Written Language Learning Research Articles

Expanding vocabulary and sight word growth through guided play in a pre-primary classroom

Background: This article is based on a study that aimed at finding out how pre-primary teachers integrate directed play into literacy teaching and learning. Play is a platform through which young children acquire language. Aim: This study uses an action research approach to understand how guided play benefits incidental reading and expands vocabulary growth in a Chinese Grade K classroom. Method: Data collection involved classroom observations, document analysis, informal and focus group discussions. Results: The results revealed the key benefits of play-based learning for sight word or incidental reading and vocabulary development. These are: (1) teacher oral and written language learning, (2) learners’ classroom engagement is promoted, (3) learners were actively engaged in learning of orthographic features of words, (4) learners practised recognising the visual or grapho-phonemic structure of words, (5) teacher paced teaching and (6) teacher assesses miscues and (7) keep record of word recognition skills. Conclusion: In the light of the evidence, it is recommended that the English Second Language (ESL) curriculum for pre-service teachers integrate curricular objectives that promote practising playful learning strategies to prepare teachers for practice.

Synesthesia in children with difficulties in written language learning.

We tested whether the acquisition of grapheme-color synesthesia during childhood is related to difficulties in written language learning by measuring whether it is more frequent in 79 children receiving speech and language therapy for such difficulties than in the general population of children (1.3%). By using criteria as similar as possible to those used in the reference study (Simner et al., 2009), we did not identify any synesthete (Bayesian 95% credible interval [0, 4.5]% for a flat prior). The odds of the null model (no difference between 0/79 and 1.3%) over alternative models is 28 (Bayes Factor). A higher prevalence of grapheme-color synesthetes among children with learning difficulties is therefore very unlikely, questioning the hypothesis of a link between synesthesia and difficulties in language acquisition. We also describe the difficulty of diagnosing synesthesia in children and discuss the need for new approaches to do so.

Spelling error analysis of written summaries in an academic register by students with specific learning disabilities: phonological, orthographic, and morphological influences

Students in grades 5–9 (N = 29) with specific learning disabilities (SLDs) (dysgraphia, dyslexia, or oral and written language learning disability, OWL LD) were asked to take notes and handwrite or type summaries of social studies texts about world geography and cultures that they read or heard. This activity required activating knowledge of academic language for the disciplinary content. Fine-grained analyses of their spelling errors focused on the phonological, orthographic and morphological aspects of word spelling affected while writing in an academic register. Nonparametric statistical analyses revealed no significant differences attributable to SLD diagnosis or combinations of the mode of the source text (reading or listening) and transcription (handwriting with stylus or typing with keyboard). Students generated similar degrees of error complexity in their spelling errors when writing in this disciplinary academic register regardless of the nature of their SLD, mode of presentation of source texts, or mode of transcription. Three types of common misspelling patterns across SLDs, mode of presentation, and mode of transcription are described in this exploratory study. Instructional applications for teaching students with SLDs to spell words in English, a morphophonemic orthography, when composing in an academic register are discussed as well as proposed future research directions.

Case studies comparing learning profiles and response to instruction in Autism Spectrum Disorder and Oral and Written Language Learning Disability at transition to high school.

This study investigated literacy learning in students with specific kinds of language challenges at a specific stage of schooling—transition to high school—when the language requirements of the curriculum can be especially challenging. For this exploratory research, a case study approach was adopted that compared 2 adolescent boys both with language learning problems but with 2 contrasting disabilities—autism spectrum disorder (ASD) versus oral and written language learning disability (OWL LD)—just before entry to ninth grade. Three research aims compared participants on (a) learning profiles assessed via a comprehensive psychoeducational assessment battery, (b) change in their learning profiles based on response to instruction to a computerized intervention, and (c) change in their personal narrative compositions and use of taught translation strategies collected during 6 lessons of the computerized intervention. Results indicated that participants demonstrated variable psychoeducational profiles and response to instruction that highlighted similar yet distinct patterns of strengths and weaknesses. Personal narrative writing samples showed that participants demonstrated distinct challenges, but only the participant with ASD showed no response to instruction and produced predominantly off-topic text. Results are discussed in reference to educational applications and future research design implications to understand the writing challenges experienced by children with ASD in reference to children with OWL LD or other specific learning disabilities.

Brain's functional network clustering coefficient changes in response to instruction (RTI) in students with and without reading disabilities: Multi-leveled reading brain's RTI.

In students in grades 4 to 9 (22 males, 20 females), two reading disability groups—dyslexia (n = 20) or oral and written language learning disability (OWL LD) (n = 6)—were compared to each other and two kinds of control groups—typical readers (n = 6) or dysgraphia (n = 10) on word reading/spelling skills and fMRI imaging before and after completing 18 computerized reading lessons. Mixed ANOVAs showed significant time effects on repeated measures within participants and between groups effects on three behavioral markers of reading disabilities—word reading/spelling: All groups improved on the three behavioral measures, but those without disabilities remained higher than those with reading disabilities. On fMRI reading tasks, analyzed for graph theory derived clustering coefficients within a neural network involved in cognitive control functions, on a word level task the time × group interaction was significant in right medial cingulate; on a syntax level task the time × group interaction was significant in left superior frontal and left inferior frontal gyri; and on a multi-sentence text level task the time × group interaction was significant in right middle frontal gyrus. Three white matter-gray matter correlations became significant only after reading instruction: axial diffusivity in left superior frontal region with right inferior frontal gyrus during word reading judgments; mean diffusivity in left superior corona radiata with left middle frontal gyrus during sentence reading judgments; and mean diffusivity in left anterior corona radiata with right middle frontal gyrus during multi-sentence reading judgments. Significance of results for behavioral and brain response to reading instruction (RTI) is discussed.

Movement Issues Identified in Movement ABC2 Checklist Parent Ratings for Students with Persisting Dysgraphia, Dyslexia, and OWL LD and Typical Literacy Learners.

Movement, which draws on motor skills and executive functions for managing them, plays an important role in literacy learning (e.g., movement of mouth during oral reading and movement of hand and fingers during writing); but relatively little research has focused on movement skills in students with specific learning disabilities as the current study did. Parents completed normed Movement Assessment Battery for Children Checklist, 2nd edition (ABC-2), ratings and their children in grades 4 to 9 (M = 11 years, 11 months; 94 boys, 61 girls) completed diagnostic assessment used to assign them to diagnostic groups: control typical language learning (N = 42), dysgraphia (impaired handwriting) (N = 29), dyslexia (impaired word decoding/reading and spelling) (N = 65), or oral and written language learning disability (OWL LD) (impaired syntax in oral and written language) (N = 19). The research aims were to (a) correlate the Movement ABC-2 parent ratings for Scale A Static/Predictable Environment (15 items) and Scale B Dynamic/Unpredictable Environment (15 items) with reading and writing achievement in total sample varying within and across different skills; and (b) compare each specific learning disability group with the control group on Movement ABC-2 parent ratings for Scale A, Scale B, and Scale C Movement-Related (Non-Motor Executive Functions, or Self-Efficacy, or Affect) (13 items). At least one Movement ABC-2 parent rating was correlated with each assessed literacy achievement skill. Each of three specific learning disability groups differed from the control group on two Scale A (static/predictable environment) items (fastens buttons and forms letters with pencil or pen) and on three Scale C items (distractibility, overactive, and underestimates own ability); but only OWL LD differed from control on Scale B (dynamic/unpredictable environment) items. Applications of findings to assessment and instruction for students ascertained for and diagnosed with persisting specific learning disabilities in literacy learning, and future research directions are discussed.

Emotional and Behavioral Correlates of Persisting Specific Learning Disabilities in Written Language during Middle Childhood and Early Adolescence.

Parents completed the Behavior Assessment System for Children-Second Edition Parent Report Scale (BASC2-PRS) while their children (94 boys, 61 girls; M=11 years-11 months) were given tests. Evidence-based profiles of multiple test scores and history (emergence and persistence) were used to assign to groups without specific learning disabilities in written language (SLDs-WL) (n= 42 control) or with SLDs-WL: (n=29 dysgraphia, n=65 dyslexia, or n=19 oral and written language learning disability [OWL LD]). Parent ratings fell in the clinical or at risk ranges for some individuals in all groups, but mean BASC2-PRS ratings showed nine significant main effects for group (n=4): Behavioral Symptoms Index, Internalizing Problems Composite, Adaptive Skills Composite, two Clinical Scales (Atypicality and Attention Problems), and four Adaptive Scales (Adaptability, Activities of Daily Living, Leadership, and Functional Communication). Each SLDs-WL group differed significantly from the control group on these nine ratings, except dysgraphia on Atypicality and dyslexia on Adaptive Composite, Adaptability, and Leadership; and each correlated with one or more hallmark impairments associated with a specific SLD-WL. In an fMRI study (without OWL LD), the dysgraphia and dyslexia groups, but not control group, showed connectivity with amygdala; BASC2 PRS Internalizing Problems Composite (internal stress) correlated with amygdala connectivity from two cortical regions involved in written word processing and production for all groups (N=40). Applications to assessing emotional and behavioral correlates of SLDs-WL for educational services and future research are discussed.

Sequential Prediction of Literacy Achievement for Specific Learning Disabilities Contrasting in Impaired Levels of Language in Grades 4 to 9

Sequential regression was used to evaluate whether language-related working memory components uniquely predict reading and writing achievement beyond cognitive-linguistic translation for students in Grades 4 through 9 (N = 103) with specific learning disabilities (SLDs) in subword handwriting (dysgraphia, n = 25), word reading and spelling (dyslexia, n = 60), or oral and written language (oral and written language learning disabilities, n = 18). That is, SLDs are defined on the basis of cascading level of language impairment (subword, word, and syntax/text). A five-block regression model sequentially predicted literacy achievement from cognitive-linguistic translation (Block 1); working memory components for word-form coding (Block 2), phonological and orthographic loops (Block 3), and supervisory focused or switching attention (Block 4); and SLD groups (Block 5). Results showed that cognitive-linguistic translation explained an average of 27% and 15% of the variance in reading and writing achievement, respectively, but working memory components explained an additional 39% and 27% of variance. Orthographic word-form coding uniquely predicted nearly every measure, whereas attention switching uniquely predicted only reading. Finally, differences in reading and writing persisted between dyslexia and dysgraphia, with dysgraphia higher, even after controlling for Block 1 to 4 predictors. Differences in literacy achievement between students with dyslexia and oral and written language learning disabilities were largely explained by the Block 1 predictors. Applications to identifying and teaching students with these SLDs are discussed.

Potenziare l’abilità di consapevolezza fonologica: uno studio preliminare sull’efficacia di un percorso educativo attraverso l’utilizzo di tecnologie specifiche

Reading-writing learning is the result of the interaction between individual cognitive maturation and standard and informal educational experiences solicited by the environment. A relationship between phonologic awareness and reading-writing learning has been hypothesized; thus, it is important studying the development of the meta-phonologic abilities on nursery school children, to facilitate written language learning in the following primary school. The present study aimed at verifying the effectiveness of a phonological awareness abilities enhancing, by means of a structured software («En Plain») which allows training meta-phonological abilities by means of virtual reality. Within a first group of 32 aged 5 children, 20 of them, who showed higher phonological awareness difficulties, have been selected. Half of them (Experimental Group, EG) was submitted to the experimental training by means of «En Plein», while the others (Control Group, CG) were submitted to the standard educational activities. Data analysis revealed that, despite a significant improvement in both groups, only EG children showed higher levels of improvement, likely due to the specific structure of the educational training (explicit work on the meta-phonological abilities), as well as to the technology which improved children’s attention, facilitating learning process. Data suggested the usefulness of including a wider sample, to detect meta-phonological abilities learning critical issues at the beginning of schooling process, as well as prescribing specific empowering training of such abilities to reduce difficulties before structure the reading-writing learning process.

Brain connectivity associated with cascading levels of language.

Typical oral and written language learners (controls) (5 girls, 4 boys) completed fMRI reading judgment tasks (sub-word grapheme-phoneme, word spelling, sentences with and without spelling foils, affixed words, sentences with and without affix foils, and multi-sentence). Analyses identified connectivity within and across adjacent levels (units) of language in reading: from subword to word to syntax in Set I and from word to syntax to multi-sentence in Set II). Typicals were compared to (a) students with dyslexia (6 girls, 10 boys) on the subword and word tasks in Set I related to levels of language impaired in dyslexia, and (b) students with oral and written language learning disability (OWL LD) (3 girls, 2 boys) on the morphology and syntax tasks in Set II, related to levels of language impaired in OWL LD. Results for typical language learners showed that adjacent levels of language in the reading brain share common and unique connectivity. The dyslexia group showed over-connectivity to a greater degree on the imaging tasks related to their levels of language impairments than the OWL LD group who showed under-connectivity to a greater degree than did the dyslexia group on the imaging tasks related to their levels of language impairment. Results for these students in grades 4 to 9 (ages 9 to 14) are discussed in reference to the contribution of patterns of connectivity across levels of language to understanding the nature of persisting dyslexia and dysgraphia despite early intervention.

Computerized Writing and Reading Instruction for Students in Grades 4 to 9 With Specific Learning Disabilities Affecting Written Language.

Computer scientists and educational researchers evaluated effectiveness of computerized instruction tailored to evidence-based impairments in specific learning disabilities (SLDs) in students in grades 4 to 9 with persisting SLDs despite prior extra help. Following comprehensive, evidence-based differential diagnosis for dysgraphia (impaired handwriting), dyslexia (impaired word reading and spelling), and oral and written language learning disability (OWL LD), students completed 18 sessions of computerized instruction over about 3 months. The 11 students taught letter formation with sequential, numbered, colored arrow cues with full contours who wrote letters on lines added to iPAD screen showed more and stronger treatment effects than the 21 students taught using only visual motion cues for letter formation who wrote on an unlined computer monitor. Teaching to all levels of language in multiple functional language systems (by ear, eye, mouth, and hand) close in time resulted in significant gains in reading and writing skills for the group and in diagnosed SLD hallmark impairments for individuals; also, performance on computerized learning activities correlated with treatment gains. Results are discussed in reference to need for both accommodations and explicit instruction for persisting SLDs and the potential for computers to teach handwriting, morphophonemic orthographies, comprehension, and composition.

The knowledge and perceptions of prospective teachers and speech language therapists in collaborative language and literacy instruction

Successful collaboration among speech and language therapists (SLTs) and teachers fosters the creation of communication friendly classrooms that maximize children’s spoken and written language learning. However, these groups of professionals may have insufficient opportunity in their professional study to develop the shared knowledge, perceptions and attitudes required for effective collaboration. This study examined the knowledge and perceptions of student teachers and student SLTs in the areas of language concepts, junior school literacy curriculum, service delivery and professional collaboration. An online survey was completed by 58 student primary school teachers and 37 student SLTs in their final year of professional study. The results indicated that these groups possessed limited understanding of each other’s expertise in literacy curriculum and spoken language concepts. Both groups demonstrated minimal knowledge of spoken–written language relationships and how SLTs can assist to develop children’s orthographic knowledge. Participants demonstrated acceptance of indirect methods of classroom-based service delivery (e.g. SLT acting as a consultant) but were less accepting of direct methods of classroom-based service delivery (e.g. shared teaching). Both groups also reported minimal experience with SLT–teacher collaboration during their pre-service education. The data suggest pre-service inter-professional education (IPE) with a focus on children’s early literacy learning is warranted to prepare prospective SLTs and teachers for collaborative instruction that enhances children’s communication.

Differential Diagnosis of Dysgraphia, Dyslexia, and OWL LD: Behavioral and Neuroimaging Evidence.

In Study 1, children in grades 4 to 9 (N= 88, 29 females and 59 males) with persisting reading and/or writing disabilities, despite considerable prior specialized instruction in and out of school, were given an evidence-based comprehensive assessment battery at the university while parents completed questionnaires regarding past and current history of language learning and other difficulties. Profiles (patterns) of normed measures for different levels of oral and written language used to categorize participants into diagnostic groups for dysgraphia (impaired subword handwriting) (n=26), dyslexia (impaired word spelling and reading) (n=38), or oral and written language learning disability OWL LD (impaired oral and written syntax comprehension and expression) (n=13) or control oral and written language learners (OWLs) without SLDs (n=11) were consistent withreported history. Impairments in working memory components supporting language learning were also examined. In Study 2, right handed children from Study 1 who did not wear braces (controls, n=9, dysgraphia, n= 14; dyslexia, n=17, OWL LD, n=5) completed an fMRI functional connectivity brain imaging study in which they performed a word-specific spelling judgment task, which is related to both word reading and spelling, and may be impaired in dysgraphia, dyslexia, and OWL LD for different reasons. fMRI functional connectivity from 4 seed points in brain locations involved in written word processing to other brain regions also differentiated dysgraphia, dyslexia, and OWL LD; both specific regions to which connected and overall number of functional connections differed. Thus, results provide converging neurological and behavioral evidence, for dysgraphia, dyslexia, and OWL LD being different, diagnosable specific learning disabilities (SLDs) for persisting written language problems during middle childhood and early adolescence. Translation of the research findings into practice at policy and administrative levels and at local school levels is discussed.

A reversed-typicality effect in pictures but not in written words in deaf and hard of hearing adolescents.

Two experiments investigated Chinese deaf and hard of hearing (DHH) adolescents' recognition of category names in an innovative task of semantic categorization. In each trial, the category-name target appeared briefly at the screen center followed by two words or two pictures for two basic-level exemplars of high or middle typicality, which appeared briefly approximately where the target had appeared. Participants' reaction times when they were deciding whether the target referred to living or nonliving things consistently revealed the typicality effect for the word, but a reversed-typicality effect for picture-presented exemplars. It was found that in automatically processing a category name, DHH adolescents with natural sign language as their first language evidently activate two sets of exemplar representations: those for middle-typicality exemplars, which they develop in interactions with the physical world and in sign language uses; and those in written-language learning.

Modes of Alphabet Letter Production during Middle Childhood and Adolescence: Interrelationships with Each Other and Other Writing Skills.

Although handwriting is typically taught during early childhood and keyboarding may not be taught explicitly, both may be relevant to writing development in the later grades. Thus, Study 1 investigated automatic production of the ordered alphabet from memory for manuscript (unjoined), cursive (joined), and keyboard letter modes (alphabet 15 sec) and their relationships with each other and spelling and composing in typically developing writers in grades 4 to 7 (N = 113). Study 2 compared students with dysgraphia (impaired handwriting, n=27), dyslexia (impaired word spelling, n=40), or oral and written language learning disability (OWL LD) (impaired syntax composing, n=11) or controls without specific writing disabilities (n=10) in grades 4 to 9 (N=88) on the same alphabet 15 modes, manner of copying (best or fast), spelling, and sentence composing. In Study 1, sequential multilevel model regressions of predictor alphabet 15 letter production/selection modes on spelling and composition outcomes, measured annually from grade 4 to grade 7 (ages 9 to 13 years), showed that only the cursive mode uniquely, positively, and consistently predicted both spelling and composing in each grade. For composing, in grade 4 manuscript mode was positively predictive and in grades 5-7 keyboard selection was. In Study 2 all letter production modes correlated with each other and one's best and fast sentence copying, spelling, and timed sentence composing. The groups with specific writing disabilities differed from control group on alphabet 15 manuscript mode, copy fast, and timed sentence composing. The dysgraphia and dyslexia groups differed on copying sentences in one's best handwriting, with the dysgraphia group scoring lower. The educational and theoretical significance of the findings are discussed for multiple modes and manners of letter production/selection of the alphabet that support spelling and composing beyond the early grades in students with and without specific writing disabilities.

Working Memory abilities, attachment relationships and learning process in children of primary school age: an empirical research

Several studies underline a definite link between “working memory” (WM) and the learning process (deficit and learning disorder in children). WM abi-lities mainly affect written language learning and arithmetic learning. According to studies related to the Attachment Theory, it is possible to rationalize that child with a secure attachment to the caregiver and/or to the teacher have higher skills in school adaptability. In this study—based on previous pilot study (Del Villano, Ce-cere, Sapuppo, & Caviglia., 2011)—the relationship between: cognitive test (WM measurement test), learning test and the student’s attachment style (both with his caregivers and his teacher) have been empirically evaluated. This pilot study was performed in several of the primary schools in Campania Italy between 2009 and 2011. The selected sample was composed of 80 children 6-7 years old (38 Female and 42 Male) who, after parental and school consent, were tested by the tools de-scribed in the main body of this research paper. The pilot study shows an absence of linguistic deficit, and a relationship between cognitive abilities and the learning le-vel achieved in reading and mathematical calculation, furthermore it has shown a modulation effect of the attachment on the relationship between the WM ability and MT calculation and reading tests. This modulation effect is more evident if we consider the unsecure or disorganized attachment, especially if we consider the data accumulated with reference to the attachment to the teacher. Our research was conducted with the sole intention to widen the sample and make the outcomes more valid and reliable. The recruited sample was composed of 130 children age 6-7 who, after parenentalt and school consent, were tested with the TVL -Linguistic As-sessment Test , the short version of AWMA (Automated Working Memory As-sessment), the SAT-Separation Anxiety Test, both family and school versions, and the Reading Trials MT -AC-MT 6-11- Calculation Ability Assessment Test. The re-sults underline the absence of deficit or malfunctions in the subjects’ linguistic de-velopment, a significant connection between the learning performances and the verbal and visual-spatial trials assessed with the AWMA, and a moderating effect of the attachment style upon the connection itself.

Computer instruction in handwriting, spelling, and composing for students with specific learning disabilities in grades 4–9

Effectiveness of iPad computerized writing instruction was evaluated for 4th–9th graders (n = 35) with diagnosed specific learning disabilities (SLDs) affecting writing: dysgraphia (impaired handwriting), dyslexia (impaired spelling), and oral and written language learning disability (OWL LD) (impaired syntax composing). Each of the 18 two-hour lessons had multiple learning activities aimed at improving subword- (handwriting), word- (spelling), and syntax- (sentence composing) level language skills by engaging all four language systems (listening, speaking, reading, and writing) to create a functional writing system. To evaluate treatment effectiveness, normed measures of handwriting, spelling, and composing were used with the exception of one non-normed alphabet writing task. Results showed that the sample as a whole improved significantly from pretest to posttest in three handwriting measures, four spelling measures, and both written and oral syntax construction measures. All but oral syntax was evaluated with pen and paper tasks, showing that the computer writing instruction transferred to better writing with pen and paper. Performance on learning activities during instruction correlated with writing outcomes; and individual students tended to improve in the impaired skill associated with their diagnosis. Thus, although computers are often used in upper elementary school and middle school in the United States (US) for accommodations (alternatives to pen and paper) for students with persisting SLDs affecting writing, this study shows computers can also be used for Tier 3 instruction to improve the writing skills of students in grades 4–9 with history of persisting writing disabilities.

Cognitive aspect of written language learning for Master students of technical university

The issue of cognitive learning of foreign language activities is one of the actual problems of modern methods of foreign language teaching. The article discusses the concept of cognition and peculiarities of cognitive processes in writing skills teaching of technical university Master students, as well as the possibility of formation a professional and personal competencies in the process of perception and generation of writing.

Predicting risk for oral and written language learning difficulties in students educated in a second language

ABSTRACTThe extent to which risk for French as a second language (L2) reading and language learning impairment are distinct and can be predicted using first language (L1) predictors was examined in English-speaking students in total French immersion programs. A total of 86 children were tested in fall of kindergarten, spring kindergarten, and spring Grade 1 using an extensive battery of L1 predictor tests (in kindergarten) and L2 outcome tests (in Grade 1). Analyses of the kindergarten predictor scores revealed distinct underlying components, one related to reading and one to oral language. Further analyses revealed that phonological awareness, phonological access, and letter-sound knowledge in L1 were significant predictors of risk for reading difficulties in L2 while performance on L1 sentence repetition, phonological awareness, and tense marking tests in kindergarten were the best predictors of risk for L1 and L2 oral language difficulties. Both fall- and spring-kindergarten predictors predicted Grade 1 outcomes to a significant extent, with the spring-kindergarten predictors being more accurate. These results provide support for distinctive risk profiles for L2 oral language and reading difficulty and, furthermore, argue that assessment of L1 abilities can be used to make reasonably accurate predictions of later reading and/or oral language learning difficulties in L2 students.

El texto narrativo en la clínica psicoanalítica del síntoma de aprendizaje del lenguaje: un análisis estructural

<p style="text-align: justify;"><strong>Resumen</strong><br /> Este artículo presenta datos de uno de los estudios desarrollados en la tesis doctoral "El texto narrativo como intervención terapéutica en problemas del lenguaje escrito en la adolescencia: el análisis estructural del texto narrativo producido en psicoterapia de orientación psicoanalítica". Se demuestra a partir de este análisis la posibilidad de utilizar el texto narrativo como instrumento de intervención y medida de resultados en investigación en psicoterapia en la clínica del adolescente que trata síntomas en el aprendizaje del lenguaje escrito.</p><p style="text-align: justify;"><strong>Palabras clave:</strong> análisis estructural, narrativa, psicoterapia de orientación psicoanalítica.</p>