Denise C. C. Santos

Agreement between scales for screening and diagnosis of motor development at 6 months

OBJECTIVE: To ascertain the degree of agreement between a score for screening and another for diagnosis of motor development in 6-month old infants and to define the most appropriate cutoff point for screening. METHODS: A sectional study, enrolling asymptomatic full term newborns with gestational ages from 37 to 41 weeks, who were discharged from the maternity unit 2 days after birth and are resident in the Campinas area. Infants were excluded if they presented genetic syndromes, malformations, congenital infections, intensive care admission or low birth weight. The assessment instruments investigated were the Alberta Infant Motor Scale (AIMS) and the Bayley Scales of Infant Development II (BSID-II). Two cutoff points were evaluated for the AIMS, the 5th and 10th percentiles, and for the BSID-II infants were classified according to its motor index score (IS) as having inadequate (IS 85, above the mean minus 1 standard deviation). RESULTS: The study sample comprised 43 infants. Six infants (14.00%) exhibited inadequate motor performance. Using the BSID-II motor classification and the 5th percentile AIMS cutoff, sensitivity was 100%, specificity 78.37%, accuracy 81.39%, kappa index 0.50 and p < 0.001; whereas, using the BSID-II motor classification and the 10th percentile AIMS cutoff, sensitivity was 100%, specificity 48.64%, accuracy 55.81%, kappa index 0.20 and p 0.025. CONCLUSIONS: The results suggest that concordance between the two 6-month assessment scales is good. The parameters employed are best combined using the 5th percentile AIMS cutoff point.

Desempenho motor grosso e sua associação com fatores neonatais, familiares e de exposição à creche em crianças até três anos de idade

OBJETIVO: Analisar o desempenho motor grosso e sua associacao com fatores neonatais, familiares e de exposicao a creche em criancas com ate tres anos de idade, frequentadoras de creches publicas. METODOS: Estudo transversal no qual foram avaliadas 145 criancas (58 com idade entre 6-11 meses, 54 entre 12-23 meses e 33 entre 24-38 meses) frequentadoras de seis creches publicas de Piracicaba (SP). O teste Peabody Developmental Motor Scale-2 foi utilizado para avaliacao do desempenho motor grosso global e subtestes motores que compoem a escala (Reflexos, Habilidades Estacionarias, Habilidades de Locomocao e Manipulacao de Objetos). Foram coletados dados neonatais, familiares e de exposicao a creche e pesquisada a associacao desses ao desempenho motor suspeito de atraso. RESULTADOS:A prevalencia de suspeita de atraso no desempenho motor grosso foi de 17%, com desvantagens em criancas menores de 24 meses e em Habilidades de Locomocao; encontrada associacao de risco de desempenho motor grosso suspeito de atraso e renda familiar, e suspeita de atraso em Habilidades de Locomocao e escolaridade paterna. Criancas cujas familias tinham renda mensal ate R

Family socioeconomic status and the provision of motor affordances in the home

700,00 estavam 2,81 vezes mais expostas a apresentar desempenho motor grosso suspeito de atraso. Criancas cujos pais tinham ate oito anos de escolaridade apresentaram risco 4,63 vezes maior de atraso em Habilidades de Locomocao. Nao foi encontrada associacao de risco com as demais variaveis. CONCLUSAO:Os resultados apontam maior atencao ao desenvolvimento motor durante os primeiros 24 meses de criancas que frequentam creches, especialmente as inseridas em familias com menor renda mensal e cujos pais tem menos escolaridade.

Visual-Motor Integration Problems in Low Birth Weight Infants

BACKGROUND Socioeconomic status (SES) and stimulation provided in the home environment are influential factors in aspects of child well-being including motor development. Little is known regarding the influence of SES on specific aspects of the home environment. OBJECTIVE To evaluate the availability of affordances in the home to promote infant motor development and family SES. METHOD The sample consisted of 300 families with infants aged 3 to 18 months. SES was assessed according to family socioeconomic class, income and parental level of education. To evaluate motor affordances found at home, the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) was used. The AHEMD-IS was designed to assess dimensions of the home environment including Physical Space (outside and inside space), Daily Activities and Play Materials (fine-motor and gross-motor toys). RESULTS SES indicators significantly influenced the availability of Physical Space and Play Materials. The Physical Space dimension was influenced by family economic class and income. The Play Materials dimension was influenced by all SES indicators. Daily Activities were not influenced by any of the SES indicators. Daily activities and play material were influenced by the infants age. CONCLUSIONS This study suggests that SES indicators are influential with regard to the provision of motor affordances in the home environment for infants. However, daily activities, which represent an aspect of the environment that is highly dependent on parental generation of situations that are conducive to motor skill development, are independent of family SES.

Motor performance of infants born small or appropriate for gestational age: a comparative study.

This paper represents a review of the research that focuses on a population of strong clinical interest on a national and international scale—infants born with low birth weight (LBW). Among the numerous developmental deficits commonly associated with this group, one of the most frequently cited problems is poor fine- and visual-motor integration. In addition to the direct perceptual-motor development concern, the literature provides a reasonable case that such deficits place this population at increased risk for subnormal academic performance and difficulties with specific daily living (self-help) activities. By assessing the infant at an early age and designing specific strategies for intervention, clinical psychologists can play a major role in improving fine- and visual-motor behavior in this population.

Motor performance of children with Down syndrome and typical development at 2 to 4 and 26 months.

Purpose: To compare the motor performance of infants born small for gestational age (SGA) with those appropriate for gestational age (AGA) at 1, 2, 3, and 6 months. Methods: A prospective cross-sectional study was conducted including infants born full-term, with birth weight under the 10th percentile for the SGA group and between the 10th and 90th percentiles for the AGA group. The Motor Scale of Bayley Scales of Infant Development-II was used to document motor performance. Results: The SGA group presented a mean motor index score lower than the AGA group at 2 and 6 months, with the SGA group presenting fewer infants that successfully accomplished “makes crawling movements,” “turns from side to back,” “balances head,” “sits alone momentarily,” and “sits alone for 30 seconds.” Conclusions: Data analysis suggested that infants who are SGA present greater risk of adverse outcomes that are detectable in motor performance measures at 2 months.

Comparison of motor and cognitive performance in infants during the first year of life.

Purpose: To compare gross motor performance of children with Down syndrome (DS) and typical development (TD) at 2 to 4 months (Phase I) and at 2 years of age (Phase II) and to investigate the relation between early motor performance and later outcome. Methods: Seventeen infants (10 with TD and 7 with DS) were assessed in Phase I using the Test of Infant Motor Performance (TIMP); 25 children were assessed in Phase II using the gross motor scale of the Bayley Scales of Infant and Toddler Development (Bayley-III); 10 participants were enrolled in both phases. Results: TIMP and Bayley-III scores were lower in the DS group. In both groups, TIMP z scores were predictive of Bayley-III scores. Conclusions: Children with DS show difficulties in early postural control and activities requiring speed, postural control, and balance. The finding that early performance relates to later outcome reinforces the relevance of early and task-specific intervention.

Desempenho motor fino e funcionalidade em crianças com síndrome de Down

Purpose: To compare motor and cognitive performance in infants with typical development in the 1st, 2nd, 3rd, 6th, 9th, and 12th months after birth. Methods: This was a repeated-measures study with unequal sample sizes in the follow-up periods, comprising 94 infants born at term. Infants with genetic syndromes, malformations, congenital infections, or hospitalized in intensive care units were excluded. The Bayley Scales of Infant Development II were used for evaluation of cognitive and motor performance. Results: There were significant differences between motor and cognitive performance at 1, 2, and 3 months. However, at 6, 9, and 12 months, there was no difference between domains. Conclusion: This study suggests that during the first year, development can be synchronous in the 2 areas evaluated by the Bayley Scales of Infant Development II, especially from the sixth month of age onward.

Motor development during the first 6 months: the case of Brazilian infants

O objetivo do estudo foi comparar criancas com sindrome de Down (SD) e criancas tipicas quanto ao desempenho motor fino, avaliado pela Bayley Scales of Infant and Toddler Development - Third Edition (BSITD-III), e o desempenho em autocuidado segundo o Inventario Pediatrico de Avaliacao de Incapacidade (PEDI); e investigar associacao entre ambos os dominios. Participaram 12 criancas tipicas e 12 criancas com SD, avaliadas na idade de 2 anos. As criancas com SD apresentaram desempenho motor fino e funcionalidade inferior as criancas tipicas, possivelmente por dificuldades em desempenhar tarefas que exijam destreza e coordenacao manual, como as que compoem a BSITD-III. Apesar disso, sua pontuacao em autocuidado foi adequada para a faixa etaria, possivelmente porque as habilidades funcionais exigidas nesse periodo, como retirar calcados/vestimenta, impoem menor demanda motora fina do que tarefas da BSITD-III. Esse fato pode ter contribuido para o bom desempenho funcional das criancas com SD, e para a ausencia de associacao entre os dominios. Fatores como os cuidados oferecidos a crianca pelos cuidadores, bem como ambientes estimuladores provavelmente tambem contribuiram para os resultados.

Atividades motoras cotidianas e suas influências no desenvolvimento de pré-escolares

This investigation documents the pattern of motor development of Brazilian infants over the first 6 months and compares the findings with a US norm. Infants were assessed once each month for the 6-month period using the Bayley II Motor Scale, which represented the US norm for comparison. Participants monthly scores increased with age and were similar to the US profile. However, the Brazilian infants did exhibit mean scores significantly lower than their counterparts on tasks of sitting and grasping in the 3rd, 4th, and 5th month; at the 6th month, scores were comparable. Explanations for differences focus on possible cross-cultural and maturational influences. Copyright