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Phonoaudiology (speech therapy) in public health

An undestanding of the activities and functions of a speech therapist within the specific context of the Basic Health Units (Unidades Básicas de Saúde) is sought. Difficulties relating to the introduction of a new service on the basis of one of the health professions that has not hitherto belonged to the group of categories which are traditionally incorporated in these same Basic Units. When the statistical data on the demand for speech therapy services by the population who attend health centres were considered, it was discovered that 32% were of schooling age and had been referred by schools, allegedly due to "learning problems". Closer contact with these children, through speech therapy, has brought a different aspect to light i.e. that one cannot consider as disturbance/deviation/problem/pathology written signs which constitute indications of the shock between the process of literacy and that of learning how to read and write. To understand the problem from the point of view of public health, a programme of teacher counselling is proposed, with the purpose of helping the school to clarify its role as co-constructor of the child's literacy process and of returning to the teacher the responsibility for the success and/or failure of teaching how to read and write. A similar programme is proposed for creches where coincidently, a greter proportion (44%) of the younger children (2 to 5 years of age) are seen to have difficulties in oral language development. Both programmes are based on the view of language as a constructor of processes of subjetivism and objectivism, and therefore the oral (and written) discoursive practices are the privileged "locus" for interpreting oral and graphic signs and their transformation into the symbolic realm.

Language development disorders; Learning disorders; Health promotion


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