Habilidades iniciais de leitura e escrita em crianças nascidas prematuras

Abstract

The objective of this study consisted of investigating the initial skills for reading and writing and their neuropsychological correlates in children born preterm. Participated in the study were 52 preterm children who were born up to 34 weeks of gestation and with low birth weights and 52 children born full term (control group). In both groups, the children had an average age of 6 years (mean = 79 months) and were enrolled in regular first grade in public schools in Belo Horizonte/MG. The two groups were paired by age, sex, schooling and socioeconomic level. Only children with an IQ 85 participated in the study. The preterm children were recruited at the Ambulatório da Criança de Risco at Universidade Federal de Minas Gerais (ACRIAR/UFMG). All participants were subjected to tasks which evaluated: reading and writing of words; intelligence, verbal comprehension and processing speed (Wechsler intelligence scale for childrenlll); phonological processing (phonological awareness [Rhyme Detection and Phoneme Detection], rapid automatized naming [Rapid Automatized Naming: digits and objects] and verbal memory [Digits Repetition]); and executive functions (planning [Tower of London Test] and cognitive flexibility [Wisconsin Card Sorting Test]).The results showed that the preterm children presented significantly lower performance on the intelligence test and on the tasks that evaluated reading and writing in comparison to the children in the control group. The preterm children also presented significantly lower scores in all the neuropsychological measures. The educational level of the mothers and the quality of the schools attended by the preterm children was also inferior. Since there were great variations in the reading skills amongst the preterm children, this group was divided into good and poor readers based on the performance of the children in the control group on the reading of words test. The results showed no significant differences between preterm groups in the indicators of verbal comprehension, cognitive flexibility and planning, however both groups of preterm children presented scores significantly lower than the control group. The two groups of preterm children didnt present differences in relation to birth weight, gestational age, socioeconomic and maternal educational level. On the other hand, the preterm children who were poor readers presented significantly lower performances than the preterm children who were good readers, as well as the good readers born full term, in tests which evaluate the phonological awareness, rapid naming, and verbal memory. They also presented lower performances than children in the control group in tasks evaluating verbal comprehension, processing speed, planning and cognitive flexibility. Except for the results found for processing speed and planning, the differences detected remained significant after controlling for the effect of variations in the factor of Perceptual Organization of the Wechsler Scale of Intelligence for Children-III, in the mothers educational level and the quality of the school. The results show that more than half of the premature children had already shown, from the beginning of school years, worse results in reading and writing. Even the good readers among the preterms presented deficits in verbal comprehension and executive function, when compared to the good readers of the control group. Such deficits did not necessarily convert themselves into academic loss, at least at the age of 6. Data relative to the initial academic abilities are important to give dimension to the educational needs of these children, such as their risks for future learning problems in reading and writing.