Ana Amélia Cardoso

Bilateral coordination and motor sequencing in Brazilian children: preliminary construct validity and reliability analysis

This study examined aspects of reliability and validity of the bilateral coordination and motor sequencing items of the Assessment of Motor Coordination and Dexterity (AMCD) for Brazilian children ages 4, 6 and 8 years old. The AMCD aims to identify children with developmental coordination disorder (DCD). A total of 84 children were evaluated. Among the 35 items piloted, all but one presented interrater reliability above 0.80 and 16 (45.7%) items presented intraclass correlation coefficient over 0.60 for test-retest reliability. Most items were sensitive to age difference and only items involving ball handling exhibited significant gender differences. As a result, this section of the AMCD could be reduced to the 20 items that were found to be reliable and more discriminative for age-related differences. This study advances on the development of the AMCD, but a limitation was the noninclusion of children with DCD. Future research should investigate whether the selected items are useful in differentiating the motor skills of children with and without coordination problems.

Validade preditiva do movement assessment of infants para crianças pré-termo brasileiras

The predictive validity of the Movement Assessment of Infants (MAI) for the detection of cerebral palsy was analyzed in 89 Brazilian infants, born with gestational age 13 and > 10. The best predictive values were obtained at 8 months, with a cut off > 13 risk points. A less restrictive criteria (> 10 points) might be useful for the prediction of motor coordination problems at school age.

Relação entre a Avaliação da Coordenação e Destreza Motora (Acoordem) e a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF)

INTRODUCTION: The International Classification of Functioning, Disability and Health (ICF) aims to provide a scientific basis for the comprehension and the study of health and its related conditions, and as such it can be used to guide the creation and utilization of outcome measures. The Motor Coordination and Dexterity Assessment (MCDA) is a Brazilian assessment tool that was designed to detect motor delay in 4 to 8 years old children. Objectives: The aims of this study were: a) to link the CIF sub domains with the MCDA items and b) determine if the MCDA items fit with the ICF framework. MATERIALS AND METHODS: One occupational therapist and one physical therapist coded, independently, the MCDA items, conducting the linking with the ICF. Whenever there was no agreement between the researchers, the opinion of other two researchers, one occupational therapist and one physical therapist, was used. RESULTS: The MCDA items were linked to the components b (body functions), d (activities and participation), e (environmental factors), and f (personal factors). DISCUSSION AND CONCLUSION: The MCDA items could be linked with the ICF framework. Professionals and researchers in the rehabilitation field can use the MCDA to get data about activities and participation of children with motor coordination problems, because the MCDA terminology and scope are in accordance with WHO’s biopsychosocial perspective.

How Can We Make Our Assessment of Motor AbilityRelevant Cross-Culturally?

The assessment of motor abilities is important to identify atypical development, to measure progress obtained with intervention, and for research. Motor assessment usually is based on the use of standardized tests, on which children are expected to perform specific tasks that are deemed common. As the majority of the motor development tests were created by researchers from European and North American countries, concepts from these cultures are embedded in the tasks, materials, and format of the instruments. This raises the question as to whether these instruments can be used internationally, with the perhaps misguided assumption that motor skill development is the same across different countries. Is it necessary to adapt standardized motor ability tests for cross-cultural use? This paper discusses the relationship between culture and motor development and points out some aspects that should be considered to make our assessment of motor ability more relevant cross-culturally.

Motor Skills in Brazilian Children with Developmental Coordination Disorder versus Children with Motor Typical Development

The aims of the study were to compare the performance of children with probable developmental coordination disorder (DCD) and motor typically developing peers on items from the Assessment of Motor Coordination and Dexterity (AMCD), to determine whether age, gender and type of school had significant impact on the scores of the AMCD items, to estimate the frequency of DCD among Brazilian children ages 7 and 8 years and to investigate whether children with DCD exhibit more symptoms of attention deficit and hyperactivity disorder than children with motor typical development. A total of 793 children were screened by the Developmental Coordination Disorder Questionnaire - Brazilian version (DCDQ-Brazil); 90 were identified as at risk for DCD; 91 matched controls were selected from the remaining participants. Children in both groups were evaluated with the AMCD, the Movement Assessment Battery for Children (MABC-II) and Ravens coloured progressive matrices. Thirty-four children were classified as probable DCD, as defined by a combination of the DCDQ-Brazil and MABC-II scores (fifth percentile). The final frequency of DCD among children ages 7 and 8 years was 4.3%. There were significant differences between children with and without DCD on the majority of AMCD items, indicating its potential for identifying DCD in Brazilian children. The use of a motor test (MABC-II) that is not validated for the Brazilian children is a limitation of the present study. Further studies should investigate whether the AMCD is useful for identifying DCD in other age groups and in children from different regions of Brazil. The application of the AMCD may potentially contribute in improving occupational therapy practice in Brazil and in identifying children that could benefit from occupational therapy services.

Efficacy of the cognitive orientation to daily occupational performance with Brazilian children with developmental coordination disorder

Abstract Background: Children with Developmental Coordination Disorder (DCD) have difficulties performing daily activities which reflects negatively on participation, impacting their lives. Objectives: To examine the effects of the cognitive orientation to daily occupational performance Approach (CO-OP Approach) protocol on occupational performance and satisfaction of Brazilian children who have DCD; to examine whether children could transfer strategies and skills learned during CO-OP to untrained goals. Methods: A pre-post group comparison design with eight boys aged 6–10 years old. Children participated in 12 CO-OP sessions with their parents twice a week, with an extra session added to the protocol for parents´ orientation. The Canadian Occupational Performance Measure and the Performance Quality Rating Scale were used as outcome measures. The study was registered by the United States Institutes of Health at ClinicalTrials.gov (NCT03112746). Results: Intervention resulted in higher, clinically and statistically significant, occupational performance measures according to parents, children’s, and external evaluators’ perspectives. All children improved occupational performance on their selected goals and five children could transfer the ability to use cognitive strategies to tasks not addressed in therapy. Conclusions: This study provides initial directions for future research to investigate the applicability and to implement CO-OP approach on pediatric settings in Brazil. Trial registration: ClinicalTrials.gov identifier: NCT03112746.

OBSERVAÇÃO DO COMPORTAMENTO NEONATAL: ADAPTAÇÃO TRANSCULTURAL DO NEWBORN BEHAVIORAL OBSERVATIONS

ABSTRACT Objective: To conduct the cross-cultural adaptation for Brazilian Portuguese of the Newborn Behavioral Observations (NBO), a new resource for observing neonatal behavior and sharing information with parents. Methods: Methodological study of translation and cultural adaptation of the NBO system, which includes the Recording Form, with 18 items, the Recording Guidelines, with instructions to score each item, the Summary Form, to record suggestions based on the observation, and the Parent Questionnaire, to record the parents’ experiences. The adaptation process followed international recommendations for cross-cultural adaptation of health care protocols, which included requesting permission from the authors, translation, back translation and pre-test, followed by external evaluators who scored the quality of the adaptation, which was analyzed quantitatively. The quality of the adaptation of the instruments’ items was evaluated by the index of agreement between evaluators for conceptual and cultural equivalence. Results: Expert panel evaluation showed that the cross-cultural adaptation of the NBO protocols was both well understood conceptually and culturally appropriate, with 140 (77.8%) items presenting concordance index higher than 90% for conceptual and cultural equivalence. Items that did not reach adequate level of agreement were revised according to experts’ suggestions. Conclusions: The Brazilian version of the NBO system can be safely used, since the methodology was rigorous enough to ensure equivalence between the original and translated versions. The NBO should be tried in clinical practice, as it can contribute to improve the quality of maternal and child care.