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School referrals of children with writing difficulties: an analysis of the position adopted by their family

ABSTRACT

Purpose:

to analyze family members' views on the complaint by educators and their explanations about the causes for the reported difficulties.

Methods:

it is an exploratory field study, approved by the Ethics Committee on Research with Human Beings 447.163/2013. Thirty-five (35) family members of children referred to psychological/speech-language therapeutic and/ or pedagogical assessment participated. Data were collected by means of semi-structured interviews and analyzed through categories elaborated by the researchers. The sample comprised 33 mothers, 1 grandmother and 1 father, ages ranged between 25 and 68 years old.

Results:

the school complaints were related to: writing difficulties (31%), reading difficulties (26%), cognitive aspects (21%), low academic performance (15%), and psychological/behavioral aspects (6.5%). The mentioned causes of the difficulties were children's typical problems (44%), family problems (23%) and problems in the school setting (3%).

Conclusion:

the importance of family-oriented interviews is pointed out in order to favor family participation in the process of writing acquisition in a more active and thought-provoking way. The results in this research point to the need to implement studies objectifying the analyses of the written language conceptions that underpin families' understanding on the process of children's writing acquisition, as these conceptions interfere in the way they participate in that process.

Keywords:
Language disorders; Family; Speech-language therapy

RESUMO

Objetivo:

analisar a visão dos familiares com relação à queixa formulada por educadores e explicações a respeito das causas das dificuldades relatadas.

Métodos:

trata-se de um estudo de campo de caráter exploratório, aprovado pelo Cômite de Ética em Pesquisa com Seres humanos sob parecer 447.163/2013. Participaram 35 familiares de crianças encaminhadas para avaliação psicológica, fonoaudiológica e/ou pedagógica especializada, sendo que os dados foram coletados por meio de entrevistas semiestruturadas e analisados a partir de categorias elaboradas pelas pesquisadoras. A amostra foi composta por 33 mães, uma avó e um pai, com idades entre 25 e 68 anos.

Resultados:

as queixas escolares estavam relacionadas à: dificuldades de escrita (31%), dificuldades de leitura (26%), aspectos cognitivos (21%), baixo rendimento acadêmico (15%) e aspectos psicológicos/comportamentais (6,5%). Foram referidas como causas das dificuldades problemas próprios das crianças (44%), da família (23%) e do ambiente escolar (3%).

Conclusão:

aponta-se para importância de intervenções direcionadas aos familiares a fim de favorecer a participação da família no processo de apropriação da escrita de forma mais ativa e reflexiva. Os resultados desta pesquisa apontam para a necessidade do implemento de estudos que objetivem a análise das concepções de linguagem escrita que subjazem o entendimento dos familiares acerca do processo de apropriação da escrita por parte das crianças, uma vez que tais concepções interferem nos modos de participação em tal processo.

Descritores:
Transtornos da Linguagem; Família; Fonoaudiologia

Introduction

Studies which aim to understand reading and writing conditions of the Brazilian population have been the target of several fields of knowledge, such as Education, Linguistics, Speech-Language Therapy and Psychology. The increasing interest of different fields on the theme is justifiable due to the scarce possibilities of reading and writing by people of different educational levels and residents in diverse regions of the country, according to data by the Functional Literacy Ratings of 2011-201211. Instituto Paulo Montenegro, Ação Educativa. Inaf Brasil 2011: principais resultados. 2012 [acesso em 13 nov 2013]. Disponível em http://www.ipm.org.br.
http://www.ipm.org.br...
. This indicator points that only 26% of Brazilians have full literacy level, which means that only one fourth of the national population masters the written language, interpreting, understanding, inferring and producing significant written texts.

Therefore, due to an expressive number of schoolchildren who do not advance in the process of writing acquisition, there is a significant incidence of those children's referrals to screening and clinical services related to specific complaints of reading and writing disorders, as well as oral language associated with writing22. Mandrá PP, Diniz MV. Caracterização do perfil diagnóstico e fluxo de um ambulatório de Fonoaudiologia hospitalar na área de Linguagem infantil. RevSocBrasFonoaudiol. 2011;16(2):121-5.),(33. Diniz RD, Bordin R. Demanda em Fonoaudiologia em um serviço público municipal da região Sul do Brasil. RevSocBrasFonoaudiol. 2011;16(2):126-31..

Added to those complaints related to reading and writing conditions, the referrals also point to the suspicion of associated disabilities, such as learning disorders, dyslexia, attention deficit hyperactivity disorder (ADHD), neurological, cognitive, emotional and behavioral problems. Thus, it can be observed that the referrals, usually by educators, commonly relate the difficulties in reading and writing to individual aspects of students and their family members44. Meira MEM. Para uma crítica da medicalização na educação. Psicol. Esc. Educ. 2012;16(1):136-42..

Theoretical and practical approaches which do not focus on the analysis of social and cultural determinants in teaching-learning processes experienced within the Brazilian educational system, have resulted in the formulation of complaints which tend to disregard students' relation to reading and writing55. Signor RCF, Santana AP. A outra face do Transtorno de Déficit de Atenção e Hiperatividade. Dist. Comun. 2015;27(1):39-54., and may contribute for a suffering relationship to writing practices66. Signor RCF. Transtorno de Déficit de Atenção/Hiperatividade: uma análise histórica e social. Revbraslinguist apl. 2013;13:1145-66..

Thus, it is pointed out the importance of conceiving language as a social and interactive activity, which articulates individual and social dimensions through the understanding that reading and writing are accomplished by the interaction between speakers and listeners in a social context. This demands several linguistic-discursive skills which enable the building of meanings in a text77. Signor RCF. Escrever é reescrever: desenvolvendo competências em leitura e escrita no contexto da clínica fonoaudiológica. Revbraslinguist apl. 2013;13(1):123-43..

Therefore, from a sociohistorical perspective, it is assumed that written language comprises subjects and social relations, and its acquisition depends on the quality of mediations established between the child, adults and written discourses88. Massi G, Berberian AP, Carvalho F. Singularidades na apropriação da escrita ou diagnóstico de dislexia? Dist. Comun. 2012;24(2):257-67.. With this in mind, it deems to evidence that family members have an outstanding position in this process, once the family context is the setting for building up the senses where the child will establish his/her first meanings to develop as the author of his/her readings and written text productions88. Massi G, Berberian AP, Carvalho F. Singularidades na apropriação da escrita ou diagnóstico de dislexia? Dist. Comun. 2012;24(2):257-67..

Understanding the family as mediator between the child and the meaning of the functions and uses of the written language means to apprehend the need for investments in family-oriented interventions of schoolchildren who are acquiring this type of language. It is assumed that the family is fundamental in children's constitution of subjectivity, as well as in children's relation to language. Thus, the perception that parents have about their children and their probable difficulties in school settings significantly impacts in the ties that a child establishes with written language99. Massi, G, Santana AP. A desconstrução do conceito de dislexia: conflito entre verdades. Paidéia. 2011;21(50):403-11..

In the light of these considerations, this study aims to analyze family members' perception in relation to the complaint formulated by educators and their explanations on the causes of the reported difficulties.

Methods

The current study was approved by the Ethics Committee on Research of Sociedade Evangélica Beneficente de Curitiba, Paraná State, Brazil, under number 447.163/2013.

It is an exploratory field research study carried out at a specialized psychological and psychopedagogical center, which treats students referred by the municipal educational network from Curitiba, Paraná State, and two speech-language pathology teaching clinics from Cascavel, Paraná State, Brazil.

The participants were thirty-five (35) family members of children, who were referred by their school for psychological, speech-language and/or psychopedagogical screening with complaints of reading and writing difficulties.

The sample 33 mothers, 1 grandmother and 1 father, ages between 25 and 68 years old, mean age of 40 years old. Participants' educational level ranged from no schooling until complete higher education, with higher frequency for complete incomplete and complete middle school, accounting for 31% and 26% respectively. Participants with incomplete high school accounted for 17%, followed by complete high school (14%), higher education (8%) and no schooling (3%). The children under the interviewed family members' responsibility ranged between 6 and 13 years of age, with mean age of 9.5 years, being 71% males and 29% females. Children's educational level ranged between the 1st and the 6th grade, higher concentration on the 3rd grade (40%) and 4th grade (17%).

For the selection of the research participants, it was adopted as the inclusion criterium: family members of children referred by educators to clinical screening due to complaint of reading and writing difficulties (psychological, speech-language and/or psychopedagogical assessment). The following exclusion criteria were adopted: family members who did not attend the referral meeting with the school team, and family members who claimed that their child or grandchild did not have any reading and writing difficulties.

Family members were invited to participate in the research while they were in the clinic waiting room for their children to be seen to. The sample was formed by adherence and the volunteers signed the free informed consent form, being informed about the study objectives, benefits and risks, according to the Guidelines and Regulations of Research involving Human Beings (CNS 466/12)1010. Brasil. Conselho Nacional de Saúde. Resolução nº466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras das pesquisas envolvendo seres humanos. Brasília, DF; 2012. [acesso em 27 mar 2015]. Disponível em http://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf..

Objectifying to keep their anonymity, the interviewed were identified by numbers (E1 to E35). The participants' distribution in each research setting was as follows: Municipal center of specialized health care (n=22/ E1 to E22), Speech-Language Pathology teaching clinic in Curitiba (n=8/ E23 to E30), and Speech-Language Pathology teaching clinic in Cascavel (n=5/ E30 to E35).

For data collection, individual semi-structured interviews were taped, comprising two questions:

1) What did educators say about your child's reading and writing?

2) Why do you think your child has such difficulties in reading and writing?

The answers were taped and analyzed through the content analysis approach1111. Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 13a. ed. São Paulo: Hucitec, 2013.. For result organization and analysis, firstly a fluctuating reading of the interviews and identification of the significant enunciates were carried out, based on the study objectives and on the previously analyzed theoretical backgrounds. After that, the provided answers for each question of the interview were clustered in categories to identify similar contents in terms of their higher or lower recurrence, and frequency analysis was carried on

It deems to clarify that, in qualitative analysis, answers are assumed as discursive productions in a collective, social and historical context, based on the assumptions formulated by Bakhtin1212. Bakhtin MM. Marxismo e filosofia da linguagem. 16ª ed. São Paulo: Hucitec; 2009..

Results

1) What did the educators say about your child's reading and writing?

In the answers regarding the complaint about their children's reading and writing during the referral, five categories can be verified, presented in Table 1, as follows: 31% related to writing; 26% related to reading; 21% regarding cognitive aspects; 15% regarding school performance; 6.5% regarding psychological/behavioral aspects. In Table 1, the complaints and respective difficulties can be viewed, and the total of complaints (n=61) overcome the number of participants (n=35), as more than one aspect was reported.

Table 1:
Categorization of school complaints according to the family members' answers

The complaints related to writing were divided in four subcategories of difficulties associated with: speech support, difficulty/lagging in writing, systematization in the use of letters, and handwriting problems.

The difficulties classified as speech support were described by the interviewees as a consequence of a problem in the oral language which hinders writing, observed in the following accounts: "they said he has had writing difficulties, he writes just like he speaks" (E29); "the teacher said that he changes many letters when he speaks and writes, he always exchanges "l" for "r"" (E15).

In the difficulty/lagging in writing subcategory, answers referring to general problems in writing acquisition were clustered, without specifying, however, the aspect that educators reported: "he has a lot of difficulties in class, and he falls far behind his classmates in reading and writing" (E19).

Regarding the difficulties in the letters systematization, the participants reported exchanges, inversions, agglutinations and letter omissions, as it can be observed in the following enunciates: E21 - "they said that he changes letter position;" E2- "you have to dictate letter by letter, he can only write his name, nothing else."

As for handwriting, family members mentioned educators' concern on the motricity aspect by reporting complaints about "the coordination problem" (E30), and "ugly handwriting" (E19).

Regarding reading problems, the greatest part of the interviewees that reported this kind of complaints, could not specify the characteristics of their child's reading conditions, being classified as difficulties/lagging in reading. Other interviewees, whose answers were included in the subcategory of difficulties in the systematization of the use of letters, mentioned aspects related to the decoding process, for example, he hasn't been able to read yet, he can't read until now, he knows all the letters, but he is unable to put them together" (E10).

The answers which mentioned difficulties in cognitive aspects as the reason for referral, pointed out attention//concentration, understanding and memory problems, evidenced in the following accounts: "they said that he changes the letters position a lot, he doesn't concentrate, lots of distraction" (E21); "He takes the exam, they give him another chance to take another, but things don't get into his mind" (E20); "he writes, he reads, and he forgets altogether" (E1).

Complaints about the academic performance were generally described by the family members as difficulties in meeting school expectations, which can be perceived in the enunciates reporting that the educator "didn't say anything, he said that he wasn't doing well, and his marks were low" (E5).

Complaints related to psychological/behavioral aspects were less frequent, being fundamentally described as inadequate emotional and behavioral responses within the school context. According to family members' account, the educators who referred their child to clinical screening "said that he was aggressive, fought with his colleagues, you know?" (E5).

2) Why do you think your child has those difficulties in reading and writing?

The answers regarding the attributed causes to the observed difficulties were organized in four categories: child-centered causes, family-centered causes, school-centered causes, and a group of participants that could not answer, according to Table 2. It is pointed out that some answers contemplate more than one difficulty. Most family members, that is, 44% reported a child-centered cause for his/her difficulty, followed by 30% who did not specify the probable reasons, and 23% who perceived the causes as related to family problems. Only one interviewee mentioned school-related aspects as the cause for his child's difficulty.

Table 2:
Causes attributed by the family and related to the reported difficulties

Child-centered causes attributed by family members entailed the following explanations: emotional/behavioral problems (n=¨), childbirth problems (n=3), lagging in the development (n=2), oral language disorder (n=2), head trauma (n=1), dyslexia (n=1), and auditory processing disorder (n=1).

Family-centered causes were mentioned by 23% of the interviewees, which cited the following factors: parents' separation (n=3), heredity (n=3), inadequate family routine (n=2), family members' death (n=1).

Cause attributed to the school routine was mentioned by only one participant, who claimed that teachers' frequent turnover along the year hindered his/her child's school performance.

Discussion

In relation to the participants' answers on the reading and writing complaints which caused their children to be referred to a clinic, concern can be observed for them not to advance in the process of the written language acquisition, mainly regarding its formal aspects, that is, the reported difficulties in the systematic use of letters, grapheme-phoneme/phoneme/grapheme conversion and writing.

The importance attributed to these aspects stems from the fact that it is necessary to master writing encoding and decoding processes in order for the learner to advance in a process of understanding1313. Spinillo AG, Hodges LVSD. Análise de erros e compreensão de textos: comparações entre diferentes situações de leitura. Psic.: Teor. e Pesq. 2012; 28(4): 381-88. and text production. Such processes certainly refer to major skills involved in the necessary linguistic analysis in order to master reading and writing, which is made possible by an array of complex factors involved in the acquisition of the written language1414. Faraco CA. Linguagem escrita e alfabetização. São Paulo: Ed. Contexto; 2012..

This complexity partly occurs when it is understood that writing does not totally represent the speech. This means that the relation in the conversion sound/letter is not regular, being predictable the arbitrary relations where a phoneme may have more than a single graphic representation, and a grapheme may have more than one value in the system, representing other sound units1414. Faraco CA. Linguagem escrita e alfabetização. São Paulo: Ed. Contexto; 2012.. Moreover, speech is distinct from writing in other aspects, such as the listener's presence/absence, prosodic and pronunciation elements88. Massi G, Berberian AP, Carvalho F. Singularidades na apropriação da escrita ou diagnóstico de dislexia? Dist. Comun. 2012;24(2):257-67..

In this sense, exchanges, inversions and agglutinations in writing can be understood as predictable manifestations in the process of its acquisition, evidencing attitudes of analyses and reflections over the language88. Massi G, Berberian AP, Carvalho F. Singularidades na apropriação da escrita ou diagnóstico de dislexia? Dist. Comun. 2012;24(2):257-67..

Such manifestations can be approached through discursive production, that is, through text production, which aims to be made public, and has something to say to someone. Taking a text as the basic unit of manifestation and acquisition of the written language means to value productions which privilege the meaning of what has been written, therefore, their semantic aspects. From these text productions, spelling starts to be meaningful to the child, and consequently the focus of his/her attention and analysis, to the extent that he/she needs or wants to be understood by a reader1515. Massi G, Signor R, Berberian AP, Munhoz CMA, Guarinello AC, Krüger S et al. Análise de elementos de referenciação em textos produzidos por sujeitos em processo de apropriação da escrita. Dist. Comun. 2009;21(2):169-78..

Cognitive aspects were often mentioned by the interviewees as the reasons for the referrals of their children with difficulties in reading and writing. Such aspects are mostly associated with disorders related to attention, memory and understanding skills, which are considered important for written language learning and appropriation, as they entail processes of acquisition, processing, integration and expression of information1616. Paula GR, Beber BC, Baggio SB, Petry T. Neuropsicologia da aprendizagem. Rev. psicopedag. 2006, 23(71):224-31..

Keeping attention and concentration in class is considered a facilitator in the learning process1717. Muzetti CMG, Vinhas MCZL. Influência do déficit de atenção e hiperatividade na aprendizagem em escolares. Psicol. Argum. 2011; 29(65): 237-48.. Keeping the attention during a certain reading and writing task enables children to organize themselves more satisfactorily. Concomitantly, attention is necessary for the school development, and that is one of the contexts in which children may participate in valuable social mediations, enabling them to develop their attention function1818. Eidt NM, Tuleski SC. Transtorno de déficit de atenção/hiperatividade e psicologia histórico-cultural. Cadernos de Pesquisa. 2010; 40(139): 121-46..

Work memory is pointed as an important cognitive function to further the phonological process and vocabulary access1919. Silva C, Capellini SA. Desempenho de escolares com e sem transtorno de aprendizagem em leitura, escrita, consciência fonológica, velocidade de processamento e memória de trabalho fonológica. Rev. Psicopedag. 2013; 30(91):3-11.. Frequently associated with the written language, it is related to integration and inference processes necessary to text comprehension. Understanding is effected by a process of meaning construction through information integration and association of diverse knowledge, enabling readers to integrate the parts of a text in order to understand its content2020. Faria ELB, Mourao Junior CA. Os recursos da memória de trabalho e suas influências na compreensão da leitura. Psicol. cienc. prof. 2013; 33(2):288-303..

Necessary to point out that as attention skills are developed through interactions in the school context, work memory can also be developed through school activities, such as reading practice2020. Faria ELB, Mourao Junior CA. Os recursos da memória de trabalho e suas influências na compreensão da leitura. Psicol. cienc. prof. 2013; 33(2):288-303.. Thus, cognitive processes are connected with the experiences that children establish with the written language.

Finally, psychological/behavioral aspects were also mentioned, which have recurrently been pointed as reasons for children's referrals to screening and follow-up in the healthcare field, as they are understood as causes and consequences of school difficulties. In this sense, aspects such as deficit in social skills, self-concept and other emotional and behavioral disorders are associated with difficulties in educational settings2121. Mazer SM, Bello ACD, Bazon MR. Dificuldades de aprendizagem: revisão de literatura sobre os fatores de risco associados Psicol. educ. 2009;28:7-21..

The diversity in the aspects addressed in the participants' accounts as well as in studies that analyze the different dimensions and determinants involved in reading and writing acquisition, evidence the complexity of such process, and guide interventions aiming at improving schoolchildren's writing conditions. One of the challenges for scientists and professionals in the area is certainly to integrate knowledge in order to deepen the understanding of the written language.

It is pointed out that knowledge acquisition on the part of families so that they can realize such complexity, is still a bigger challenge to be confronted, as their perceptions and views on this subject are ultimately built from views they got in the media, taken for granted, mostly fragmented knowledge.

Regarding family members' views on the causes for the difficulties in reading and writing, the association of learners' individual aspects and those of their family settings was prevalent, a widespread view among professionals in the area2222. Bray CT, Leonardo NST. As queixas escolares na compreensão de educadoras de escolas públicas e privadas. Psicol. Esc. Educ. 2011;15(2):251-61. and in the media2323. Carvalho FS. A dislexia na mídia impressa jornalística: análise de matérias publicadas nos jornais gazeta do povo e folha de S. Paulo (2005-2010) [dissertação]. Curitiba (PR): Universidade Tuiuti do Paraná; 2013..

That fact could be apprehended in a study, a literature review by Leonardo, Leal and Rossato (2015)2424. Leonardo NST, Leal ZFRG, Rossato SPM. Naturalização das queixas escolares. Psicol. Esc. Educ. 2015;19(1):163-71.) on the underlying conceptions of learning complaints and explanations for academic failure, as 67% of the researched studies related learning problems to student, family and/or teacher-centered factors.

The analysis of the interviewed family members' answers evidences this trend: 44% referred to causes related to learners' individual aspects, and 23% to causes related to their family environment, while only 3% reported causes regarding the school settings.

Regarding children's centered explanations, psychosocial and cognitive factors are often related to their school difficulties, as it was already mentioned1616. Paula GR, Beber BC, Baggio SB, Petry T. Neuropsicologia da aprendizagem. Rev. psicopedag. 2006, 23(71):224-31.),(2121. Mazer SM, Bello ACD, Bazon MR. Dificuldades de aprendizagem: revisão de literatura sobre os fatores de risco associados Psicol. educ. 2009;28:7-21..

Family-centered causes are also frequently pointed as the origin of difficulties in writing acquisition, as evidenced by the findings of Oliveira et al. (2012)2525. Oliveira JP, Santos AS, Aspilicueta P, Cruz GC. Concepções de professores sobre a temática das chamadas dificuldades de aprendizagem. Rev. bras. educ. espec. 2012;18(1):93-112., with the greatest part of the interviewed teachers associating family settings to the causes of problems and/or school failure, pointing out heredity, lack of support, incentive and absence from their children's academic life.

Psychosocial aspects related to the family environment, such as family socio-economic factors, schooling and history of parents' reading difficulties, family changes (family members' death and parents' separation) may be related to the conditions of schoolchildren's development in reading and writing. If the relation between family psychosocial aspects and school difficulties may help identify risk and preventive factors, studies call the attention to the fact that such relationship should not be understood apart from the complexity involved in the phenomenon of academic failure2626. Enricone JRB, Salles JF. Família e Desempenho em Leitura/Escrita. Psicol. Esc. Educ. 2011;15(2):199-210..

Reinforcing the need of approaches which articulate the individual and collective dimensions involved in the academic success or failure, it can be recurrently followed that since the 1980s, studies have pointed to the need of considering the historicity of such processes and their social and economic determinants2424. Leonardo NST, Leal ZFRG, Rossato SPM. Naturalização das queixas escolares. Psicol. Esc. Educ. 2015;19(1):163-71..

In the middle of those discussions, without overlooking the influence that individual aspects may have in the process of writing acquisition, it seems relevant to include the families in extensive discussions on their conceptions and perceptions, thus promoting their participation in their children's processes of reading and writing appropriation in a more critical and effective way.

By understanding the written language as constitutive to subjects, and that its acquisition is effected by means of the quality of mediations established between subjects and written texts, families can assume positions that foster meaningful experiences in this type of language, evidencing its different uses, functions and values.

Families' knowledge expansion on the role that writing plays in social organizational ways and participation, depends on interventions carried out by health professionals, among others, who should promote discussions about the language and its probable acquisition difficulties in view of demands associated to school complaints, enabling to re-mean such complaints, and empowering families to overcome them.

Conclusion

A significant number of schoolchildren referrals was caused by complaints of difficulties in reading and writing, involving processes of systematization in the use of letters, grapheme-phoneme/phoneme-grapheme conversion and written production.

In general, the greatest part of the interviewees evidenced a trend to explain their children's difficulties based on individual aspects, which may lead to the risk of overlooking other important factors to understand and overcome the observed difficulties.

The results of this research point to the need of implementing studies which aim to analyze the writing conceptions that underpin families' understanding on the process of writing acquisition by children, as such conceptions interfere in their way of participating in such process.

It is also pointed out the importance of developing approaches to promote families' empowerment through discussions on the aspects involved in writing, with its processes of acquisition/use and the related problems and difficulties. That empowerment is fundamental for meaningful practices of reading and writing to be shared in family settings.

Finally, this study stresses the importance of the contribution of speech-language therapists, along with educators and teachers, to the systematization of procedures grounded on the analysis of the problematic involved in the reported complaints around reading and writing, as well as the impact caused by children's referrals due to such complaints.

Referências

  • 1
    Instituto Paulo Montenegro, Ação Educativa. Inaf Brasil 2011: principais resultados. 2012 [acesso em 13 nov 2013]. Disponível em http://www.ipm.org.br
    » http://www.ipm.org.br
  • 2
    Mandrá PP, Diniz MV. Caracterização do perfil diagnóstico e fluxo de um ambulatório de Fonoaudiologia hospitalar na área de Linguagem infantil. RevSocBrasFonoaudiol. 2011;16(2):121-5.
  • 3
    Diniz RD, Bordin R. Demanda em Fonoaudiologia em um serviço público municipal da região Sul do Brasil. RevSocBrasFonoaudiol. 2011;16(2):126-31.
  • 4
    Meira MEM. Para uma crítica da medicalização na educação. Psicol. Esc. Educ. 2012;16(1):136-42.
  • 5
    Signor RCF, Santana AP. A outra face do Transtorno de Déficit de Atenção e Hiperatividade. Dist. Comun. 2015;27(1):39-54.
  • 6
    Signor RCF. Transtorno de Déficit de Atenção/Hiperatividade: uma análise histórica e social. Revbraslinguist apl. 2013;13:1145-66.
  • 7
    Signor RCF. Escrever é reescrever: desenvolvendo competências em leitura e escrita no contexto da clínica fonoaudiológica. Revbraslinguist apl. 2013;13(1):123-43.
  • 8
    Massi G, Berberian AP, Carvalho F. Singularidades na apropriação da escrita ou diagnóstico de dislexia? Dist. Comun. 2012;24(2):257-67.
  • 9
    Massi, G, Santana AP. A desconstrução do conceito de dislexia: conflito entre verdades. Paidéia. 2011;21(50):403-11.
  • 10
    Brasil. Conselho Nacional de Saúde. Resolução nº466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras das pesquisas envolvendo seres humanos. Brasília, DF; 2012. [acesso em 27 mar 2015]. Disponível em http://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf.
  • 11
    Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 13a. ed. São Paulo: Hucitec, 2013.
  • 12
    Bakhtin MM. Marxismo e filosofia da linguagem. 16ª ed. São Paulo: Hucitec; 2009.
  • 13
    Spinillo AG, Hodges LVSD. Análise de erros e compreensão de textos: comparações entre diferentes situações de leitura. Psic.: Teor. e Pesq. 2012; 28(4): 381-88.
  • 14
    Faraco CA. Linguagem escrita e alfabetização. São Paulo: Ed. Contexto; 2012.
  • 15
    Massi G, Signor R, Berberian AP, Munhoz CMA, Guarinello AC, Krüger S et al. Análise de elementos de referenciação em textos produzidos por sujeitos em processo de apropriação da escrita. Dist. Comun. 2009;21(2):169-78.
  • 16
    Paula GR, Beber BC, Baggio SB, Petry T. Neuropsicologia da aprendizagem. Rev. psicopedag. 2006, 23(71):224-31.
  • 17
    Muzetti CMG, Vinhas MCZL. Influência do déficit de atenção e hiperatividade na aprendizagem em escolares. Psicol. Argum. 2011; 29(65): 237-48.
  • 18
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Publication Dates

  • Publication in this collection
    Mar-Apr 2016

History

  • Received
    24 July 2015
  • Accepted
    13 Mar 2016
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