Alessandra Bombarda Müller

Associations of biological factors and affordances in the home with infant motor development

Whereas considerable work has been published regarding biological factors associated with infant health, much less is known about the associations of environmental context with infant development – the focus of the present cross‐sectional study.

Affordances in the home environment for motor development: Validity and reliability for the use in daycare setting

The range of stimuli provided by physical space, toys and care practices contributes to the motor, cognitive and social development of children. However, assessing the quality of child education environments is a challenge, and can be considered a health promotion initiative. This study investigated the validity of the criterion, content, construct and reliability of the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), version 3-18 months, for the use in daycare settings. Content validation was conducted with the participation of seven motor development and health care experts; and, face validity by 20 specialists in health and education. The results indicate the suitability of the adapted AHEMD-IS, evidencing its validity for the daycare setting a potential tool to assess the opportunities that the collective context offers to child development.

Motor development in the hospitalized infant and its biological and environmental characteristics

Introduction: Hospitalization is a risk factor for delayed motor development, due to the lack of adequate stimulation; therefore, it is important to assess child development during hospital admission. Methods: In this study, motor development of previously healthy hospitalized infants was assessed and associated with biological and environmental characteristics, including length of hospital stay and physiotherapeutic treatment. The assessment was made before discharge, with questionnaires and a motor assessment scale. Results: The sample of 32 infants aged from zero to 18 months had an average length of hospital stay of 4.94±2.39 days. 50% of infants were girls (n = 16) and mostly belonged to socioeconomic class C (n = 16). Length of hospital stay explained only 3.3% of motor development variation, showing no significant impact. Infants from lower socioeconomic classes were nearly six times more susceptible to motor delays than those belonging to higher classes (p = 0.05). During hospitalization, 25% of the sample (n = 8) was treated with physiotherapy. All these patients were hospitalized for respiratory dysfunction and presented five times less chance of altered motor development when compared to those who did not undergo physiotherapy. Conclusion: These results should be interpreted with caution, since the type of physiotherapy care provided and infant’s degree of motor impairment were unknown. In this study, length of stay and hospital environment were not significant risk factors when analyzed individually, concluding that the greater the exposure and the amount of associated factors, the more susceptible the infant will be to present motor delays. Keywords: Child development; hospitalization; developmental disabilities

Desenvolvimento motor, cognição e linguagem em lactentes que frequentam creches

AIMS: To evaluate the acquisition of motor milestones in the first two years of life and the relationship between gross motor function and manipulation, cognition and language in infants who attend day care centers. METHODS: Cross-sectional study with a non-probabilistic sample of infants attending public and private day care centers in a city in southern Brazil. The Alberta Infant Motor Scale and the Bayley Scales of Infant and Toddler Development were used to assess the motor performance of each child. Descriptive statistics were used for the characterization of the sample and simple linear regression in three different age groups (group 1: between six and nine months; group 2: between 10 and 12 months; group 3: between 13 and 16 months) for the analysis of relationships between the variables gross and fine motor skills, cognition and language. RESULTS: We studied 63 infants between six and 16 months of age who did not present statistically significant differences in their biological and sociodemographic characteristics when the three stratified groups were compared. Most children did not acquire the developmental milestones in the period expected for their age group. There was correlation between the developmental scores, and the gross motor function was able to explain a large part of the variability in the fine motor function, cognition and language scores (R 2 ajust>0.5) over the first two years of life. CONCLUSIONS: The evaluated motor skills occurred generally late in the sample. The delay in the acquisition of gross motor milestones had an impact on the overall developmental skills, corroborating the influence of gross motor function in the other domains of development.

Impact of compensatory intervention in 6- to 18-month-old babies at risk of motor development delays

ABSTRACT Purpose: Research indicates that delayed motor development observed in the first years of life can be prevented through compensatory intervention programmes that provide proper care during this critical period of child development. Method: This study analysed the impact of a 12-week compensatory motor intervention programme on 32 babies with atypical motor development, characterising and correlating risk factors for developmental delays between the ages of 6 and 8 months. We conducted play activities that involved muscle stretching, improving muscle tone, sight and sound tracking, posture control in different situations, handling objects and movement. The aim was to allow babies to experience new movement situations and overcome challenges. Results: The results showed significant improvements in motor performance, reinforcing the positive effects of a contextualised approach that addresses the needs of developing children, as opposed to focusing solely on acquiring specific skills in early childhood.

Physical therapy in avoidable hospitalizations for primary care-sensitive conditions

Avoidable hospitalizations for primary care-sensitive conditions have been used as indicators of access to timely and appropriate care because hospital admissions for many conditions could be prevented by interventions in primary care. Physical therapists play an important role in health promotion, disease prevention, and the pursuit of fairness and improvements in the effectiveness of health care services, which are the goals of the public policies proposed by the Brazilian unified health care system. We used MEDLINE and SciELO to search the literature for articles concerning the association between physical therapy and the reduction of avoidable hospitalizations for primary care-sensitive conditions. The literature on the topic is still in its infancy and confined to relatively few studies. Although the available literature associates access to quality primary care with reduced hospitalizations for primary care-sensitive conditions, there is a need for original studies investigating whether there is an association between physical therapy and decreased hospital admissions for primary care-sensitive conditions.