Estudio epidemiológico del déficit lector en educación primaria en Uruguay

Resumen

Problem: Uruguay stands amongst the countries with most reading assessing in Latin America, both in grade and high school levels. Not withstanding, outcomes are significantly lower when compared to OCDE Interantional Assessment PISA, showing concerning results such as 48% of children in third grade (INEEd, 2018) and 42% in highschool students (OECD, 2019) with decended reading results. Purpose: to contribute with a set of valid, reliable and discriminative tests for reading déficit for Uruguay. It aims to: a) estimate the prevalence of reading déficit in private primary education; b) determine diagnostic accuracy (sensitivity and specificity) of three reading déficit scales (TECLE, TEO and TEO-P); c) determine comorbility in students with reading déficits with at least one additional difficulty in: calculation, wirtten expression, attention, coordination and behavioral and emotional difficulties related to internalizing or externalizing behavior. Method: 1820 students from a private primary school in Uruguay, enrolled from second to sixth grade consititute the sample. A gold standard was made for the present purpose, using ROC cruves for sensitivity and specificity calculation of the reading assessment tests, also determining its discriminative power. For the prevalence calculation, word and pseudoword reading (Cuetos et al., 2014); Reading Fluency (Muñoz-Sandoval, Woodcock, McGrew & Mather, 2005); TECLE (Cuadro et al., 2009); TEO (Cuadro et al., 2014) and TEO-P (Cuadro & Palombo, 2017); g Factor (Cattell & Cattell, 2009). The comorbility was calculated through the scales: Calculation fluency (Muñoz-Sandoval et al., 2005); TECA (Singer, Cuadro, Costa, & Von Hagen, 2014); d2 (Brickenkamp, 2012); CTDC (Wilson et al., 2009); SDQ (Goodman, 1997); Word dictation (Defior et al., 2006). Results: Reading difficulties prevalence was estimated (5.1%) in primary students in levels from second to sixth grade; tests used presented excellent discriminating values among students with reading déficits and standard readers, showing high both sensitivity and specific. It was determined that the diagnostic tests for reading déficit showed discrimination power in all the school levels, presenting (ABC) ≥ .90 areas under the ROC curve. The total reading deficit prevalence for second to sixth level students with an intelectual coefficent CI ≥ 85, sway between 8.9% and 5.1%. Of the 100% of the students identified with reading difficulties, 71,4% simultaneusly showed at least one possible neurodevelopmental disorder. Outstanding results showed 38% of students who shared reading difficultes and arithmetic disfluency and 58% who presented both reading difficulties and deficits in written expression. Conclusion: Reported prevalence of reading difficulties lines up with estimates in the DSM-5 as with estimates reported in transparent orthographies such as in Spain, Colombia and Germany. Different estimation methods are sensible to cutting points defined a priori. Authors such as Rutter & Yule( 1975) hold the theory of reading déficit presenting a bimodal distribution, while others hold the view of the reading déficit with a normal distribution (Elliot, 2020; Wagner et al., 2020). A posible research persuit to avoid this cutting points arbritary issue is to use the response to the intervention model as a diagnostic approach (Fletcher & Vaughn, 2009). Finally, given the high comorbility with calculation fluency and written expression, it could be understood as a shared déficit or an underlying déficit based on the phonologic déficit. Furthermore, the concurrance of the difficulties in reading, calculating and written expression, suggest considering calculating déficit and written expression difficulties as posible additional critera for predicticting reading difficulties (Joyner & Wagner, 2020).