Processamento fonológico em adolescentes e fatores associados

Abstract

The ability to process language, both oral and written, based on sound information of language, it characterizes phonological processing. Literature shows that it is a strong predictor of the development of written language, since reading and writing demand the processing of sound structures of language, retention, besides it, speedy and accurated access to information and relationship between graphic symbols and sound elements. Some studies suggested relationship of reciprocity between development of written language and development of phonological processing skills. In this way, reading and writing also contribute to the improvement of phonological processing, whose components are: phonological awareness, operational memory and rapid lexical access. Naming task automatic and fast is one way to assess lexical access. In this task, time of nomination and its current mistakes are registered. Nomination process could fail, but it is controlled by monitoring cognitive system that allows the necessary repairment. So that an individual perceives and corrects the errors in his/her speech or writing, it is necessary to involve several cognitive and linguistic resources, that also are involved in the process of nomination of figures. Thus, it is understood that rapid automatic naming test makes it possible to investigate the performance of such resources through self-correction. PURPOSE: To characterize the performance of adolescents in tasks being involved the operational memory, the fast automatic nomination and the phonological awareness, as well as verifying the factors that influence the performance in such abilities; and to verify the self-correction among the adolescents and the association with cognitive functions and the vocabulary. METHODOLOGY: The observational analytical cross-sectional study was performed with non-probabilistic sample composed of 83 youngs of both gender, they aged between 11 and 16 years old, enrolled from the 6th to 9th degree, without complaints of learning difficulties. Were applied: Phonological Awareness Tests of the Assessment of the Written Language and its Disorders, Rapid Automatic Naming Speed Test, Short Neuropsychological Assessment Instrument, Textual Reading and Understanding Test, Boston Nomination Test and the anamnesis questionnaire. During quick naming task were recorded time, errors, and selfcorrections. Data collection was done in two public schools in Belo Horizonte. The data had been inserted in spread sheets of the Excel® in order to submit analysis statistics. Qualitative variables were analyzed for absolute and relative frequencies. For the quantitative variables, measures of position, central tendency and dispersion were used. The investigation of the self-correction was made based on the variation of the mistakes number. The sample was categorized as: as "does not perform substitution", "performs substitution and does not perform self-correction" and "performs substitution and self-correction". Wilcoxon and Friedman tests were used to verify the median error, Fisher Exact and Mann-Whitney tests to verify the association with schooling and the Kruskal Wallis test to verify the association of selfcorrection with cognitive and linguistic functions. To analysis of phonological processing, we used Linear Regression with consistent standard errors for the covariance matrix of the estimated coefficients and the HC estimator. Stepwise method and the Variance Inflation Factor (VIF) were used to select the variables. Significance level adopted was 5%. RESULTS: The sample was composed for 33,7% adolescents of 6th degree, 26.5% of 7th degree, 24.1% of 8th degree and 15.7% of 9th degree. About age of pertaining entrance to school, 36.2% entered to the 3 years of age, 21.3% before the 12 months or after 4 years and 10.6% entered with 1 or 2 years. Regarding the performance in phonological processing, the mean time of naming of objects was 48.20' and of letters was 21,24'. The mean accuracy in phonological awareness was 28.86 and the operational memory was 25.52. Regarding cognitive and linguistic performance, 82.7% (n = 62) presented an adequate operational memory performance and 17.3% (n = 13), inadequate. Attention rated as adequate 87.8% (n = 65) and inadequate 12.2% (n = 9). By 65.3% (n = 49), the performance of episodic-semantic verbal memory was adequate and by 34.7% (n = 26) inadequate. Of the evaluated adolescents, 85.3% (n = 64) had presented performance adjusted in the tasks of verbal language and 14.7% (n = 11) inadequate. Concerning mistakes in the rapid naming test, 75.9% of the adolescents in the sample performed substitutions. As for the type of visual stimulus of the rapid naming test, there was a higher frequency of self-correction between the nonalphanumeric stimuli. The occurrence of self-correction was high in all school years analyzed. However, when comparing the adolescents who attended the initial and final grades in elementary school II, the sample differed in the task of rapid naming of letters. Adolescents who did not commit substitutions during the test presented better cognitive and linguistic performance than those who presented errors, and the adolescents who performed self-correction were better at attention than those who missed and did not correct. Despite the relevance of the self-correction, accounting for it during the test causes double registration, since indirectly it is accounted for in the time register. However, it is necessary that the examiner observes the practical one of self-correction during the nomination task. Regarding to the phonological processing, the operational memory revealed significant for the time of object nomination and the phonological awareness and fluency of reading for the time of nomination of letters. Times of object nomination and letters had shown reciprocal relation. Operational memory performance was influenced by object naming time, episodic-semantic memory, executive functions, and attention. A high naming time of objects contributed to the classification of the operational memory as inadequate. Phonological awareness was associated with the naming time of letters, executive functions and attention. Thus, according to the sample evaluated it was observed that it is important that the therapist observe the cognitive and linguistic performance of the adolescents when investigating the phonological processing. CONCLUSION: The practice of self-correction in the rapid automatic naming test was associated with the cognitive performance of investigated adolescents. Likewise, phonological processing was influenced by cognitive functions, such as episodic-semantic verbal memory, attention and executive functions, and linguistic, such as reading fluency and textual comprehension. Relation was verified enters the performance of the components of the phonological processing.