Heloisa Gagheggi Ravanini Gardon Gagliardo

Método para avaliação da conduta visual de lactentes

The purpose of this study is to introduce a method to evaluate visual functions in infants in the first three months of life. An adaptation of the Guide for the Assessment of Visual Ability in Infants (Gagliardo, 1997) was used. The instrument was a ring with string. It was implemented a pilot study with 33 infants, selected according to the following criteria: neonates well enough to go home within two days of birth; 1 to 3 months of chronological age; monthly evaluation with no absence; subjects living in Campinas/SP metropolitan area. In the first month we observed: visual fixation (93,9%); eye contact (90,9%); horizontal tracking (72,7%); inspects surroundings (97,0%). In the third month, we observed: inspects own hands (42,4%) and increased movements of arms (36,4%). This method allowed the evaluation of visual functions in infants, according to the chronological age. Alterations in this function will facilitate immediate referral to medical services for diagnoses.

Qualidade de vida em sujeitos respiradores orais e oronasais

PURPOSE: to investigate the life quality of subjects with mouth or oronasal breathing. METHOD: the sampling was composed of 49 volunteers distributed into 2 groups: mouth breathing subjects’ group with 24 subjects and oronasal breathing subjects’ group (mouth and nose) with 25 subjects, within the 18-38 age group, both genders. The WHOQOL-BREF (Portuguese version) protocol was used and the data analysis and recording were carried out using the Statistical Analysis System. RESULTS: the obtained results underwent Mantel-Haenszel chi-square test and variance analysis. Life quality in oronasal breathing subjects was demonstrated to be better in environmental, physical and psychological domain in relation to mouth breathing subjects. CONCLUSION: considering the obtained differences, the study draws attention to the need for better investigating the profile of oronasal breathing subjects and its relevance, so that the conducts, such as disregarding the group of oronasal breathing subjects or gathering them as mouth breathing subjects, are not improperly adopted.

Estudo da audição em crianças portadoras de deficiência visual

Purpose: analyze the hearing of students presenting with visual deficiency (low vision and blindness). Method: evaluation of 30 (100%) children, divided into two groups: Group I comprised 15 (50%) children with visual deficiency; and Group II comprised 15 (50%) children with normal vision, without hearing and/or education complaints. The patients underwent meatoscopy, liminal tonal audiometry, logoaudiometry and immitanciometry; in addition to sound location tests in five directions, verbal and non-verbal sequential memory, speech-in-noise tests, dichotic digit tests, duration standard behavior and random gap detection test (RGDT). Results: concerning the basic auditory evaluation in Group I, four (26.6%) students showed results altered – two (13, 3%) with conductive hearing loss, one (6, 8%) with mixed and one (6, 8%) with neurosensorial hearing loss. Conversely, all participants in Group II showed normal results. In the sequence of auditory processing tests, 10 (66.6%) students in Group I showed results altered and four (26.6%) showed normal results. Conclusion: Group I demonstrated unfavorable performance in comparison with Group II, either in the basic auditory evaluation or in the sequence of auditory processing tests.

The LEA Grating Test in assessing detection grating acuity in normal infants less than 4 months of age.

PURPOSE To assess binocular detection grating acuity using the LEA GRATINGS test to establish age-related norms in healthy infants during their first 3 months of life. METHOD In this prospective, longitudinal study of healthy infants with clear red reflex at birth, responses to gratings were measured at 1, 2, and 3 months of age using LEA gratings at a distance of 28 cm. The results were recorded as detection grating acuity values, which were arranged in frequency tables and converted to a one-octave scale for statistical analysis. For the repeated measurements, analysis of variance (ANOVA) was used to compare the detection grating acuity results between ages. RESULTS A total of 133 infants were included. The binocular responses to gratings showed development toward higher mean values and spatial frequencies, ranging from 0.55 ± 0.70 cycles per degree (cpd), or 1.74 ± 0.21 logMAR, in month 1 to 3.11 ± 0.54 cpd, or 0.98 ± 0.16 logMAR, in month 3. Repeated ANOVA indicated differences among grating acuity values in the three age groups. CONCLUSIONS The LEA GRATINGS test allowed assessment of detection grating acuity and its development in a cohort of healthy infants during their first 3 months of life.

Programas de intervenção precoce: caracterização de instituições e profissionais

The terms early intervention, early stimulation and essential stimulation have been historically discussed and, although similar, reflect in different performance practices. With regard to early intervention (EI) programs, these aim to provide accompaniment not only to children with developmental disorders, but also to the family and the context in which they are inserted. In this sense, it was intended with this study to characterize the institutions that provide EI services in the city of Curitiba-PR and the professionals working in these services. The sample consisted of 19 institutional representatives and 142 professionals. The institutions of the 3rd sector predominated, which work in educational area and with a multidisciplinary team. As for the population served, the clientele with multiple disabilities and intellectual disability prevailed. Prevailed professors with specialization that works over 10 years in EI programs and the teams were classified as multidisciplinary. From the results it was concluded that the prevalence of third sector institutions and the education area may be linked to historical aspects such as welfare and national education policies. The interdisciplinarity between health and education sectors still’s a conceptual, methodological and practical challenge, requiring greater dissemination and understanding of its guidelines and functioning. Knowing the characterization of institutions and their professionals is fundamental to understand the challenges that are posed to serving the clientele in question, and it is necessary to expand these services in general and the access to them.

Clientele profile of early intervention services: a focus on eye health

Objectives: To describe and analyze the profile of children with developmental disorders treated at early intervention services (IP) and their mothers or caregivers, focusing on aspects related to the child’s ocular health. Methods: Quantitative survey, exploratory-descriptive. The data collection instrument consisted of a questionnaire applied with mothers or caregivers of children assisted in IP services. The data were transcribed in Microsoft Excel spreadsheet and analyzed based on simple descriptive statistics. The sample consisted of 273 subjects. Results: There was a prevalence of mothers (84.2%) between 30 and 40 years old (38.8%). The children were between 1 and 2 years of age (34.8%), and, for the most part, with Down’s Syndrome (26.7%). The mean age of entry of children in IP services was 7.93 months and the age at first consultation with the ophthalmologist of those who had already performed (82.8%) was 6.8 months, with 45,6% presented ophthalmological alterations, predominating strabismus (40.8%). Conclusions: The results obtained allowed the identification and characterization of mothers or caregivers and children attending IP services, especially in questions related to ocular health. Understanding this scenario should support actions aimed at ocular health education, prevention and rehabilitation and should be directed to IP services, managers, families and children.Objectives: To describe and analyze the profile of children with developmental disorders treated at early intervention services (IP) and their mothers or caregivers, focusing on aspects related to the child’s ocular health. Methods: Quantitative survey, exploratory-descriptive. The data collection instrument consisted of a questionnaire applied with mothers or caregivers of children assisted in IP services. The data were transcribed in Microsoft Excel spreadsheet and analyzed based on simple descriptive statistics. The sample consisted of 273 subjects. Results: There was a prevalence of mothers (84.2%) between 30 and 40 years old (38.8%). The children were between 1 and 2 years of age (34.8%), and, for the most part, with Down’s Syndrome (26.7%). The mean age of entry of children in IP services was 7.93 months and the age at first consultation with the ophthalmologist of those who had already performed (82.8%) was 6.8 months, with 45,6% presented ophthalmological alterations, predominating strabismus (40.8%). Conclusions: The results obtained allowed the identification and characterization of mothers or caregivers and children attending IP services, especially in questions related to ocular health. Understanding this scenario should support actions aimed at ocular health education, prevention and rehabilitation and should be directed to IP services, managers, families and children.

Eye health attention of children with developmental disorders in early intervention services: barriers and facilitators

Objective: To identify factors that influence on the early detection of visual impairment and in early intervention onset for children with developmental disorders. Methods: The study consisted of a exploratory and descriptive survey, which included the use of questionnaires with institutional representatives, professional team of early intervention and mothers or caregivers of children served in these services. The data received statistical analysis through software SAS Statistical Analysis System 9.3, Wolfram Mathematica and Microsoft Excel. The sample consisted of 434 subjects (19 institutional representatives, 142 professionals of the early intervention services and 273 mothers/ caregivers of children served). Results: The results showed statistical values of p=0.0119 for the realization of eye test with regard to the beginning of early intervention. The mother receive guidance on the development of vision obtained values of p-value=0.0106 for early intervention start and values of p=0.0061 for the first visit to the ophtalmologist. Conclusion: Realise the eye test constitutes as a facilitating factor for the onset of early intervention and have an exclusively visual impairment and attend private institution as a barrier. Late entry into early intervention service adversely affects the age of first ophthalmologic consultation.The mother receive guidance on the development of vision showed as a facilitating factor for the first visit to the ophtalmologist and start of timely intervention.The field of eye health constitutes as public health demand and requires attention to actions and educational programs directed to families, professionals and institutional managers who provide services to children.

ESTUDO COMPARATIVO DO DESEMPENHO VISO MOTOR E MOTOR GLOBAL DE GÊMEOS PRÉ-TERMO NA IDADE ESCOLAR

Gemelaridade pode representar probabilidade de atraso no desenvolvimento devido a tendencia ao retardo nocrescimento intrauterino com consequente nascimento pre-termo. Este estudo tem como objetivo descrever odesempenho motor e viso motor de gemeos, com historico de nascimento prematuro, no inicio da escolarizacao.Quatro pares de gemeos foram comparados com criancas nascidas pre-termo nao gemeas e criancas denascimento a termo em relacao as performances nos testes Denver II, Visual Motor Integration e DevelopmentalCoordination Disorder Questionaire-Brasil 2. Na analise descritiva um par de gemeos apresentou classificacaoinferior ao esperado para a idade no teste Denver II; nos instrumentos DCDQ-Brasil 2 e VMI foi constatadadiferenca em todos os pares de gemeos. Analise estatistica demonstrou que prematuros gemelares apresentamdesempenho semelhante aos prematuros de gestacao unica. Criancas prematuras, gemeos ou nao, apresentaramum desempenho inferior em aspectos motores e viso motores quando comparadas com sujeitos a termo.Reforca-se importância do acompanhamento de criancas pre-termo ate os anos iniciais da escolarizacao. Descritores : Gemeos; Nascimento prematuro; Destreza motora; Desenvolvimento infantil.