Isidora de Andraca

Factores de riesgo para el desarrollo psicomotor en lactantes nacidos en óptimas condiciones biológicas

OBJETIVO: Avaliar o efeito dos fatores de risco para o desenvolvimento infantil em criancas de nivel socioeconomico baixo, nascidos em otimas condicoes biologicas, mas expostos a condicoes sociais adversas. METODOLOGIA: Lactentes dos dois sexos, no total de 788, foram exaustivamente estudados quanto a alimentacao, crescimento, ambiente fisico e psicossocial controladas. Controlaram-se prospectivamente ate os 12 meses de idade, momento em que se avaliou o desenvolvimento mental (MDI) e o motor (PDI) atraves da escala de Bayley. A partir das variaveis medidas, identificaram-se 18 fatores de risco, que foram dicotomizados (baixo e alto risco). RESULTADOS: Amamentacao materna, temperamento da crianca, inteligencia materna e estimulo no lar associam-se consistentemente com MDI e PDI. Apos ajuste por co-variaveis, o estimulo no lar persiste como fator significativo na explicacao da variabilidade do MDI e do PDI, e o sexo da crianca aparece-se como fator condicionante do desenvolvimento motor. O efeito acumulado de sete ou mais fatores de risco associa-se a uma diminuicao significativa das pontuacoes de desenvolvimento. A combinacao de categorias de risco de temperamento infantil, inteligencia materna, papel do pai e estimulo no lar, atinge melhor predicao do desenvolvimento infantil que outras combinacoes analisadas. CONCLUSAO: Conclui-se que, mesmo para as criancas em otimas condicoes biologicas, o desenvolvimento psicomotor e afetado na presenca de condicoes ambientais adversas que agem simultaneamente.

Evaluación de la inteligencia a través de formas cortas del WAIS para poblaciones de nivel socioeconómico bajo

A WAIS-S short form for the assessment of intelligence as a confounding variable is proposed. A number of 161 complete WAIS-S protocols, relating to women of lower-middle and low socioeconomic status were analysed. Six subtests (Social Comprehension, Similarities, Vocabulary, Block Design, Picture Completion and Object Assembly) were chosen using two criteria: specific functions evaluated by each subtest and correlation coefficients relating IQ to the subtests. Five WAIS-S short forms were evaluated: one consisting of six subtests and the others with different combinations of four of them. Data showed that they were all appropriate for the measurement of intelligence as a confounding variable; the correlation coefficients between short forms and total IQ ranged from 0.90 to 0.94. The standard errors of the short forms for the estimation of total IQ were of 3 or 4 points, and 3 to 7% of the subjects were wrongly classified. When maternal intelligence had to be measured in relation to infant development the short form that included Social Comprehension, Similarities, Block Design and Picture Completion seemed the most appropriate. Nevertheless when choosing a WAIS-S short form not only economy of time but also the specific relevant functions assessed in each subtest must be considered.A WAIS-S short form for the assessment of intelligence as a confounding variable is proposed. A number of 161 complete WAIS-S protocols, relating to women of lower-middle and low socioeconomic status were analysed. Six subtests (Social Comprehension, Similarities, Vocabulary, Block Design, Picture Completion and Object Assembly) were chosen using two criteria: specific functions evaluated by each subtest and correlation coefficients relating IQ to the subtests. Five WAIS-S short forms were evaluated: one consisting of six subtests and the others with different combinations of four of them. Data showed that they were all appropriate for the measurement of intelligence as a confounding variable; the correlation coefficients between short forms and total IQ ranged from 0.90 to 0.94. The standard errors of the short forms for the estimation of total IQ were of 3 or 4 points, and 3 to 7% of the subjects were wrongly classified. When maternal intelligence had to be measured in relation to infant development the short form that included Social Comprehension, Similarities, Block Design and Picture Completion seemed the most appropriate. Nevertheless when choosing a WAIS-S short form not only economy of time but also the specific relevant functions assessed in each subtest must be considered.Se propone una version abreviada de la forma WAIS para evaluar la inteligencia en grupos de poblacion. Se analizaron 161 protocolos completos del WAIS aplicados a mujeres de nivel socioeconomico bajo y se estudio las correlaciones de las distintas subpruebas con el CI total y con los CI verbal y manual. Se seleccionaron seis subpruebas (Comprension, Semejanzas, Vocabulario, Cubos, Completacion y Ensamblaje) en base a dos criterios: las correlaciones observadas, y las funciones evaluadas en cada subprueba. El analisis de una forma corta con 6 subpruebas y cuatro formas cortas con 4 subpruebas demuestra que todas ellas son adecuadas para la evaluacion de la inteligencia como variable de confusion. El error estandar para la estimacion del CI total varia entre 3 y 4 puntos, y el error de clasificacion corresponde a un 3-7%. Cuando se evalua inteligencia materna como variable de confusion del desarollo infantil la forma corta que combina Comprension, Semejanzas, Cubos y Completacion parece la mas adecuada. La eleccion de la forma corta a usar dependera del ahorro de tiempo en la aplicacion y de las funciones evaluadas en cada subprueba en funcion del problema en estudio.Propoe-se uma versao abreviada da forma WAIS para a avaliacao da inteligencia em estudos da populacao. Analisaram-se 161 protocolos completos do WAIS, aplicados a mulheres de nivel socioeconomico baixo, e estudaram-se as correlacoes entre as diferentes subprovas e o coeficiente de inteligencia (QI) total, o QI verbal e o QI manual. Selecionaram-se seis subprovas (compreensao, semelhancas, vocabulario, cubos, complemento e montagem) conforme os criterios: correlacoes observadas e funcoes avaliadas em cada subprova. A analise de uma versao com 6 subprovas e 4 versoes com 4 subprovas demonstram que todas elas sao adequadas para a avaliacao da inteligencia como variavel de confusao. O erro padrao para a estimacao do QI varia entre 3 e 4 pontos e o erro de classificacao e de 3 a 7%. Quando se avalia a inteligencia materna como variavel de confusao do desenvolvimento infantil, a versao que combina compreensao, semelhancas, cubo e complemento pareceu a mais adequada. A eleicao da versao a ser utilizada devera basear-se na maior eficiencia do tempo de aplicacao e das funcoes avaliadas pelas subprovas, tendo em vista o problema em estudo.

BREAST FEEDING (BF) INFLUENCES INFANT DEVELOPMENT. † 83

Beneficial effects of BF on child morbi-mortality are well known, but the effects on infant development are still controversial. A prospective cohort study was carried out with 709 healthy low socioeconomic Chilean 4-mo-old infants, with follow-up until 12 mo. All infants were born at term weighing> 3.0 kg and were without acute or chronic illness. 100% were initially breastfed -- the norm in the community. Age at first bottle feeding and last breast feeding were determined by means of weekly home visits and monthly clinic visits. Longer BF before the introduction of any other milk feeding was associated with higher Bayley mental scores (MDI) at 12 mo (p <.05). This association remained statistically significant (p <.05) after control for environmental/family factors, such as sex, HOME score, mothers IQ, and socioeconomic status. This study shows that longer BF before the introduction of milk or formula is associated with higher mental development test scores in a developing country, an effect that has been previously reported in industrialized societies. The characteristics of this sample (100% initiation of BF and uniformly lower socioeconomic status) support the hypothesis that breast milk and/or the interactional process of nursing hypothesis contribute to better developmental outcome. Funded by NICHD and FONDECYT - Chile; milk and formula donated by Ross Laboratories. Table

Avaliação de inteligência por meio de versão abreviada de WAIS para população de baixo nível socioeconômico

A WAIS-S short form for the assessment of intelligence as a confounding variable is proposed. A number of 161 complete WAIS-S protocols, relating to women of lower-middle and low socioeconomic status were analysed. Six subtests (Social Comprehension, Similarities, Vocabulary, Block Design, Picture Completion and Object Assembly) were chosen using two criteria: specific functions evaluated by each subtest and correlation coefficients relating IQ to the subtests. Five WAIS-S short forms were evaluated: one consisting of six subtests and the others with different combinations of four of them. Data showed that they were all appropriate for the measurement of intelligence as a confounding variable; the correlation coefficients between short forms and total IQ ranged from 0.90 to 0.94. The standard errors of the short forms for the estimation of total IQ were of 3 or 4 points, and 3 to 7% of the subjects were wrongly classified. When maternal intelligence had to be measured in relation to infant development the short form that included Social Comprehension, Similarities, Block Design and Picture Completion seemed the most appropriate. Nevertheless when choosing a WAIS-S short form not only economy of time but also the specific relevant functions assessed in each subtest must be considered.A WAIS-S short form for the assessment of intelligence as a confounding variable is proposed. A number of 161 complete WAIS-S protocols, relating to women of lower-middle and low socioeconomic status were analysed. Six subtests (Social Comprehension, Similarities, Vocabulary, Block Design, Picture Completion and Object Assembly) were chosen using two criteria: specific functions evaluated by each subtest and correlation coefficients relating IQ to the subtests. Five WAIS-S short forms were evaluated: one consisting of six subtests and the others with different combinations of four of them. Data showed that they were all appropriate for the measurement of intelligence as a confounding variable; the correlation coefficients between short forms and total IQ ranged from 0.90 to 0.94. The standard errors of the short forms for the estimation of total IQ were of 3 or 4 points, and 3 to 7% of the subjects were wrongly classified. When maternal intelligence had to be measured in relation to infant development the short form that included Social Comprehension, Similarities, Block Design and Picture Completion seemed the most appropriate. Nevertheless when choosing a WAIS-S short form not only economy of time but also the specific relevant functions assessed in each subtest must be considered.Se propone una version abreviada de la forma WAIS para evaluar la inteligencia en grupos de poblacion. Se analizaron 161 protocolos completos del WAIS aplicados a mujeres de nivel socioeconomico bajo y se estudio las correlaciones de las distintas subpruebas con el CI total y con los CI verbal y manual. Se seleccionaron seis subpruebas (Comprension, Semejanzas, Vocabulario, Cubos, Completacion y Ensamblaje) en base a dos criterios: las correlaciones observadas, y las funciones evaluadas en cada subprueba. El analisis de una forma corta con 6 subpruebas y cuatro formas cortas con 4 subpruebas demuestra que todas ellas son adecuadas para la evaluacion de la inteligencia como variable de confusion. El error estandar para la estimacion del CI total varia entre 3 y 4 puntos, y el error de clasificacion corresponde a un 3-7%. Cuando se evalua inteligencia materna como variable de confusion del desarollo infantil la forma corta que combina Comprension, Semejanzas, Cubos y Completacion parece la mas adecuada. La eleccion de la forma corta a usar dependera del ahorro de tiempo en la aplicacion y de las funciones evaluadas en cada subprueba en funcion del problema en estudio.Propoe-se uma versao abreviada da forma WAIS para a avaliacao da inteligencia em estudos da populacao. Analisaram-se 161 protocolos completos do WAIS, aplicados a mulheres de nivel socioeconomico baixo, e estudaram-se as correlacoes entre as diferentes subprovas e o coeficiente de inteligencia (QI) total, o QI verbal e o QI manual. Selecionaram-se seis subprovas (compreensao, semelhancas, vocabulario, cubos, complemento e montagem) conforme os criterios: correlacoes observadas e funcoes avaliadas em cada subprova. A analise de uma versao com 6 subprovas e 4 versoes com 4 subprovas demonstram que todas elas sao adequadas para a avaliacao da inteligencia como variavel de confusao. O erro padrao para a estimacao do QI varia entre 3 e 4 pontos e o erro de classificacao e de 3 a 7%. Quando se avalia a inteligencia materna como variavel de confusao do desenvolvimento infantil, a versao que combina compreensao, semelhancas, cubo e complemento pareceu a mais adequada. A eleicao da versao a ser utilizada devera basear-se na maior eficiencia do tempo de aplicacao e das funcoes avaliadas pelas subprovas, tendo em vista o problema em estudo.

The use of short forms of WAIS for the assessment of the intelligence of persons of low socioeconomic status

A WAIS-S short form for the assessment of intelligence as a confounding variable is proposed. A number of 161 complete WAIS-S protocols, relating to women of lower-middle and low socioeconomic status were analysed. Six subtests (Social Comprehension, Similarities, Vocabulary, Block Design, Picture Completion and Object Assembly) were chosen using two criteria: specific functions evaluated by each subtest and correlation coefficients relating IQ to the subtests. Five WAIS-S short forms were evaluated: one consisting of six subtests and the others with different combinations of four of them. Data showed that they were all appropriate for the measurement of intelligence as a confounding variable; the correlation coefficients between short forms and total IQ ranged from 0.90 to 0.94. The standard errors of the short forms for the estimation of total IQ were of 3 or 4 points, and 3 to 7% of the subjects were wrongly classified. When maternal intelligence had to be measured in relation to infant development the short form that included Social Comprehension, Similarities, Block Design and Picture Completion seemed the most appropriate. Nevertheless when choosing a WAIS-S short form not only economy of time but also the specific relevant functions assessed in each subtest must be considered.A WAIS-S short form for the assessment of intelligence as a confounding variable is proposed. A number of 161 complete WAIS-S protocols, relating to women of lower-middle and low socioeconomic status were analysed. Six subtests (Social Comprehension, Similarities, Vocabulary, Block Design, Picture Completion and Object Assembly) were chosen using two criteria: specific functions evaluated by each subtest and correlation coefficients relating IQ to the subtests. Five WAIS-S short forms were evaluated: one consisting of six subtests and the others with different combinations of four of them. Data showed that they were all appropriate for the measurement of intelligence as a confounding variable; the correlation coefficients between short forms and total IQ ranged from 0.90 to 0.94. The standard errors of the short forms for the estimation of total IQ were of 3 or 4 points, and 3 to 7% of the subjects were wrongly classified. When maternal intelligence had to be measured in relation to infant development the short form that included Social Comprehension, Similarities, Block Design and Picture Completion seemed the most appropriate. Nevertheless when choosing a WAIS-S short form not only economy of time but also the specific relevant functions assessed in each subtest must be considered.Se propone una version abreviada de la forma WAIS para evaluar la inteligencia en grupos de poblacion. Se analizaron 161 protocolos completos del WAIS aplicados a mujeres de nivel socioeconomico bajo y se estudio las correlaciones de las distintas subpruebas con el CI total y con los CI verbal y manual. Se seleccionaron seis subpruebas (Comprension, Semejanzas, Vocabulario, Cubos, Completacion y Ensamblaje) en base a dos criterios: las correlaciones observadas, y las funciones evaluadas en cada subprueba. El analisis de una forma corta con 6 subpruebas y cuatro formas cortas con 4 subpruebas demuestra que todas ellas son adecuadas para la evaluacion de la inteligencia como variable de confusion. El error estandar para la estimacion del CI total varia entre 3 y 4 puntos, y el error de clasificacion corresponde a un 3-7%. Cuando se evalua inteligencia materna como variable de confusion del desarollo infantil la forma corta que combina Comprension, Semejanzas, Cubos y Completacion parece la mas adecuada. La eleccion de la forma corta a usar dependera del ahorro de tiempo en la aplicacion y de las funciones evaluadas en cada subprueba en funcion del problema en estudio.Propoe-se uma versao abreviada da forma WAIS para a avaliacao da inteligencia em estudos da populacao. Analisaram-se 161 protocolos completos do WAIS, aplicados a mulheres de nivel socioeconomico baixo, e estudaram-se as correlacoes entre as diferentes subprovas e o coeficiente de inteligencia (QI) total, o QI verbal e o QI manual. Selecionaram-se seis subprovas (compreensao, semelhancas, vocabulario, cubos, complemento e montagem) conforme os criterios: correlacoes observadas e funcoes avaliadas em cada subprova. A analise de uma versao com 6 subprovas e 4 versoes com 4 subprovas demonstram que todas elas sao adequadas para a avaliacao da inteligencia como variavel de confusao. O erro padrao para a estimacao do QI varia entre 3 e 4 pontos e o erro de classificacao e de 3 a 7%. Quando se avalia a inteligencia materna como variavel de confusao do desenvolvimento infantil, a versao que combina compreensao, semelhancas, cubo e complemento pareceu a mais adequada. A eleicao da versao a ser utilizada devera basear-se na maior eficiencia do tempo de aplicacao e das funcoes avaliadas pelas subprovas, tendo em vista o problema em estudo.