title: Deficits in working memory, reading comprehension and arithmetic skills in children with mouth breathing syndrome: analytical cross-sectional study.
abstract: OBJECTIVE
  Mouth breathing syndrome is very common among school-age children, and it is possibly related to learning difficulties and low academic achievement. In this study, we investigated working memory, reading comprehension and arithmetic skills in children with nasal and mouth breathing.
  
  
  METHODS
  Analytical cross-sectional study with control group conducted in a public university hospital.
  
  
  METHODS
  42 children (mean age = 8.7 years) who had been identified as mouth breathers were compared with a control group (mean age = 8.4 years) matched for age and schooling. All the participants underwent a clinical interview, tone audiometry, otorhinolaryngological evaluation and cognitive assessment of phonological working memory (numbers and pseudowords), reading comprehension and arithmetic skills.
  
  
  RESULTS
  Children with mouth breathing had poorer performance than controls, regarding reading comprehension (P = 0.006), arithmetic (P = 0.025) and working memory for pseudowords (P = 0.002), but not for numbers (P = 0.76).
  
  
  CONCLUSIONS
  Children with mouth breathing have low academic achievement and poorer phonological working memory than controls. Teachers and healthcare professionals should be aware of the association of mouth breathing with children's physical and cognitive health.
authors.affiliation: Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil.
authors.forename: Rita Cristina Sadako
authors.initials: RC
authors.lastname: Kuroishi
authors.affiliation: Department of Psychology, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (FFCLRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil.
authors.forename: Ricardo Basso
authors.initials: RB
authors.lastname: Garcia
authors.affiliation: Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil.
authors.forename: Fabiana Cardoso Pereira
authors.initials: FC
authors.lastname: Valera
authors.affiliation: Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil.
authors.forename: Wilma Terezinha
authors.initials: WT
authors.lastname: Anselmo-Lima
authors.affiliation: Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil.
authors.forename: Marisa Tomoe Hebihara
authors.initials: MT
authors.lastname: Fukuda
mesh_terms: D001301:Audiometry, Pure-Tone; D016022:Case-Control Studies; D002648:Child; D003072:Cognition Disorders / Q000503:physiopathology*; D032882:Comprehension / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008433:Mathematics; D008570:Memory, Short-Term / Q000502:physiology*; D009058:Mouth Breathing / Q000503:physiopathology*; D011932:Reading; D013577:Syndrome; D014477:Underachievement