Effects of workshops about storytelling through children's books realized with deaf children relatives

OBJETIVO:analisar os efeitos nas estrategias utilizadas por familiares de criancas surdas ao contar historia por meio de livros infantis, antes e depois de oficinas com fonoaudiologo.METODOS:pesquisa exploratoria, qualitativa e descritiva. Foi desenvolvida com familiares que frequentavam uma clinica escola de uma universidade publica federal. No primeiro momento deste estudo foram analisados os prontuarios dos pacientes. No segundo foi realizada a gravacao em video da diade familiar-crianca surda enquanto contava historias com livros infantis. No terceiro os familiares participaram de oficinas com fonoaudiologo, envolvendo temas sobre brincar e contar historias. Apos as oficinas, foram realizadas novas gravacoes em video das diades contando historias. Os dados foram transcritos e submetidos a analise de video, bem como computado a frequencia do numero de direcao de olhares.RESULTADOS:participaram do estudo tres adultos e tres criancas. Apos as oficinas houve modificacoes significativas nas estrategias utilizadas pelos familiares ao contar historias. Empregaram variacao da entonacao; usaram onomatopeias; recursos corporais como expressoes faciais, movimentos, toques na crianca e destacaram as ilustracoes. Com relacao a direcao do olhar, apos as oficinas as criancas olham mais para o livro e ambos passaram a olhar mais uns para os outros.CONCLUSAO:apos as oficinas observaram-se mudancas qualitativas na maneira de contar historias, utilizando-se livros infantis como mediadores da interacao linguistica, por parte dos familiares participantes deste estudo. Os efeitos produzidos proporcionaram uma participacao mais produtiva da diade para o desenvolvimento de linguagem das criancas.


INTRODUCTION
In addressing the language in the deafness of the universe is important to highlight the difference between the language of concepts, language and speech. The speech would be the production of a particular speaker in interaction situation, the language the regulatory aspects that together is the use of some strategies because it enables the understanding and the maintenance of the child's interest in story. Among the strategies to be used, stand out: comment on the story or on the illustrations; make use of varying the intonation of the voice, marked by changes in syllabic composition and speaking speed; employ repetitions of the text; use visual aids; make written text adaptations into oral one and use gestures associated with verbalization 15 .
Thereby, the aim of this study is to analyze the effects on the strategies used by relatives of deaf children to tell story through children's books before and after workshops with speech and language therapist.

This study was approved by the Ethics in Research
Committee of Universidade Federal de Santa Maria, in the opinion CAAE 26743114.9.0000.5346. All participants signed the Informed Consent (IC) according to the standard 466/12 of the National Health Council, which provides guidelines and regulatory standards, focused on research involving human subjects. This is an exploratory research that has as methodological approach the qualitative and descriptive study. It was developed in a Public University.
The selection of subjects was taken from the study participants "Speech Intervention with families of deaf children", attended by eight familyeight children. To compose this sample, three family members who regularly accompanied three children to speech language therapy were randomly selected, two mothers and a grandmother, totaling six subjects, among adults and children.
All participants attended the Speech Language Therapy Service that provides services for Serviço Único de Saúde (SUS). Service is linked to the clinical school of Speech, Hearing and Language Sciences at the university. To select the research participants the following criteria were adopted: • Inclusion criteria: for family members were eligible who signed the Informed Consent (IC); they were literate and normal hearing. For children, those who were aged between one and seven years; were diagnosed with hearing loss moderately severe, severe and / or profound degree in at least one ear, regardless of presenting another associated compromising, and who used hearing aids in both ears. • Exclusion criteria: deaf family; illiterate family; children older than seven years and that did not use hearing aids.
a visual way. This hearing loss can lead to a deaf child's language delay 6,7 .
If the family does not understand the specifics of the child or it does not have access to technologies such as the Personal Hearing Amplification Device (HA) or Cochlear Implant, the child will be deprived of the basic conditions for the development of oral language and affective-social relationship 8,9 . Thus, the speech and language therapist should be aware that the therapeutic work is not only focused on the child, but the family must also be involved in the whole process. When in the speech and language therapy are inserted workshops involving parents and children in contact with children's books, a possibility is open so that both pass through the language universe. Therefore, the family can take an active role in building and language development of their children, because children's literature whether oral or written enables the child to establish contact with the books 10 .
Dialogical and social relationships that the child establishes with family members promote language development as well as their integration into communicative universe. The interaction between the mother-child dyad enables the child to establish initial contact with the language. From that contact, within the family, the child will develop their language skills, broaden their understanding of aspects of the language, build increasingly complex structures and reflect on the knowledge acquired in a metalinguistic way 11 .
In the process of language acquisition the child develops the storytelling, an important skill that enables greater control of orality. Narrating allows the child to relate their own experiences, make chain of words and get perceptions of temporal events 12 . The construction of the storytelling in children occurs in the interaction, especially with parents. Thus, the narrative skills can develop in various ways, such as through lullabies, reading children's stories and through conversations with an adult 11 .
Thus, this article highlights the importance of reading children's stories to promote language development of children. Infant's literature can be defined as a literary form that appropriates texts that share fairy-tale characteristics. The books of this style reproduce the adult world, to the extent that it is in a different position of the child occupies because intervenes in child imaginary reality 13 .
The choice of books must take into consideration the interests of the child, highlighting the illustrated and sung stories. Thus, engravings, drawings, dolls, puppets, folding, and music, when part of the stories, easily involve the kids 14 .
Another important aspect of involvement of children's literature between the adult and the child After the closing of workshops, new video recordings of each dyad were conducted, following the same procedures described above.
To better analyze the dialogues were transcribed, video analysis was adopted in this study. For this, we used in full the "Mother/ child behavior analysis Protocol" 15 .
Mother behavior analysis Protocol is divided into four topics, which are: 1) speaker identification; 2) Direction of the eye; 3) Intonation change and 4) Facial expression change or gesture 15 .
All topics underwent verbalizations transcription and actions such as: direction of the eye, touch, gestures and signs shown by the child and the adult. For analysis of direction of the eye, the frequency of occurrence of the number of eye direction was tabulated in Microsoft Excel 2010 spreadsheet program.
The use of this protocol (Appendix 1) the analysis aimed clarity on the dynamics of dialogue between the dyads, during the practice of telling children's stories, and the child's spontaneous record.

Dyad 1-J and A
"J" is 58 years old and is a housewife. Her level of education is the elementary school and reports not have the habit of reading stories to A. J is A's paternal grandmother and takes care of the child since the parents abandoned it. Besides the grandmather and the granddaughter, a child of "J" lives with them which is child's uncle. "A" is a fiveyear-old girl and she has diagnosis of moderate preverbal sensorineural hearing loss in the right ear and severe in the left ear. Associated with hearing loss, the girl has neurological deficiency. She uses hearing aids for a year and seven months in both ears. Related to the language she uses gestures and vocalizations to communicate. Currently, she attends a regular primary education.

Dyad 2-C and G
"C" is the child's mother, she is 39 years old and is a trader. Her level of education is high school and reports that reads and tells many stories to her son. "G" is a three-year-old boy and he has diagnostic of moderate preverbal sensorineural hearing loss in the left ear and severe in the right ear, without other associated deficiency. He uses hearing aids in both ears for a year and eleven months. The child lives with his parents, a twin brother and a nine-yearolder brother. Regarding language, He communicates using oral language and he has already built simple sentences. He also attends a regular primary education.
This study was developed in three stages. At first, after the composition of the sample, analysis of medical records of patients seen in the Service was effected. Data were analyzed to report on the family background of the child, as well as aspects of language, listening skills and communicative modality of the child, in other words, it was only used the oral language, or if it was bilingual using oral language and sign language.
In a second moment, a video recording of the deaf family-child dyad was effected while the family told the stories, in order to investigate the strategies used to tell stories with children's books of each dyad. A camera SONY Handycam DCR-SX60 was used in a light and airy room of Speech Language Therapy Service, with a rubber mat and cushions. The duration of each recording was determined by performing time of each dyad on task, it was not exceeded 30 minutes.
Family members were instructed to tell the stories as they were accustomed to do it, using the available books. For that, two children's books of the same collection were available: O cãozinho Dengoso and A Gatinha Lu (written by Paulo Moura and illustrated by MW Editora e Ilustrações).
The selected stories have in common the following aspects: they were written by the same author, the text is displayed below the illustrations and it is written two to three lines, the illustrations have vibrant and bright colors, revealing the highlight they receive in the chosen children's books.
The stories also have similar themes, as they approach the following aspects: "A gatinha Lu" tells the story of a spoiled cat which loves to walk and gets compliments. It also has its routine, showing how it is happy close to its mother. the children's books, valuing the uniqueness of each other. Figure 1 shows excerpts from the transcript of the interaction between "J" and "A" during the reading of children's books. The analysis showed that before the workshops "J" made clarifications of the story to the child, emphasized the book's illustrations, named and compared with situations and people that were part of the context of A's life. However, she hardly used variation of vocal intonation during interaction. She also did not allow the child to explore the book, because she always held the child's hands to not touch the book and she did not return pages when the girl asked it.
When "J" told the stories after the workshops she began using the change in intonation, onomatopoeic elements were included when she referred to animals from the books. "J" also always tried to keep the attention of "A", she touched the girl and looked for girl's eye.

Dyad 3-E and L
"E" (L's mother) is 40 years old and she works as a farmer. Her level of education is incomplete elementary education and reports not be accustomed to telling stories to the child. "L" is a threeyear-old boy and he lives with his parents and a nineteen-year-older brother. "L" has a diagnosis of moderate preverbal sensorineural hearing loss in the right ear and severe in the left ear. Associated with hearing loss, he presents neurological changes. He uses hearing aids in both ears for two years and one month. Related to language, he uses gestures and vocalizations to communicate. "L" does not attend school.
By comparing the strategies used to tell stories with children's books in the two moments of the study, it was revealed that there were significant changes in all dyads. Here, some particularities of the dyads are highlighted during the interaction with  9. Running on the grass, around the flowers! __B__ (11) (child bends the book to look at the cover) 10. There, there is a little bee! This one is the little bee, daughter oh, the little bee (12) (grandma holds firmly the book) __B__ (13) (child tries to turn the book cover) 11. Look there oh! Everyday I pick the newspaper up at the gate and I take to scare the postman.    In Figure 2, the transcripts between "C" and "G" show that the mother used intonation change in the first moment of interaction. She pointed and explained the illustrations of books for children. However, "C" questioned "G" about the stories a lot, making it impossible for the story to flow naturally. In addition, she almost left no time for the child to answer the questions because she responded immediately and gave clues to "G" to complete the word or phrase.
After the workshops "C" explored more intonation and prosody of speech, she used onomatopoeia, highlighted the illustrations of books by entering detailed explanations in addition to the books presented. "C" used facial and body expression while reading the stories. It was also less frequent questioning on the story that was being told. Figure 3 shows excerpts from the transcription that allowed to characterize "C" style to tell the stories to "L". It could be perceived that she used less time than other mothers to tell the stories, showing that she had little familiarity with books. But before the workshops she kept the child's attention in story through gestures, touching and pulling "L" when he was not looking at the books. She also did not change the vocal intonation, looked a few times to the child, focusing all the time in the book. She did not allow "L" to explore the book and tried to keep him away from it.
After the workshops, she conducted more variation in prosody, expanding the vocal intonation to make the most attractive story. "C" used onomatopoeia to estimulate the child's interest and interacted more with "L", without much concern for the books.

Story 1 Story 2
Pre-Workshops 1. Oh L oh! (1) (mother pulls the child by the arm to show the book) _____________ (B/U) _________ 1. 2. Nice to meet you I'm Lu, a very spoiled cat _____________B____________ 3. Wow the little cat! ___ N______ (2) (child smiles and pulls the book of mother's hand) 4. Oh when I go for walk I receive many compliments (3) (mother keeps the book away from the child) ___________B___________ 5. Look at the puppy! Oh the puppy! ___________ B_____________ 6. Everyday I pick the newspaper up at the gate and I take to scare the postman. __B__HE LOOKS AT THE VIDEO CAMERA ___ 7. I confess I do not like to take a shower, but not always I escape.
Post-Workshops  The graphs below show the frequency of the eye direction of participants, during the storytelling, before and after the workshops that were conducted. In Figure 4 can be seen that all the children began to look into the book the second time the stories were told. Among adults, only "E" looks into the book after the workshops. Figure 5 shows a prevalence of adults in looking and pointing the book in both moments.
In the Figure 6 all study participants, adults and children, started looking more at each other after the workshops.

DISCUSSION
Taking into account the results of the research, the effects could be seen by the occurrence of transformation in the strategies used by family members to tell stories, considering the two moments that were observed.
Conducting practical workshops with families of deaf children has proved a potentially beneficial resource for the acquisition and development of children language. The experiences generated by the workshops promoted family interaction listener / deaf child mediated by children's books, which are important tools for the development and learning of children 17 .
Of the three family members who participated in this research, only one reported that he had the habit of reading for deaf children. This shows that the place that the child occupies in the family reading practices is restricted.
By analyzing literacy practices aimed at deaf child in the family and school ambient, a study showed that the first restricted to the use of the Bible and in the second predominated textbook. The conclusion of the study showed that there was no change in the use of literary genres in this context, which it hinders the formation of the deaf subject as a reader and cancels significant situations in the practice of reading 18 . story, moreover, this variation causes the child and makes it reflect the vocal intonation produced by the mother 15 , linguistically interacting in the story.
The voice is the main instrument of the person who tells a story. The listener can engage himself emotionally if it is used properly, creating expectations throughout story, leading to the suspense and climax in the outcome. The voice of the narrator should be expressed in a clearly defined manner, with vocal variation in brief and timely pauses 23 .
Onomatopoeia allows to give action to the text because they make in the excerpt in which they appear the words acquire sound and movement. When animal sounds appear in the stories the text comes alive. So reading becomes more attractive and pleasant and the listener participates in the story as a co-author, living every move of words and building sense 21 .
The features like facial and body expressions associated with children's literature characterize the development of literacy and stimulate the production of knowledge 21 . Activities that allow the child to use facial and body expression enrich the experiences, they can also develop imagination, stimulate the attention, help organizing ideas and thoughts 14 .
When illustrations of the story are highlighted deaf children's visual experiences are enhanced and valued, giving interest in reading and writing. What it is important for deaf people depend more on vision to learn than hearing people 24 . The images associated with the text enrich content, concretize the topic and are resources that help the internalization of learning 20 .
There was also a change in the frequency of eye direction between dyads. The children started to look more books when their family told stories after the workshops. This shows that there was more interaction between them in the second time. The involvement of children with children's books increased, enabling them to be sufficient for them to become aware while maintaining the eye in the illustrations. After participating in the workshops the family began to explore the images of books and modify the way to tell the stories, thus children's interest in books also intensified.
The language and images present in tales and stories provide the child an imaginary world to be explored, enabling learning a language. A study developed an online tool for literacy deaf children observed the following: the use of simplified stories, illustrated with drawings and definitions were more effective for reading comprehension by children 25 .
The illustrations in the books when rich and colorful turn the books in charming objects that captivate and attract small readers 20 . The chosen books for this search had designs with vibrant colors, The family is the child's first contact with reading and writing, enabling it to create hypotheses and establish meanings of the literary universe. The greater the opportunity for children to handle written material, listen to stories, watch people reading and writing will be better its relationship with books as well as its formation as readers and authors 18,19 . Thus, to attend school, they will be able to understand the social function of reading and writing, making the school an extension of family atmosphere 18 .
This work allowed the family to raise a privileged position in speech intervention, it began to mediate the interaction with their children. In this sense, the workshops were essential for them to understand the importance of children's stories and their contribution in the development of language.
Studies that consider sign language as a first language and Portuguese as the second language which the deaf people acquire, they highlight the visual behavior of deaf children and the different way in which they relate and perceive the world. In this context children's literature goes to mediate the learning of a second language through the discovery and the relationships established through the literary universe. In addition, children's literature is a tool that allows young readers to question themselves and to others, guiding their interests and needs of self-assertion and safety 20 .
It is also known that the use of children's stories, taking into account the text, allows the language to become instrument and teaching object concurrently. In addition, the child can build assumptions about the organization of the text and listen to understand the story 21 . It also allows the child to have an active role in expanding its vocabulary and build relationships of meaning during storytelling 17 . The stories also allow the children's development of language creativity 22 .
It was observed that in all dyads there were expansion and use of strategies that enable the maintenance of attention and the involvement of children with stories. They used, in a more accentuated way, the change in intonation; use of onomatopoeia; bodily features such as facial expressions, movements, touches in child and gave greater prominence to the illustrations.
Several studies 15,17,18,20 highlight the importance of such associated resources during the action of storytelling to enable the child involvement in children's literature. Through the use of these resources there was more fluid in storytelling after the workshops, because the family began to use children's books and interact with them more naturally.
It is understood that by applying variation of vocal intonation the child remains interested in the in vocabulary, in morphosyntax, prior knowledge and the development of the theory of mind 17,27 .

CONCLUSION
The study showed that the workshops enabled a positive exchange between therapist and family, which brought benefits for deaf children as come to share language moments mediated by children's books. There was expansion and use of strategies such as variation in intonation, use of onomatopoeia, body features, facial expressions and especially the illustrations, enabling the engagement of children with stories. In addition, dyads started to present more frequent exchange of eyes after the workshops, strengthening interaction and understanding of books by children.
The families of the children in this study did not have the habit of storytelling. It is understood that a relevant practice for the acquisition and development of oral language was hardly emphasized, been little explored. By enabling the family / child interaction through children's books the speech language therapist contributed to enrich this moment, bringing changes in the meaning given to books, as they are no longer distant objects and negligible to be mediating instruments of linguistic interaction.
All things considered, it is evident the importance of the speech language therapist, who works with hearing habilitation and rehabilitation, involves family members in the therapeutic process, promoting ways and means of these play and tell stories to children.
but the look of the children was only captured more intensely after the workshops, because the family learned to explore these resources.
Another important aspect is that the dyads were more frequent in the exchange of eyes after the workshops. This shows the positive effect of the intervention of the speech and language therapist, because the exchange of eyes during the stories there was dialogue and search for understanding of the child and family in the story to make sure that the child was understanding what it was being told.
There was a predominance of adults in look and point the book in the moments before and after the workshops. It can be seen that the reduced practice of family in storytelling for children, exploring children's literature as a resource also prevents them allow the kids handling the books. The books are still treated as fragile objects, which must be preserved so that children do not spoil them.
The family kept the books with them, always holding firm so that children would not pull and move them away, with this, they did not touch the books. This breaks the natural process of storytelling and prevents children establish a playful relationship with books. The children's literature should allow the child to feel, see and touch the book. So it can enjoy the literary work and sympathize with the text, separating the obligation image and didactic aspects of reading 26 .
The low reading habit of deaf children's parents may aggravate the difficulties of children with reading and writing when they join the school. Studies show that the lack of shared reading between parents and children may bring difficulties in the literacy process,