To synthesize the relevant scientific information regarding the assessment of language development in prelingually deaf children during their first six years of life, in order to determine whether it is sufficient to confirm the presence of some language development in this population, or if a more integrated approach would be more appropriate.A structured review of the relevant scientific literature was carried out in the following databases: PubMed, Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial and Nice.Systematic reviews, health technology assessments, randomized clinical trials, observational cohorts and case-control studies; including publications of assessments concerning any aspect of language development or any intervention in any language. Evaluations related exclusively to hearing and speech, to central, sudden or transient deafness, to deaf-blindness, to further disabilities or to autism spectrum disorders, were excluded.GRADE methodology was used to analyze evidence quality.It is possible to evaluate the language development of prelingually deaf children. A moderate quality of evidence was obtained, suggesting that the evaluations’ results are fairly trustworthy, provided that the assessments are conducted within an integrated approach of other linguistic elements.The results of the language evaluations must be supported mostly by receptive and expressive language data, and the found evidence can be improved by combining the assessments of the formal linguistic elements of both oral and gestural modalities with the pragmatic components of the communication process. In other words, the urge, when facing a disability or a hearing impairment condition, to try to rehabilitate the child so they can “speak”, by any means necessary. Those who adhere to this idea start from the hypothesis that hearing is enough to fully develop language. Hence, it is necessary to consider whether the assessment of hearing and speech production is considered sufficient to establish some language development in deaf children, or if a more integrated approach would be more strategic.In many ways, the investigation of prelingual deafness in children has been a difficult issue to consider, because most of its approaches arise from the physical medicine and rehabilitation perspective, along with an oralistic view of the physical component of deafness: the hearing impairment. However, the aforementioned sequence of stages is not always applicable to situations where the language might not adhere to the oral modality. Therefore, a lack of follow-up leads to significant language development risks that could be prevented by seeking the guidance of professionals specialized in this population. The present review targets the population of prelingually deaf children with multifactorial hearing loss, as well as its consequences, such as the substantial negative impact on the developing auditory system and on language development, the risk of delayed speech (difficulty to produce sounds and/or to understand speech), poor academic performance, behavioral problems, and decreased quality of life.The first six years of every child, deaf or hearing, are crucial to determine their future development, including language. During the first three years occurs the phenomena of natural language acquisition, and in the subsequent three years this assimilation is consolidated, so that from six years old onward the processes of organized and planned language learning may take place. Deaf children are not outside of this conjecture. That being said, an extra factor happens to them: the world is built for listeners. If their development is directed to the oral sphere, their acquisition process is not spontaneous and natural, but rather a difficult learning process planned by an adult; if their development is gestural, it is usually natural, but with limitations related to the environment in which they are born. A complete language assessment is considered a complex task to perform, given the assortment of multiple components that differ in their conceptualization according to the chosen perspective. In general terms, language can combine elements of production and comprehension, being influenced by elements of hearing, phonation, form (phonology and morphology), content (semantics), and use (pragmatics).When word production and speech are not sufficient to predict any language development, we must necessarily resort to other options. In the seventies, several philosophical, linguistic, and sociological movements were promoted to support a broader understanding of language, from functionality to pragmatics, that is, children's language had to be interpreted starting at the communication aspect, taking into consideration the intention and the situation in which the child assimilates their inputThe conception of language and language development is undoubtedly broad and surpasses hearing and producing words. Nevertheless, the everyday reality seems to keep pushing the fate of deaf children towards the search for an apparently “normal” hearing, without considering other options. For this reason, the present systematic review seeks to answer the following research question: What language development assessments are currently being performed on prelingually deaf children during their first 6 years of life?To identify, select, evaluate, and synthesize the relevant evidence available on the current assessment of language development during the first six years of prelingually deaf children., Lilacs, Ibecs, Trip DataBase, Cochrane Library, Clinical Trial, and Nice, were primarily included in the present review the following types of studies: systematic reviews, health technology assessments, randomized clinical trials, in addition to cohorts, case-control studies and further related researches conducted in the past 5 years. The recommendations of The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) have been followed, and its flowchart, as presented in A structured review of the scientific literature was carried out, consisting of the search, selection, analysis, and synthesis of the information based on the PICO question, namely - P: prelingually deaf children; I: assessment of the language development during their first six years of life, according to the MeSH terms  along with search filters. After consulting the ensuing databases: PubMedAn exhaustive reading and data collection of the selected articles was carried out, and the information was compiled in charts using Microsoft Excel. The following data was plotted: author and year, title, population and age, type of deafness and intervention, language assessments performed and related outcomes. Such information was grouped into the following language assessment variables: general language development, receptive language, expressive language, other language elements, and additionally, sign language..After this process, evidence charts were prepared with the Grade Pro GDT program, and the GRADE methodology was followed to analyze the information as well as to consider the importance of the outcomes : generalThe research process for related and relevant articles is detailed in Annex A. Initially, we analyzed 403 publications, which were reduced to 21 after applying the inclusion and exclusion criteria, along with the elimination of duplicates. Subsequently, were excluded the studies that did not correspond to the established objective due to: 1) defining language development as deriving from the listening ability, 2) focusing on the functioning of hearing devices, and 3) inferring the development of language from the assessment of other factors such as cognitive, social and cultural context skills. Finally, 15 publications were considered for the present review, with the corresponding data described in Annex B. The results related to the language development assessment are detailed in the following sections, according to the importance of selected outcomes.Overall, the findings obtained herein show that it is possible and feasible to perform language development assessments in prelingually deaf children during their first six years of life, and that the resulting data can also be used to maintain a long-term follow-up. Regarding language development, the moderate quality of evidence  suggests adapting the concepts of receptive and expressive language to child signers who are users (including natives) of sign language.In total, seven of the selected researchers opted for the assessment of receptive and expressive language, while only three considered other elements to justify their results. A high quality of evidence  for the , versus a production of elements that corresponds to an actual development.Even though expressive language is an observable element of language and therefore easier to measure, a moderate quality of evidence , when co, in other words, they guarantee that such certainty of reception or expression has observable linguistic elements. A low quality of evidence . This feat can be compared with the brief note found in the publication by Meinzen-Derr et al., mentioning that their randomized clinical study with an oral deaf population should be replicated, in the future, with a signing deaf population.The studies that consider oral rehabilitation and cochlear implants do not include in their results the intervening variables related to the possible presence of gestures or even approaches to sign language. This situation is surely explained by the historical prejudices against sign language, where this language is seen as a supplementary instrument or even as a detrimental hindrance to oral skillsMost studies agree that the age of the deafness diagnosis coupled with an early intervention can generate an improved and more timely response to better cater for the needs of deaf children; however, there is no consensus on how to choose the information type, prioritizing oral rehabilitation and leaving sign language aside.. Such considerations challenge other reviews and studies that do not contemplate costs and resources in their outcomes, as well as the values and preferences of both mothers and fathers with deaf children.The majority of the studies focus on a level of language development after the cochlear implantation, close or similar to the hearing child, but never the same; except for the researches that consider sign language and gestures, placing the deaf child on the same level as the hearing person. Therefore, the possibilities of sign language should be taken into account when talking about development and assessment, even when it is acquired or learned by hearing children without hearing loss. Nevertheless, when the problem is approached from an integrated perspective of language, the evidence is still scarce and there is no consensus for determining the best way to perform the evaluations. Undoubtedly, this issue is connected to a problem that precedes the assessments: the intervention options, or rather, the decisions made by medical professionals who mostly advocate for the prompt rehabilitation of deaf children into normative hearing standards. From this starting point, language assessment becomes biased towards the observable elements that the deaf child can orally produce, from which the presence of language is inferred. However, this approach overlooks the possibility that the child has achieved some language with elements that surpass the sound production. The proposals made by Paul Watzlawick et al. provide a spectacular paradigm shift in human interaction, where this “beyond the production of language” is put in context as the first axiom of communication: “it is impossible not to communicate”, which perfectly describes the fact that even if a child does not produce speech sounds, there are other instances of language working in their head.The published literature regarding the efficacy of interventions and the assessment of the language of prelingually deaf children seems to be reliable, as long as based on the lack or reduction of hearing and the need for oral speechIt is crucial to perform an early detection and intervention of deafness, and there is sufficient evidence to consider it as the best way to prevent all sort of problems for deaf children, not only language issues. With that in mind, and considering the aforementioned, it is time to start instigating some extreme paradigm shifts in order to allow language to be addressed in an integrated approach and in all its possible modalities. The present review considers to be extremely important the valuable contribution that the participation of deaf, speaking, and signing professionals, both medical and from other areas, could have in the production of scientific evidence that take into consideration the patient’s values and preferences. This approach would certainly make it possible to narrow the gaps between the lack of consensus and the communication barriers. For this purpose, not only research is needed, but also an epistemological review of the treatments and results historically directed towards oralization.. On the other hand, is pertinent to begin to describe the long-term adverse effects in an integrated approach, as already stated, for example, the occurrence of otosclerosis or residual hearing loss.The electronic assistive devices for the hearing impaired, such as cochlear implants and hearing aids, deserve special mention. The present study has no intention whatsoever to dismiss, deny, or prohibit its use, on the contrary, the interest herein is directed to reconsider how these devices are offered and provided to mothers, fathers and deaf children. The burgeoning growth of technology in recent years cannot be underestimated, and it would be unfathomable not to acknowledge that the scope and benefits of such implants will surely show an improvement. However, faced with this accelerated evolution, it is better to be sure of all intervening factors. On the one hand, it is opportune to continue building evidence on the economic impact of cochlear implants for familiesConsidering the course of the discussion thus far, it is important to mention the urgency of transmitting this knowledge to all of the audiologists who determine the fate of deaf children. To take into account the values and preferences of these patients is not only a medical issue, but a social and cultural matter that is directly linked to the struggle that the Deaf Community deals with worldwide. Therefore, it is necessary to ensure a complete and continuous training concerning hearing loss, deafness, the deaf community, deaf culture and sign language, to establish this long overdue integrated approach. Along with these changes, an impact is expected not only on the interventions, but on the entire regulatory apparatus which is also responsible for the fate of the deaf child.Additionally, it is worth mentioning that the clinical studies may be affected by an imprecision bias due to their relatively small samples, but they do have good designs and methodologies. It must be reckoned that the diversity of deafness is too extensive, leading these studies to strive to obtain more homogeneous samples. Even so, it is noticeable that there is a lack of differentiation between populations that use implants or hearing aids, or those who have a deaf or hearing family, points that tend to diminish the quality of the evidence related to expressive language. The present review must concede that it may be affected by an indirect evidence bias, given that the selected studies assess various degrees of hearing loss, from mild to severe, when it is acknowledged that language development will differ according to each case. Furthermore, reports on the use of cochlear implants and hearing aids should be considered as extra feedback, since they are not part of the research question. Nevertheless, we expect that they inspire future research and systematic reviews.Based on the quality ratings of the body of evidence regarding the evaluation of the development of prelingually deaf children, it is considered that there is sufficient reliable information to perform assessments during the first six years of the children’s life. However, the interpretation of the results must consider that the obtained data on general language development should be mostly supported by the evaluation of receptive language over expressive language, moreover, the evidence can be enriched by including assessments of the formal linguistic elements of the oral modality, such as gestures, along with the pragmatic components of the communication processes.Further research is required for the assessment of formal elements of the gestural modality of communication, such as the sign languages, which enable the construction of tools  that allows to compare the results of the development of deaf children according to the intervention they have been exposed to, or the choice they have made. . Es decir, frente a una enfermedad o condición de discapacidad de la audición, se busca, a toda costa, recuperarla de tal forma que el niño sea capaz de “hablar”; quienes se adhieren a esta idea parten de la hipótesis de que basta con la audición para desarrollar integralmente el lenguaje. Por tales razones, se hace necesario considerar si la evaluación de la audición y de la producción del habla están considerándose suficientes para establecer algún desarrollo de lenguaje en niños sordos o si es prudente optar por un enfoque más integral.El abordaje de la sordera prelocutiva en niños ha sido, desde múltiples perspectivas, una cuestión difícil de considerar en vista de que la mayor parte de sus planteamientos surgen de una visión médica - rehabilitadora, y además oralista del componente físico de la sordera: la deficiencia auditiva, sin embargo, tales descripciones no siempre son aplicables a aquellas situaciones donde el lenguaje podría no apegarse a la modalidad oral. Por lo tanto, enfrentar una falta de seguimiento, implica riesgos importantes en el desarrollo del lenguaje que podrían prevenirse procurando el accionar de profesionales especializados en esta población. La presente revisión dirige su atención a la población de niños sordos prelocutivos cuya condición responde a múltiples causas, así como consecuencias, entre las que están: un impacto negativo sustancial en el sistema auditivo en desarrollo y en el desarrollo del lenguaje, el riesgo de retraso del habla (problemas para producir sonidos y/o comprender el habla), rendimiento académico deficiente, problemas de comportamiento y disminución de la calidad de vida.Los seis primeros años de vida de todo niño, sordo u oyente, son cruciales en la determinación de su desarrollo posterior, incluido el lenguaje; mientras que durante los tres primeros años suceden los fenómenos de adquisición natural del lenguaje, a los tres posteriores se garantiza el afianzamiento del mismo, para que a partir de los seis tengan lugar procesos de aprendizaje organizado y planificado del lenguaje. Los niños sordos no están fuera de estas aproximaciones; sin embargo, les acaece un factor extra; un mundo construido para oyentes. Si su desarrollo se dirige a la esfera oral, su proceso de adquisición no es espontáneo y natural, sino un difícil aprendizaje planificado por el adulto; si su desarrollo es gestual, suele ser natural, pero con limitaciones en relación en el entorno en el que nacen. Una evaluación completa del lenguaje se considera una tarea compleja de realizar, en vista de agrupar varios componentes y de diferir en su conceptualización según la perspectiva que se tome. De manera general el lenguaje puede agrupar elementos de producción y comprensión, donde intervienen elementos de audición, de fonación, de forma (fonología y morfología), de contenido (semántica) y de uso (pragmática).Cuando la producción de palabras y el habla no son suficientes para predecir algún desarrollo de lenguaje, necesariamente hay que recurrir a otras opciones. En los años setenta, varias corrientes filosóficas, lingüísticas y sociológicas impulsaron movimientos que sostenían el entendimiento amplio del lenguaje desde la funcionalidad y la pragmática, es decir, había que interpretar el lenguaje infantil desde la comunicación; desde la intención y la situación en la que el niño capta mensajesLa concepción del lenguaje y del desarrollo de lenguaje es, evidentemente, amplia y sobrepasa el hecho de la audición y producción de palabras. Sin embargo, un vistazo a la realidad actual, parece seguir empujando el destino de los niños sordos hacia la audición aparentemente “normal”, sin considerar otras opciones. Por tal motivo, la presente revisión sistemática busca responder a la pregunta de investigación: ¿Qué evaluaciones del desarrollo del lenguaje se están realizando en la actualidad a los niños sordos prelocutivos durante sus primeros 6 años de vida?Identificar, seleccionar, evaluar y sintetizar la evidencia relevante disponible sobre la evaluación actual del desarrollo del lenguaje durante los primeros seis años de vida de niños sordos prelocutivos., Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial y Nice, se incluyeron en la revisión primordialmente estudios de tipo: revisiones sistemáticas, evaluaciones de tecnologías sanitarias, ensayos clínicos aleatorizados, y además se consideraron: estudios de cohorte, de casos y controles y otros relacionados, de los últimos 5 años. Se ha seguido las recomendaciones de The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), cuyo diagrama de flujo, que se presenta en la Se realizó una revisión estructurada de la literatura científica, consistente en búsqueda, selección, análisis y síntesis de la información a partir de la pregunta PICO; P: niños sordos prelocutivos I: evaluación del desarrollo de lenguaje durante los primeros seis años de vida, con términos MeSH  y filtros de búsqueda. Luego de consultar las siguientes bases de datos: PubMedSe procedió a realizar una lectura y recolección de datos exhaustiva de los artículos seleccionados, cuya información se recopiló en cuadros, por medio de Microsoft Excel. Se identificó la siguiente información: autor y año, título, población y edad, tipo de sordera e intervenciones, evaluaciones de lenguaje realizadas y resultados relacionados. Tal información se agrupó en las siguientes variables de evaluación del lenguaje: desarrollo general de lenguaje, lenguaje receptivo, lenguaje expresivo, otros elementos de lenguaje y, adicionalmente, lengua de señas..Posterior a este proceso, se elaboraron cuadros de evidencia con el programa Grade Pro GDT y se siguió la metodología GRADE para analizar la información, y considerar la importancia . de los El proceso de búsqueda de artículos relacionados y relevantes se detalla en el Anexo A. Se obtuvieron inicialmente 403 publicaciones, que se redujeron a 21 luego de aplicar criterios de inclusión, exclusión y eliminación de duplicados. Luego, se procedió excluir los estudios que no correspondían al objetivo planteado debido a: 1) definir el desarrollo del lenguaje a partir de la habilidad auditiva, 2) mayor atención al funcionamiento de dispositivos auditivos y 3) inferir el desarrollo del lenguaje partir de la evaluación de otros factores como las habilidades cognitivas, sociales, y del contexto cultural. Finalmente se obtuvieron 15 publicaciones que se consideraron para la revisión, cuyos datos se describen en el Anexo B. Los resultados relacionados con la evaluación del desarrollo del lenguaje son descritos en los siguientes apartados, según la importancia de los desenlaces seleccionados.De manera general, los hallazgos obtenidos demuestran que es posible y factible realizar evaluaciones del desarrollo de lenguaje a niños sordos prelocutivos durante sus primeros seis años de vida, y que además los datos obtenidos sirven para mantener un seguimiento a largo plazo. En cuanto al desarrollo del lenguaje, una calidad de la evidencia moderada . sugiere, que adapta los conceptos de lenguaje receptivo y expresivo a niños signantes usuarios (incluidos nativos) de lengua de señas.En total, siete de los estudios seleccionados optan por la evaluación del lenguaje receptivo y expresivo, mientras que solo tres toman en cuenta otros elementos que justifiquen sus resultados. Una calidad de evidencia alta . para la, versus una producción de elementos que en realidad responden a un desarrollo.A pesar de que el lenguaje expresivo es el elemento observable del lenguaje, por ende, más sencillo de medir, una calidad de la evidencia moderada ., en com, es decir, justifican que tal certeza de recepción o expresión tenga realmente elementos lingüísticos observables. Una calidad de evidencia baja . Tal proeza se puede comparar con la breve anotación de la publicación de Meinzen-Derr et al. que mencionan que su estudio clínico aleatorizado, en población sordo oralizada, deben ser replicados, en un futuro, en población sordo signante.Los estudios que toman en cuenta la rehabilitación oral y el implante coclear, no adjuntan en sus resultados factores intervinientes sobre la posible presencia de gestos o incluso acercamientos a la lengua de señas. Esta situación seguramente se explica por los históricos prejuicios a la lengua de señas, donde se coloca a este idioma como un instrumento extra o incluso como un perjudicial estorbo de la habilidad oralLa mayoría de estudios concuerdan en que la edad de detección de la sordera, sumado a una intervención temprana, es capaz de responder mejor y oportunamente a las necesidades de los niños sordos; sin embargo, se distancian uno de otro en escoger el tipo de información, priorizando la rehabilitación oral, y dejando de lado a la lengua de señas.. Tales consideraciones ponen en tela de juicio las revisiones y los estudios que no consideran en sus desenlaces los costos y recursos, además de los valores y preferencias de madres y padres con hijos sordos.En la gran mayoría de estudios se destaca un nivel de desarrollo del lenguaje, luego de la implantación coclear, cercano o similar al del niño oyente, más nunca igual. Se exceptúan aquellos que toman en cuenta la lengua de señas y los gestos, que ubican al niño sordo en mismo nivel que el oyente. Por lo tanto las posibilidades de la lengua de señas deben considerarse al momento de hablar de desarrollo y evaluación, incluso cuando es adquirida o aprendida por niños oyentes sin pérdida auditiva. Sin embargo, cuando el problema se aborda desde una óptica integral del lenguaje, las evidencias aún son escasas y no hay un consenso que permita determinar la mejor vía de evaluación por la cual optar. Esta cuestión seguramente se debe a un problema antecesor al de la evaluación: las opciones de intervención, o más bien, las decisiones de los profesionales médicos que, en su mayoría, abogan por un pronto ajuste del niño sordo a los estándares oyentes normativos. Desde ese punto de partida, la evaluación del lenguaje queda sesgada a los elementos observables que el niño sordo sea capaz de producir de forma oral, de los cuales se infiere la presencia de lenguaje. Sin embargo, estas aproximaciones dejan de lado la posibilidad de que el niño haya logrado algo de lenguaje con elementos que van más allá de la producción del sonido. Trayendo a colación ese espectacular cambio de paradigma de la interacción humana con las propuestas de Paul Watzlawick et al., se pone en contexto este “más allá de la producción de lenguaje” en el primer axioma de comunicación, “es imposible no comunicar”, que describe perfectamente el hecho de que, aunque un niño no produzca sonidos de habla, hay otras instancias de lenguaje que funcionan en su cabeza.La literatura publicada en relación a la eficacia de las intervenciones y la evaluación del lenguaje de niños sordos prelocutivos parece ser confiable si parten de la falta o reducción de la audición y la necesidad de habla oralLa detección e intervención temprana de la sordera es una necesidad urgente, y hay evidencia suficiente para colocarla como la mejor forma de prevención de problemas, no solo de lenguaje, en niños sordos. Sin embargo, considerando lo antes expuesto, es hora de empezar a provocar cambios de paradigmas extremos que permitan abordar al lenguaje de forma integral y en todas sus modalidades posibles. La presente revisión considera sumamente importante el valioso aporte que podría tener la participación de profesionales sordos, oralizados y signantes, tanto médicos como de otras áreas, en la producción de evidencia científica que tome en cuenta sus valores y preferencias. Sin duda, una aproximación tal, permitirá acortar las brechas tanto en las faltas de consenso mencionadas, como en las barreras de comunicación. Para ello, hace falta, no solo investigación, sino una mirada epistemológica de los tratamientos y resultados históricamente direccionados a la oralización., por otro lado, empezar a describir, de forma integral una vez más, los efectos adversos a largo plazo, por ejemplo, el aparecimiento de hueso nuevo o la pérdida de los restos auditivos.Los dispositivos electrónicos para la sordera, implantes cocleares y audífonos, merecen una especial mención. La presente revisión, en ningún momento, tiene por objetivo desestimar, negar o prohibir su uso; al contrario, el interés se dirige a replantear la manera en que son ofrecidos y brindados a madres, padres y niños sordos. No se puede menospreciar el excelente crecimiento de la tecnología en los últimos años, y sería incompatible no sostener que seguramente los implantes mejorarán su alcance y sus beneficios. Sin embargo, frente a una acelerada evolución, más vale asegurarse de todos los factores intervinientes. Por un lado, es oportuno continuar construyendo evidencia sobre el impacto económico de los implantes cocleares para las familiasCon el recorrido realizado en el momento, es pertinente mencionar la necesidad urgente de la transmisión del conocimiento a todos aquellos profesionales de la sordera que determinan el destino de los niños sordos. Tomar en cuenta los valores y preferencias de estos pacientes, no es sólo una cuestión médica, sino una problemática social y cultural que se enlaza directamente con la lucha que mantiene la Comunidad Sorda a nivel mundial. Por lo tanto, es necesario garantizar la capacitación completa y continua en temas de pérdida auditiva, sordera, comunidad sorda, cultura sorda, y lengua de señas, que aseguren ese abordaje integral que tanto se anhela. Con esos cambios, no solamente se espera un impacto en la intervención, sino en todo el aparato normativo, que es también responsable del destino del niño sordo.Es importante mencionar que los estudios clínicos, podrían verse afectados por un sesgo de imprecisión en vista de que sus muestras son relativamente pequeñas, pero cuentan con buenos diseños y metodologías. Se debe considerar que la diversidad de la sordera es demasiado amplia, por lo que estos estudios se han esforzado por obtener muestras homogéneas. Aun así, se ha notado una falta de diferenciación entre las poblaciones que usan implante u audífono, o quienes tienes familia sorda u oyente, cuestiones que han disminuido la calidad de la evidencia relacionada al lenguaje expresivo. La presente revisión, debe reconocer que puede verse afectada por un sesgo de evidencia indirecta, en vista de que los estudios seleccionados toman en cuenta varios grados de pérdida auditiva, de leve a profunda, cuando se considera que el desarrollo de lenguaje será particular en cada uno. Además, las menciones al uso de implantes cocleares y audífonos deben considerarse como comentarios extras, en vista de que no formar parte de la pregunta de investigación. Sin embargo, se espera que sean invitaciones para futuras investigaciones y revisiones sistemáticas.Sobre la base de las calificaciones de la calidad del cuerpo de la evidencia de la evaluación del desarrollo en niños sordos prelocutivos, se considera que hay suficiente información confiable para realizarla durante los seis primeros años de vida. Sin embargo, la interpretación de sus resultados debe tomar en cuenta que los datos obtenidos sobre un desarrollo general del lenguaje deben sostenerse en mayor medida en evaluaciones de lenguaje receptivo sobre el expresivo, y que cuyas evidencias pueden enriquecerse al adjuntar evaluaciones de elementos lingüísticos formales tanto de la modalidad oral como gestual, y de los componentes pragmáticos de los procesos comunicacionales.Se requiere más investigación sobre la evaluación de elementos formales de la modalidad gestual del lenguaje, las lenguas de señas, que permitan la construcción de herramientas , capaces de contrastar los resultados del desarrollo de niños sordos según la intervención a la que hayan sido expuestos o la elección que hayan tomado.


To verify the association between caregivers' and teachers' perceptions of the changes imposed by social isolation and the impact on students' learning.nd-grade students from a public financing school and their respective teachers. The caregivers were submitted to interviews by means of the questionnaires: Abilities and Difficulties Questionnaire, Family Environment Resources Inventory and COVID-19 monitoring questionnaire that checks the behavior of schoolchildren and families. The collection took place in two moments by telephone call: the first moment (M1) was started in June 2020, and the second, (M2) in December 2020. The progress reports prepared by the regular teachers were received in January 2021.This is an analytical observational and longitudinal study, with the participation of 19 caregivers (family members) of 2A negative implication was observed in the change of routine and an impact on the parents' lives. In parents' perceptions, significant and negative issues were also present in children's mental health, such as changes in routine. Teacher evaluation reports showed a similar pattern, with the vast majority of them lacking information about learning performance.This study pointed out the importance of accompanying schoolchildren and families in a period of social withdrawal, in order to guide and intervene together with parents and teachers. Governmental . School plays a crucial role in the development of children and with their closures lessons had to be adapted to an online format so that there was no interruption to classes. With this change came the need to adopt strategies that would help to reduce the impact caused by the suspension of in-person lessons. Considering such difficulties and limitations it is important to reflect on the impact caused to the process of learning to read and write during this period of online teaching, especially to children at the beginning of elementary school.Digital education in Brazil was already facing many challenges and impasses, such as difficulties to access the internet in the classroom, problems to train teachers in activity planning, among othersWhen comparing in-person teaching with online teaching it is necessary to take into account the issues and challenges faced, whether from the viewpoint of teachers, children, families or the technologies employed. The teacher has to adapt and learn how to use these new technologies in his or her professional daily life so that there can be an interaction with the students and to prepare videos and exercises among other activities. For the families the main challenge is the availability and awareness of those responsible, to be able to follow the lessons and or explain the content to children. Very often the parents or guardian did not have a sufficient level of education to do this. Children need motivation to maintain their attention and study pace, and to achieve this previous development of skills and academic content is essential.. Such questions lead us to ask whether the conditions of access that encompass the online schooling process are being sufficiently monitored.Technology includes access and the ability to use equipment and also connection quality, there is a strong link between these issues and socioeconomic status, since families with low socioeconomic status do not have sufficient access to technology and those responsible tend to have a poorer level of schooling, therefore it is important to accompany students in vulnerable situations, since access to schooling sometimes has further to go, becoming even more important in the context of online teaching and the return to in-person teaching. When one knows how the pace of development strategies can be employed to minimize the impact caused to families.It is a well-known fact that cognitive and linguistic development is associated with socioeconomic status, and children from low income families have a poorer academic performance-7. A study carried out in São Paulo with students from the 1st to 5th years showed that students who had poorer school performance in the opinion of those responsible are the ones with the greatest problems related to behavior and hyperactivity.Studies show that mental health and family resources are also associated with the academic performance of school children, when there is a family interaction with pre-established routines and greater access to extracurricular activities, the encouragement of reading and monitoring of school activities and the family-school relationship.In addition to the impact on mental health, the family environment also positively influences school performance. In addition children were socially isolated and missed out on opportunities for leisure and socializing with people outside of their families. Understanding how these families experienced and are experiencing this period of confinement is a way to help them to understand how to face such difficulties. The objective of this study was to analyze the changes brought about by social isolation and the impact on the learning development of students in the second year of a public elementary school from the viewpoint of parents and teachers.During social distancing the family-school relationship became distant in the context of the conventional classroom and there was a greater need for family participation and support during this timeThis is an analytical and longitudinal observational study approved by the Research Ethics Committee of the institution under protocol number 3,906,514. All guardians signed a consent form (FICT). Those who participated in the study were parents or guardians made up of the closest family members responsible for the children, and the teachers of 19 students from the 2nd year of an elementary school. Data collection was carried out by phone survey and parents and guardians who agreed to participate were interviewed by telephone and the interviewer read out the consent form and the interviewees responded by giving their names and agreement as requested by the ethics committee and each interview was recorded.This study is part of a larger project based on the Intervention Response Model (RTI) that began in February 2020 in-person. With the closure of schools, only children enrolled in classes of the second year of a public elementary school in the city of Brasília who had a signed consent form before the school closures were included in this study. Childrens´ parents who did not take part in the two interviews were excluded.For data collection, the following instruments as answered by the (family members) were used:The Abilities and Difficulties Questionnaire (SDQ-Por)7 is an instrument used internationally to detect problems related to children's mental health, It consists of 25 items, 10 of which are about capabilities, 14 about difficulties and one neutral item, It is divided into five sub-scales each with five statements namely, emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial behavior. The questionnaire's score followed the proposal of the instrument itself, with the classification of the score of each scale and the total score as normal, borderline and altered. is a script with closed-ended questions that makes it possible to survey the resources of the family environment that can contribute to school performance during the elementary school years. It consists of 10 questions divided into three domains, proximal processes , stability in family life  and family-school relationship (parent participation in school life and meetings).The Inventory of Family Environment Resources (RAF)The COVID-19 Monitoring Questionnaire. Specially prepared for this study has 18 questions about the behavior of children and families as detailed below. The suspension of classes due to social isolation, family income during this period, how the child dealt with social isolation and information about preventative measures, and the child's routine and behavior during isolation. For each question a Likert scale of up to seven points was used. For the analysis of each variable, the Likert scale score of each item was added, with the following maximum total scores; parents explained preventative measures to schoolchildren 16 points, schoolchildren understood social distancing 12 points, knew that measures had to be taken 8 points, took or accepted to take preventive measures 16 points, leisure activities at home 10 points, impact of school suspension on parents' lives 12 points, changes in students' behavior 40 points, and changes in play 54 points. The closer to the maximum score, more positive the behavior.End of school year reports. The children's progress was analyzed by reading the end of the school year reports for 2020 as prepared by the teachers.th of July 2020 in public schools. During the previous months (April and June), a period in which there was no school, strategies were drawn up and improved on, to involve student through printed activities and an online platform.Data collection was carried out in three steps, the first two being interviews with the guardians or parents of the children, and the third reception of the progress reports. The interviews were carried out by phone by the first interviewer and questions were asked from the first questionnaires as described above. The first moment (M1) started in June 2020, and the second moment (M2) in December 2020. The progress reports prepared by the teachers were received in January 2021. It is worth mentioning that school activities were resumed in an online format on the 13The data was submitted for descriptive and inferential statistical analysis with a significance level of 5%. The analyzes were performed using the IBM SPSS statistical platform  version 21.0. The tests used to compare the two instances were, the Mcnemar Bowker, to measure the behavior at moment 1 (M1) and moment 2 (M2) of the same sample for dependent qualitative variables, and the Wilcoxon Rank Test for dependent quantitative variables . For correlation analysis the Spearman test was used for a non-normal distribution.Data analysis showed that more than 80% of respondents were mothers/fathers or grandmothers of the students. Regarding the suspension of classes, 94.7% agreed with the government's decision to suspend in-person classes as a coping measure imposed by COVID-19 and 68.4% agreed or strongly agreed to the suspension of classes for the same reasons mentioned above.The data collected from the COVID-19 Monitoring Questionnaire did not generate the same variables in M1 and M2. For M2, the following variables were collected and compared, family income, access to emergency assistance, changes in the child's behavior, access to remote classes and hours of study. Due to the difficulties faced by teachers in assessing the children's progress, online school reports show us a similar pattern, with the vast majority lacking information (with a little more than 60% of the sample missing information). For the analysis of the reports, we sought to identify the following elements about the children's development, carried out school activities, the family followed the activities, collective reading, silent reading, reading and interpretation of simple and complex texts, reading and interpretation of short and long texts, comprehension and syllable separation, ordering of words and phrases, writing simple and complex sentences, retelling of written text, and oral speech . It was The teachers' evaluations showed us that 36.8% of the 19 students were developing collective reading and 31.6%, silent reading. 36.8% read simple texts and 31.6% read complex, short and long texts and interpreted simple and complex, short and long texts .Regarding writing, 36.8% could write simple sentences and 31.6% could write complex sentences. Only 31.6% could order words in alphabetical order, and 36.8% of students could order sentences . 31.6% understood and could separate syllables. 36.8% of students could retell written texts . In the oral speech performed by the students the percentage was 36.8%. The psychogenesis levels evaluated by the teachers showed that 5.3% of the students were in the pre-syllabic level, 15.8% in the alphabetic II level and 15.8% in the alphabetic III level. Other tA crossing between the RAF and the COVID-19 Monitoring Questionnaire was performed at moments M1 and M2. The Spearman correlation was used for the analysis. Because there are many variables we chose to present only statistically significant results. According to the results presented in The purpose of this study was to verify the association between the changes imposed by social distancing, the learning development and the behavior of students. We present the results of 19 children from the second year of an Elementary School from the perspective of their parents and teachers as collected in June and December of 2020.The students were evaluated through questionnaires (parents' perspective) about the situation of school closures, the period of social isolation and the teachers' progress reports.. Although the study deals with young people, the similarity with the present study is due to the contextual analysis of the perspective of the parents.The data shows that the families agreed with the suspensions of classes due to the spread of the virus, but not everyone liked it. Similar findings were found in another survey carried out in the Czech Republic where despite a lack of technology and the difficulties in teaching school activities at home, parents still preferred to maintain social distancing and online teaching due to COVID-19.Most families did not have access to the emergency aid program in M2. It´s a well-known fact that a decrease in income is an aggravating factor in families and this was already being discussed well before the period of social isolation, however during the pandemic it was worse with an even greater impact with results dependent on the length of social isolation.Regarding how children coped with social isolation, most schoolchildren understood social distancing because parents were careful to explain about preventive measures that should be taken and when necessary. The influence of parents in health education is very important because children feel more comfortable and confident in the home environment, however results did not show this. Because the beginning of data collection took place two months after the school closures, it could be concluded that families were already adapting to the changes imposed by the pandemic.There were significant changes in leisure and play, children's behavior and parents' lives after the school closuresth of February 2020, however they were suspended on the 12th of March 2020 due to the COVID-19 pandemic. Online teaching started at SEE on the 13th of July 2020 and some difficulties were found in accessing the classes at M1, with more than 70% of students without any type of access. However in the M2 of the collection, all students already had access to classes, with classes between one and six times a week and each class containing one hour or more of school activities.Classes as authorized by the Municipal Secretary of Education (SEE) started on The 10.It is important to emphasize that even though the students did not have access to classes at M1, their parents/guardians were concerned enough to dedicate a few hours to school activities with books and others materials of choice. Similar data can be found in terms of both study hours and parents/guardians´ dedication to school assignments in a survey carried out in the Czech Republic. This study  surveyed data from 72% of students who dedicated between 2-4 hours of study per day, and 66% of their parents/guardians helped during half of this time with school activities. However, the results show us that when it came to books no differences were found between M1 and M2, in fact book collection decreased in M2.During social distancing, schoolchildren spent more time at home than usual. Regarding the resources of the family environment, the variable playing on the street did not change in both moments, but the amount of toys in M2 was greater, this may be because parents bought more toys to help improve the playtime of children, bringing a certain degree of comfort during self isolation, we did not find academic articles that focused on the variation of children's books available during the pandemic in Brazil. Despite not being a specific objective of this study, the limitation that it was not possible to verify the variability of books during the period should be taken into account, data that is needed by the instruments used.We can speculate that this decrease, could have been because of free access to virtual books, which were more accessible and accompanied by national campaigns or donations. However despite there being different studies on early childhood education during the pandemic.During social isolation family outings decreased considerably which shows the extent of caution that families took during social distancing in Brazil. The decrease in extracurricular activities during the pandemic had a negative effect because they are particularly important for children to help build relationships between peers and for socialization. Playing is one of the activities that most helps children in the process of affectivity, development and socialization. In the teachers' report, this relationship was seen with 78.9% of the families accompanying the activities.The school has always sought to involve children´s families in the students' learning process and the family is the first to start this process. Trust and commitment are part of the family school relationship and need to be in harmony to guarantee continued and effective education. In this study, we saw that families improved this relationship and they needed to have better contact with the school because they often accompanied their children during online classes, which can be explained by the fact that data collection started two months after the social distancing measures were adopted in the municipality in question. In the variable stability in family life, which surveys the times that the family usually spends time together, it was found that at almost all times the family was together, because they were spending more time at home due to social distancing. Changes in the family environment generate instabilities, directly affecting socialization (decreased contact between peers) and economics (decreased income).The routine did not change between the two moments of collection, changes in routine and family life were as expectedRegarding reading at home, there was an increase in students who dedicated themselves to reading in M2, and it can be reasoned that reading increased because it was a time when all the students had online access and classes, which gave them greater motivation to read. Additionally during this period it was easier for the students to read because of the availability of free online books which were made available through platforms such as Google Classroom.. Because families spent more time at home they correspondingly spent more time watching and talking about TV.Most parents/guardians said that they talked about school with their children even with the closures, probably because parents needed to supervise school activities more closely, whether it be teaching homework, collecting material from school or accompanying children in online classes, additionally they talked more about television. A study carried out with Brazilians aged 18 and over found that the average time spent watching television was longer after the COVID-19 pandemic, with 1 hour and 45 minutes more viewing time,24, we can see in nd-grade students (N=25), indicating an absence or difficulty in imposing limits on child development. It is important to emphasize that reports of emotional problems in the family environment were already common before the pandemic, however during social distancing these reports became more evident.When comparing the results of the SDQ-Por. This data lead to the hypothesis that they may be related to changes in routines, sometimes caused by disobedience and irritability, or the prevalence in this age group of a low socioeconomic level.Regarding behavioral problems, three students had an altered level (15.8%), corroborating a previous study with students with an average age of 8.18 years oldThe instrument's total score is the sum of the scores of 4 scales that refer to difficulties  and the 01 scale that refers to capabilities , found in able 3. No difference was found between the two moments, but 17 of the 19 students showed changes in M1, and in M2 this number dropped to 12. This event may have occurred because families and children were already used to the new reality that had been imposed on them.. Due to social isolation family income was affected which may have led to instability in the mental health of families, and consequently of the children.A study with the same objective carried out with 6,727 adolescents aged 11 to 17 years old reached a total score of 8.8% on the altered scale. In this same sample it was found that students with a low socioeconomic status had higher rates on all the scales of the SDQ.It is important to emphasize that the SDQ cannot be seen in isolation for pathological signs, it needs other assessments to complete it. It should be used as a screening for prevention strategies and new adaptations for children.Data taken from the teacher's assessment showed that 18 schoolchildren carried out their activities fully, effectively or partially. One of the objectives of school activities is to consolidate what was taught by the teacher and to measure what was learned in class by them. Many students may not have developed or their knowledge was not measured through reading, writing, text interpretation and comprehension, word ordering and text retelling activities, since in most school reports we did not find answers as to whether the student would be able or not according to the measurement of development. It is worth highlighting the difficulties the education system faced by teachers in evaluating students remotely, often needing to reinvent themselves as a matter of urgency to meet the demands that were imposed on them during the pandemicWhen we think about correlating the findings of the two questionnaires , the intention is that they should show us behavior of these students, as well as adjustments so that they can be worked on in a clinical and educational context. We also intended to understand whether having more resources in the family environment associated with pre-established routines lead children to adapt better to social isolation.Understanding of social distancing is positively related to the number of toys in M2. This may have happened because as children were given toys, which was a positive factor they began to understand the need for social isolation..Leisure is also positively related to book collections on various subjects. During social distancing students spent more leisure time reading in M1. This data was also found in a study using questionnaires with university students in Macapá - AP. 456 questionnaires on leisure and the impact of the COVID-19 pandemic were analyzed, and reading was one of the leisure activities significantly marked (41.9%)General outings were positively related in M1 with understanding of social distancing. We can hypothesize that since schoolchildren understood about social distancing, they understood that they needed to stay at home longer and reduce outings and take preventive measures.. There was also a positive relationship in the routine, including an explanation of preventive measures to which the whole family were committed to caring for themselves and others. Before the pandemic families had routines but during the pandemic, it was necessary to include new information in the daily lives of these students, which resulted in a positive relationship.There was also a positive relationship in extracurricular activities and an impact on parents' lives. This relationship may have been brought about by the schoolchildren's routines which were divided into moments with the family and activities outside the home. Parents had to take on many new activities to occupy their children's time and this may have had a negative impact on their livesFamily stability refers to the times when the family is usually together. Here there was a positive relationship, since the family spent more time together, knowledge about preventative measures increased since more time was devoted to explanations and perhaps if the family spent less time together preventative knowledge would have been less as well.Another limitation of this research concerns the other relevant aspects related to learning, such as reading, writing and comprehension of texts. Although important, they were not part of the scope of this study and should be taken into account in this context when returning to in-person classes.In view of the findings presented and the changes brought about by social distancing during the attempt to combat the COVID-19 pandemic, these changes affected various areas in the families monitored in this study during the period from June 2020 to December 2020. There was a negative impact on parent’s lives due to the suspension of in-person classes and extracurricular activities and parents had to adapt to new responsibilities and roles. The positive side was that there was an improvement in the family-school relationship, which should be explored further in the post-pandemic period.Negative changes in routines were also found through the SDQ-Por, causing instabilities in children's mental health.We propose that school-age children should be monitored, evaluated and given the opportunity of early multidisciplinary intervention, because despite having a less representative sample the study showed us the real situation of 19 families with negative factors that will be reflected in the school development of these children. This study points out as a limitation the description of the progress reports by teachers on school learning, since little more than 60% of the sample did not have this information. We suggest for future research a collection with a more representative sample and a comparison with children from other school years. We also suggest associating the assessment of the questionnaires with the reading performance of students from different socioeconomic levels. .O distanciamento social foi adotado em diferentes estados do Brasil como medida preventiva de combate à COVID-19, incluindo o fechamento de escolas . A escola exerce um papel importante no desenvolvimento da criança, e com seu fechamento, as aulas precisaram ser adaptadas à modalidade remota para que o ensino não fosse interrompido. Com isso, veio a necessidade de se traçarem estratégias que auxiliassem na diminuição dos impactos provocados pela suspensão das aulas presenciais. Considerando tais dificuldades e limitações encontradas, é importante refletir sobre os impactos gerados no processo de aprendizagem da leitura e escrita nesse período de ensino remoto, principalmente em crianças no início do Ensino Fundamental.O processo de inclusão digital na educação brasileira já vinha sofrendo desafios e impasses, como dificuldades de acesso à internet na sala de aula, capacitação dos professores no planejamento de atividades, entre outros. Tais questões nos levam a questionar se as condições de acesso que englobam o processo de escolarização online estão sendo monitoradas.Quando comparamos o ensino presencial com o ensino remoto, é preciso levar em consideração questões ou desafios, sejam do ponto de vista do professor, das crianças, das famílias ou das tecnologias. O professor precisou se adaptar ao uso de tecnologias em seu dia a dia profissional para que houvesse interação com os estudantes, elaboração de vídeos, questionários, entre outros. Em relação às famílias, o principal desafio foi a disponibilidade e consciência dos responsáveis para acompanhar as aulas ou explicar o conteúdo para as crianças, sendo que nem sempre tinham escolarização suficiente para isso. As crianças precisavam de motivação para manter a atenção e o ritmo de estudo, e para isso, o desenvolvimento prévio de habilidades e conteúdos acadêmicos foi fundamental. Já quanto à tecnologia, podemos pensar no acesso e domínio de equipamentos e na qualidade da conexão. Essas questões estão fortemente associadas ao nível socioeconômico, pois famílias de baixo nível socioeconômico não conseguem ter acesso suficiente às tecnologias e os responsáveis tendem a ter menor escolaridade. Dessa forma, destaca-se a importância de acompanhar escolares em situação de vulnerabilidade, pois o acesso à aprendizagem escolar é, por vezes, um caminho maior a percorrer, tornando-se ainda mais importante no contexto de ensino remoto e retorno do ensino presencial. A partir do momento em que se tem conhecimento de como eles estão se desenvolvendo, estratégias podem ser utilizadas para minimizar os impactos causados às famílias.Sabe-se que o desenvolvimento cognitivo e linguístico está associado ao nível socioeconômico, com pior desempenho entre as crianças de baixa renda-7. Estudo realizado em São Paulo com escolares do 1º ao 5º ano evidenciou que escolares que possuem pior desempenho escolar na visão dos responsáveis são os que mais apresentam problemas relacionados à conduta e hiperatividade.A literatura aponta que a saúde mental e os recursos do ambiente familiar também estão associados ao desempenho acadêmico de crianças em idade escolar, quando proporciona: interação familiar com rotinas pré-estabelecidas e mais acesso a atividades extras; estímulo à leitura e acompanhamento das atividades escolares; e relação família-escola.Além dos impactos da saúde mental, o ambiente familiar também influencia positivamente o desempenho escolar. Além disso, as crianças ao ficarem isoladas socialmente, perderam oportunidades de lazer e interação com pessoas fora do seu núcleo familiar. Entender como essas famílias vivenciaram e vivenciam esse período de confinamento é uma forma de ajudá-las a entender como enfrentar tais dificuldades. Portanto, o objetivo deste trabalho foi verificar a associação entre a percepção dos cuidadores e dos professores acerca das mudanças impostas pelo isolamento social e o impacto na aprendizagem de estudantes do 2º ano do Ensino Fundamental de uma escola pública da região administrativa de Samambaia-Distrito Federal.Com o período de distanciamento social, a relação família-escola passou a ficar distante no contexto de sala de aula convencional, porém houve uma maior necessidade de participação e apoio da família durante esse período remotoTrata-se de estudo observacional analítico e longitudinal aprovado pelo Comitê de Ética em Pesquisa da instituição sob parecer nº 3.906.514. Todos os responsáveis assinaram o Termo de Consentimento Livre e Esclarecido (TCLE). Participaram do estudo cuidadores, compostos pelos familiares responsáveis mais próximos às crianças, e professores de 19 escolares do 2º ano do Ensino Fundamental. Para a atender às mudanças no formato da coleta de dados, que passou a ser remota, os pais que concordaram em participar das entrevistas por telefone, ouviram a leitura do TCLE, falaram o nome e “de acordo” como solicitação do Comitê de Ética para a coleta de maneira remota, sendo esta informação gravada.Este estudo faz parte de um projeto maior baseado no Modelo de Resposta à Intervenção (RTI) que se iniciou em fevereiro de 2020 de forma presencial. Com o fechamento das escolas, foram incluídas para o presente artigo apenas as crianças regularmente matriculadas nas turmas do 2º ano do Ensino Fundamental I de uma escola pública da cidade de Samambaia- Distrito federal e que estavam com os TCLEs assinados antes do fechamento das escolas. Foram excluídas as crianças cujos pais não participaram das duas entrevistas.Para coleta dos dados, foram utilizados os seguintes instrumentos respondidos pelos responsáveis cuidadores (familiares):: instrumento utilizado internacionalmente para a detecção de problemas relacionados à saúde mental infanto-juvenil. É composto por 25 itens, sendo 10 itens sobre capacidades, 14 sobre dificuldades e um item neutro. Está dividido em cinco subescalas, cada uma com cinco afirmações, a saber: sintomas emocionais, problemas de conduta, hiperatividade, problemas de relacionamento com colegas e comportamento pró-social. A pontuação do questionário seguiu a proposta do próprio instrumento, com a classificação da pontuação de cada escala e da pontuação total em: normal, limítrofe e alterado.Questionário de Capacidades e Dificuldades (SDQ-Por): roteiro com questões fechadas que possibilita o levantamento dos recursos do ambiente familiar que podem contribuir para o aprendizado escolar nos anos do ensino fundamental. É constituído por 10 questões divididas em três domínios: processos proximais , estabilidade na vida familiar  e vínculo família-escola (participação dos pais na vida escolar e reuniões).Inventário de Recursos do Ambiente Familiar (RAF)Questionário de monitoramento COVID-19: Elaborado para o presente estudo, conta com 18 questões sobre o comportamento das crianças e famílias detalhadas a seguir: a suspensão das aulas devido à necessidade de isolamento social; renda da família nesse período; como a criança está lidando com o isolamento social e as informações sobre as medidas de prevenção; e a rotina e os comportamentos da criança durante o isolamento. Para cada pergunta, foi utilizada escala likert de até sete pontos. Para análise de cada variável, somou-se a pontuação da escala likert de cada item, com a seguinte pontuação máxima total: pais explicaram sobre as medidas de prevenção para os escolares, 16 pontos; escolares compreendem o distanciamento social, 12 pontos; sabem que as medidas devem ser feitas, 8 pontos; fazem ou aceitam fazer as medidas de prevenção, 16 pontos; atividades de lazer em casa, 10 pontos; impacto da suspensão das aulas na vida dos pais, 12 pontos; mudanças no comportamento dos escolares, 40 pontos; e mudanças na brincadeira, 54 pontos. Quanto mais próximo da pontuação máxima, mais positivos os comportamentos.Relatório evolutivo das crianças: Foi analisado o relatório evolutivo individual das crianças elaborado pelo professor regente ao final do ano letivo de 2020.A coleta de dados foi realizada em três momentos, sendo as duas primeiras de entrevistas com os responsáveis das crianças, e a terceira de recebimento dos relatórios evolutivos. As entrevistas foram realizadas, pela primeira autora, por meio de ligações telefônicas para aplicação dos questionários descritos anteriormente. O primeiro momento (M1) foi iniciado em junho de 2020, e o segundo momento (M2) em dezembro de 2020. Os relatórios evolutivos elaborados pelos professores regentes foram recebidos em janeiro de 2021. Vale ressaltar que as atividades escolares foram retomadas na modalidade de ensino remoto em 13 de julho de 2020 nas escolas públicas. Durante os meses anteriores (abril e junho), período que não foi contabilizada presença, estratégias foram organizadas e aprimoradas buscando o envolvimento dos estudantes por meio de atividades impressas e plataforma on-line.Mcnemar Bowker, para medir o comportamento no momento 1 (M1) e momento 2 (M2) de uma mesma amostra para variáveis qualitativas dependentes, e o Teste dos Postos de Wilcoxon para variáveis quantitativas dependentes. Para a análise de correlação, foi utilizado o teste de Spearman para uma distribuição não normal.Os dados foram submetidos à análise estatística descritiva e inferencial com nível de significância de 5%. As análises foram realizadas com o pacote estatístico IBM SPSS  na versão 21.0. Os testes utilizados para comparação entre os dois momentos foram: A análise dos dados demonstrou que mais de 80% dos respondentes eram mãe/pai ou avó dos escolares. Em relação à suspensão das aulas, 94,7% concordaram com a decisão governamental de suspensão, como medida de enfrentamento imposta pela COVID-19 e 68,4% gostaram ou adoraram a suspensão das aulas pelos mesmos motivos citados acima.A coleta realizada por meio do Questionário de monitoramento COVID-19 não levantou as mesmas variáveis em M1 e M2. Para o M2, foram coletadas e comparadas as seguintes variáveis: renda familiar, acesso ao auxílio emergencial, mudança no comportamento da criança, acesso à aula remota e horas de estudo. A A Devido às dificuldades enfrentadas pelos professores na avaliação remota, os relatórios evolutivos das crianças nos mostram um padrão similar, com a grande maioria sem informação (com um pouco mais de 60% da amostra sem informação). Para a análise dos relatórios, buscou-se identificar os seguintes elementos sobre o desenvolvimento das crianças: realizou as atividades da escola; a família acompanhou as atividades; leitura coletiva; leitura silenciosa; leitura e interpretação de textos simples e complexos; leitura e interpretação de textos curtos e longos; compreensão e separação de sílabas; ordenação de palavras e frases; escrita de frases simples e complexas; reconto de texto escrito; e discurso oral . ObservaA avaliação dos professores nos trouxe dados de que 36,8% dos 19 escolares estão em desenvolvimento de leitura coletiva e 31,6%, de leitura silenciosa. Quanto à leitura, 36,8% leem textos simples e 31,6% realizam leitura de textos complexos, curtos e longos e interpretam textos simples e complexos, curtos e longos .Em relação à escrita, 36,8% escrevem frases simples e 31,6% escrevem frases complexas. Na ordenação de palavras por ordem alfabética, apenas 31,6% a realizam, e na ordenação de frases , 36,8% dos escolares a realizam; 31,6% compreendem e separam sílabas. Quanto ao reconto de texto escrito, 36,8% dos escolares realizam esse tipo de atividade. No discurso oral realizado pelos escolares, a porcentagem é de 36,8%. Nos níveis da psicogênese avaliado pelos professores, 5,3% dos escolares encontravam-se no nível pré-silábico, 15,8%, no alfabético II e 15,8%, no alfabético III . Os demaFoi realizado um cruzamento entre o RAF e o Questionário de monitoramento COVID-19 nos momentos M1 e M2. Para essa análise, foi utilizada a correlação de Spearman. Como são muitas variáveis, optou-se por apresentar apenas os resultados estatisticamente significativos. De acordo com os resultados apresentados na Este estudo verificou a associação entre as mudanças impostas pelo isolamento social, a aprendizagem e o comportamento dos escolares. Apresentamos resultados de 19 crianças do 2º ano do Ensino Fundamental, na percepção de seus pais e professores, coletados em junho e dezembro de 2020. Os escolares foram avaliados por meio de questionários (percepção dos pais) sobre a situação do fechamento das escolas, período de isolamento social e relatório evolutivo dos professores.. Apesar do estudo tratar de jovens, a similaridade com o presente se dá pela análise contextual na percepção de pais.Os dados mostram que as famílias concordaram com as suspensões das aulas por conta da disseminação do vírus, porém nem todos gostaram. Achados similares foram encontrados em uma pesquisa realizada na República Tcheca em que, apesar da falta de tecnologia e das dificuldades para o ensino das atividades escolares em casa, os pais ainda preferem manter o distanciamento social e o ensino remoto em razão da COVID-19.A maioria das famílias não teve acesso ao programa de auxílio emergencial no M2. Sabe-se que a diminuição da renda é um agravante que já vinha sendo discutido bem antes do período de isolamento social, porém, nesse momento, foi mais intensificada com resultados ainda mais impactantes que dependerão de quanto tempo durará esse isolamento.Em relação a como as crianças lidaram com o isolamento social, a maioria dos escolares compreenderam o distanciamento social, pois os pais tiveram o cuidado de explicar sobre as medidas de prevenção que devem ser feitas e tomadas quando necessário. A influência dos pais na educação em saúde é muito importante, pois as crianças se sentem mais acolhidas, além de estarem em um ambiente que traz conforto e confiança, entretanto, os resultados não mostraram isso. Como o início da coleta de dados ocorreu dois meses após o fechamento das escolas, pode-se inferir que as famílias já estavam se adequando às mudanças impostas pela pandemia.Esperava-se mudanças significativas no lazer, brincadeiras, no comportamento das crianças e na vida dos pais após o fechamento das escolasAs aulas autorizadas pela Secretaria de Educação (SEE) do município se iniciaram em 10 de fevereiro de 2020, no entanto, foram suspensas no dia 12 de março de 2020 em função da pandemia da COVID-19. O ensino remoto na SEE iniciou em 13 de julho de 2020 e foram observadas algumas dificuldades de acesso às aulas no M1, com mais de 70% dos escolares sem nenhum tipo de acesso à tecnologia. Porém, no M2 da coleta, todos os escolares já estavam com acesso às aulas, dividindo-se entre uma e seis vezes por semana de aula remota, entre 1h e mais de 1h nas atividades escolares..É importante frisarmos que mesmo os escolares não tendo acesso à aula no M1, seus cuidadores preocuparam-se em dedicar algumas horas de atividades escolares com livros e outras de livre escolha. Observa-se um dado semelhante tanto de horas de estudo como de dedicação dos cuidadores nas tarefas escolares em uma pesquisa realizada na República Tcheca. Esse estudo (N=9.810) obteve um dado de 72% dos escolares que dedicam entre duas a quatro horas de estudo por dia, e 66% dos seus cuidadores auxiliam com metade desse tempo nas atividades escolares. Porém, os resultados mostram que, nos livros no geral, não foram observadas diferenças nos M1 e M2, na verdade o acervo de livros diminuiu no M2.No período de distanciamento social, os escolares passaram mais tempo em casa do que o costume. Em relação aos recursos do ambiente familiar, a variável brincar na rua não mudou nos dois momentos, porém a quantidade de brinquedos no M2 foi maior, isso pode ter ocorrido pelo fato dos pais investirem em brinquedos para suprir o lazer desses escolares, trazendo um certo grau de conforto no isolamento, não encontramos artigos acadêmicos que se debruçassem sobre a variação de livros infantis e o período da pandemia no Brasil. Apesar de não ser um objetivo específico do estudo, deve-se levar em conta a limitação de que não foi possível verificar a variabilidade de livros nesse período, questão que faz parte dos instrumentos utilizados.Algumas hipóteses podem ser levantadas aqui para justificar essa diminuição, como por exemplo, o acesso gratuito a livros virtuais, mais acessíveis e com campanhas nacionais ou a doações. Entretanto, apesar de termos diferentes estudos sobre a educação infantil no período da pandemia.Com o isolamento social, os passeios em família diminuíram consideravelmente, demonstrando o cuidado que essas famílias tiveram na situação em que o país está vivendo de distanciamento social. As atividades extracurriculares também diminuíram e elas têm como objetivo a socialização do escolar e que no momento de isolamento social foi diminuída, sendo um ponto negativo para o relacionamento entre pares. O brincar, por exemplo, é uma das atividades que mais auxilia a criança no processo de afetividade, desenvolvimento e socialização. No relatório dos professores, esse relacionamento foi evidenciado com 78,9% das famílias acompanhando as atividades.A escola tem sempre buscado o engajamento das famílias no processo de aprendizagem dos escolares, visto que a família é a primeira a começar esse processo. A confiança e o comprometimento são relações que a família e a escola precisam estar em harmonia para que haja uma educação continuada. Neste estudo, vimos que as famílias melhoraram esse relacionamento, precisando ter mais contato com a escola pelo fato de muitas vezes acompanharem seus filhos nas aulas remotas,o que pode ser explicado pela coleta ter se iniciado dois meses após as medidas de distanciamento social implementadas no município em questão. Na variável estabilidade na vida familiar, que levanta os momentos que a família costuma estar reunida, foi observado que em quase todos os momentos a família estava reunida, tendo em vista estarem passando mais tempo em casa por conta do distanciamento social. Mudanças ocorridas no ambiente familiar geram instabilidades, afetando diretamente os aspectos sociais (diminuição do contato entre pares) e econômico (diminuição da renda).A rotina não foi alterada entre os dois momentos da coleta, eram esperadas mudanças na rotina e no convívio familiar(google classroom).Em relação à leitura em casa, foi observado um aumento de escolares que se dedicaram à leitura no M2, podendo-se inferir que a leitura aumentou por ter sido o momento em que todos os escolares já estavam com acesso às aulas remotas e se sentiam mais motivados a ler. Durante esse período, também foi observada a facilidade da leitura através de plataformas que disponibilizaram livros de forma gratuita . Provavelmente, como as famílias saíram menos de casa e tiveram mais tempo em frente à televisão, conversaram mais sobre o assunto.A maioria dos responsáveis relatou que conversaram sobre a escola com seus filhos mesmo com o fechamento, provavelmente porque os pais precisaram acompanhar mais de perto a vida escolar das crianças, seja ensinando as tarefas, buscando materiais na escola ou acompanhando as crianças nas aulas online. Da mesma forma, conversaram mais sobre assuntos da televisão. Estudo realizado com brasileiros de 18 anos ou mais, observando que o tempo médio em frente à televisão foi maior após a pandemia da COVID-19, com 1:45 minutos a mais de exposição,24, podemos observar, na . É importante ressaltar que relatos de problemas emocionais no ambiente familiar já eram comuns antes do período de pandemia. No entanto, com o período de distanciamento social, os relatos ficaram mais evidentes.Ao comparar os resultados do SDQ-Por. Esses dados levam a hipótese de que podem estar relacionados às mudanças de rotinas, causadas às vezes por desobediências e irritabilidade, ou à prevalência, nessa faixa etária, de um nível socioeconômico baixo.Em relação aos problemas de conduta, três escolares apresentaram nível alterado , corroborando estudo anterior com escolares de média de idade de 8,18 anosA pontuação total do instrumento é a soma dos escores de 4 escalas que se referem a dificuldades  e 01 escala que se refere a capacidades , observado na . Por conta do isolamento social, a renda familiar foi alterada, podendo ter acarretado instabilidade na saúde mental das famílias, consequentemente das crianças.Nessa mesma perspectiva, observa-se um estudo realizado com 6.727 crianças e adolescentes de 11 a 17 anos, que obtiveram uma pontuação total de 8,8% na escala alterada. Nessa mesma amostra, foi observado que escolares em nível socioeconômico baixo apresentaram índices mais altos em todas as escalas do SDQ.É importante salientarmos que o SDQ não pode ser visto de forma isolada para sinais patológicos, necessita de outras avaliações para complementação. Ele deverá ser usado como triagem para estratégias de prevenção e novas adaptações para as crianças.Dados retirados da avaliação do professor revelaram que 18 escolares realizaram suas atividades de forma integral, efetiva ou parcial. As atividades escolares têm como um dos objetivos a consolidação do que foi ensinado pelo professor e medir o conhecimento adquirido em aula por elas. Portanto, muitos escolares podem não ter evoluído ou não foram medidos seus conhecimentos pelas atividades de leitura, escrita, interpretação e compreensão de texto, ordenação de palavras e reconto de texto, pois, na maioria dos relatórios escolares, não obtivemos respostas se o escolar estaria apto ou não de acordo com a medição dos conhecimentos. Entretanto, vale destacar as dificuldades do sistema educacional enfrentadas pelos professores na avaliação dos escolares de forma remota, muitas vezes precisando se reinventar em caráter de urgência para suprir as demandas que no período de pandemia foram impostasQuando pensamos em correlacionar os achados dos dois questionários , pretendemos que eles nos tragam indicadores do comportamento desses escolares, bem como ajustes para que possam ser trabalhados no contexto clínico e educacional. Pretendemos também entender se o fato de ter mais recursos no ambiente familiar associado a rotinas pré-estabelecidas levam a uma melhor adaptação das crianças no período de isolamento social.A compreensão sobre o distanciamento social está relacionada de forma positiva com a quantidade de brinquedos no M2. Isso pode ter acontecido, pois, à medida que as crianças foram ganhando brinquedos, que é algo bom para eles, foram entendendo que precisam ficar isolados..O lazer também está relacionado de forma positiva com acervo de livros de variados temas. Com distanciamento social, os escolares dedicaram mais momentos de lazer com os livros no M1. Esse dado também pode ser evidenciado em um estudo com uma população de jovens universitários de Macapá - AP através de questionários. Foram analisados 456 questionários sobre lazer e impactos da pandemia da COVID-19, e a leitura foi uma das atividades de lazer assinaladas de forma significativa Os passeios gerais foram relacionados de forma positiva no M1 com a compreensão do distanciamento social. Podemos levantar a hipótese de que, à medida que os escolares compreendem sobre o distanciamento social, entendem que precisam ficar mais tempo em casa, diminuindo os passeios e fazendo as medidas de prevenção.. Houve também uma relação positiva na rotina, inclusive ao explicar sobre as medidas de prevenção em que toda a família empenhava-se pelo cuidado dos seus e dos outros. Antes da pandemia, a família tinha uma rotina; com a pandemia, foi necessário inserir novas informações no dia a dia desses escolares, o que ocasionou uma relação positiva.Foi observado também uma relação positiva nas atividades extracurriculares e um impacto na vida dos pais. Essa relação pode ter acontecido, pois a rotina dos escolares dividia-se em momentos com a família e as atividades fora do lar. Os pais precisaram assumir muitas atividades para preencher o tempo dos seus filhos e isso pode ter impactado de forma negativa na vida delesA estabilidade familiar diz respeito aos momentos em que a família costuma estar reunida. Nesse âmbito, houve uma relação positiva, tendo em vista que, à medida que a família ficava mais tempo reunida, o saber sobre as medidas de prevenção aumentava, pois havia uma dedicação de mais tempo para tal explicação e que se caso esses momentos fossem menores, talvez o saber sobre as medidas de prevenção seria mais resumido, pouco explicados.Outro limite desta pesquisa diz respeito aos demais aspectos relevantes relacionados à aprendizagem, como leitura, escrita e compreensão de texto. Apesar de importantes, não foram escopo deste estudo e devem ser levados em consideração nesse contexto de retorno às aulas presenciais.Diante das reflexões apresentadas, as mudanças impostas pelo distanciamento social no período de combate à pandemia da COVID-19 atingiram diferentes esferas nas famílias acompanhadas neste estudo durante o período de junho de 2020 a dezembro de 2020. Houve uma implicação negativa na mudança de rotina e um impacto causado na vida dos pais, pois, com a suspensão das aulas presenciais e das atividades extracurriculares, eles precisaram desempenhar novas funções. De forma positiva, observou-se uma melhora na relação família-escola, que deve ser ainda mais explorada no momento pós-pandemia.As mudanças na rotina também foram observadas, de forma negativa, por meio do SDQ-Por, gerando instabilidades na saúde mental das crianças.Propomos que crianças em fase escolar sejam acompanhadas, avaliadas e tenham oportunidade de intervenção multiprofissional precocemente, pois, apesar de apresentarmos uma amostra menos representativa, o estudo nos mostra a realidade de 19 famílias com fatores negativos que serão refletidos no desenvolvimento escolar dessas crianças. Este estudo aponta como limitação a descrição dos relatórios evolutivos dos professores sobre a aprendizagem escolar, uma vez que um pouco mais de 60% da amostra está sem informação nesse quesito. Sugerimos, para pesquisas futuras, uma coleta com amostra mais representativa e uma comparação com crianças de outros anos escolares. Também sugerimos associar a avaliação dos questionários com o desempenho de leitura em escolares de diferentes níveis socioeconômicos.