. It may be due to external factors, such as environmental factors, socioeconomic and pedagogical conditions, being, in this case, considered as a learning disability or internal factors, such as cognitive deficit of genetic or neurological origin which, in this case, refers to learning. Objective: To investigate the phonological processing of children with poor school performance in the age group of seven to ten years before and after speech therapy intervention and the association with behavioral aspects. Methods: This is a pre-experimental study with a non-probabilistic sample. The research was carried out in four stages: 1) elaboration of a systematic review article of scientific productions that addressed the association of phonological processing with development of reading and writing or poor school performance, in children in the early years of schooling; 2) initial evaluation: Twenty children aged seven to ten years with poor school performance, from the municipal school system, were sent for specialized care. The research was carried out at the Child and Youth Psychosocial Care Center (CAPSij), inserted in the health care network within the scope of psychosocial care, in the municipality of Itabirito, Minas Gerais. The instruments used for the initial assessment consisted of three questionnaires and eight assessments, namely: Questionnaire for sample characterization (anamnesis), Difficulties and Capabilities Questionnaire (SDQ) and Brazil Economic Classification Criterion (CCEB), applied to parents or caregivers; Hearing assessment; Phonology assessment, Child Phonological Assessment Protocol (PAFI); Evaluation of lexical access, Vocabulary Test by USP figures (reduced version); Assessment of the child's ability to manipulate speech sounds, Phonological Awareness sequential assessment instrument (CONFIAS); Evaluation of information processing speed, Rapid Automatic Naming Test (RAN); Reading assessment, Reading Process Assessment Tests (PROLEC); Evaluation of the stage of reading development, Test of Competence in Reading Words and Pseudowords (TCLPP) and Evaluation of writing, through the Pinheiro List; 3) speech therapy intervention in group: the students were distributed in groups according to criteria of similarity of symptoms and age, with a program of activities constituted according to the chronicity of development and the skills involved in the semantic-lexical and phonological processing, with duration of twelve sessions; 4) reassessment: questionnaires and protocols were reapplied and, subsequently, performance analysis and comparison were performed before and after speech therapy intervention. After the collection, the responses of the instruments were organized, typed in a database and checked. To meet the objective of the study, a descriptive analysis of the data was performed, by means of the frequency distribution of categorical variables and analysis of measures of central tendency and dispersion of continuous variables. Pearson's chi-square and Mann-Whitney tests were used for association analyzes, with p-value ≤ 0.05 being considered as statistically significant associations. SPSS software, version 21.0, was used for data entry, processing and analysis. Results: In the systematic literature review, 982 potentially relevant studies were found. After using the evidence matrices, 38 scientific productions were selected for detailed analysis, twenty-nine cross-sectional observational studies, eight longitudinal observational studies and one experimental study. Regarding the study of the investigation of phonological processing of children with poor school performance, there was a statistically significant association between SDQ and RAN colors, sex and RAN colors and school year and RAN letters in the post-testing group. Children with poor school performance, submitted to the group speech therapy intervention program, demonstrated progress in all phonological processing skills and behavioral aspects after carrying out the activities developed. Conclusion: The detailed analysis of scientific productions in the systematic literature review revealed that, in children in the early years of schooling, phonological processing was associated with fluidity of reading, rapid naming, spelling, reading comprehension and mathematical skills, acting as an essential factor for the Learn. The group speech therapy intervention program proved to have applicability to improve phonological processing skills, receptive vocabulary and behavioral aspects of children with poor school performance.