Oferta de programas para el desarrollo integral de la primera infancia en Chile: revisión exploratoria / Program offer for the integral development of early childhood in Chile: scoping review

OBJETIVO: Describir la oferta programática en primera infancia destinada a favorecer el desarrollo infantil integral en Chile. MÉTODO: Se realizó una revisión exploratoria siguiendo el marco método lógico del Joanna Briggs Institute. La búsqueda fue realizada por un investigador y los criterios de inclusión fueron: programas gubernamentales destinados al desarrollo integral en menores de 5 años en Chile. Los datos fueron organizados y sintetizados para describir características del programa y de la o las prestaciones que entrega. RESULTADOS: La búsqueda identificó 2060 documentos y 72 cumplieron los criterios de inclusión. Se describen 59 programas vigentes que abarcan la primera infancia, es tando principalmente a cargo de los Ministerio de Justicia, Educación, Salud y Desarrollo Social. Los programas están destinados en su mayoría a la promoción e intervención, se encuentran focalizados en población vulnerable, son intersectoriales y utilizan diversas estrategias para su implementación. CONCLUSIÓN: La oferta programática en Chile para la primera infancia presenta características sugeridas como efectivas para favorecer el desarrollo infantil.

OBJECTIVE: To describe the program offering designed to promote comprehensive early childhood de velopment in Chile. METHOD: A scoping review was carried out following the Joanna Briggs Institute's methodological framework. A researcher conducted the review considering as inclusion criteria go vernment programs aimed at the comprehensive development of children under 5 years of age in Chile. The data were organized and synthesized to describe the characteristics of the program and the service(s) it provides. RESULTS: The search identified 2.060 documents and 72 met the inclusion crite ria. 59 current programs are covering early childhood, which are mainly managed by the Ministries of Justice, Education, Health, and Social Development. Most of the programs are aimed at promotion and intervention, focusing on vulnerable populations, are cross-sectoral, and use different strategies for their implementation. CONCLUSION: The program offering in Chile for early childhood has charac teristics suggested as effective to promote child development.

Implementação do programa de promoção do estilo de vida ativo em estudantes: o fortaleça sua saúde / Implementing the active lifestyle program for students: the fortaleça sua saúde

RESUMO Este estudo objetivou avaliar a implementação de um programa de intervenção para promoção do estilo de vida ativo e saudável em estudantes. Estudo avaliativo, realizado durante a intervenção, que incluiu como amostra a comunidade escolar envolvida nas atividades (estudantes, professores, coordenadores e pais), por meio de entrevista ou por observação externa. A matriz avaliativa foi construída e validada contendo 32 medidas em oito indicadores: capacitação dos professores, modificação nas aulas de Educação Física, modificação nas aulas regulares, distribuição de panfletos, distribuição de material, ginástica na escola, visibilidade do programa e conhecimento e distribuição de material. A análise descritiva (quantitativas) ou de conteúdo (qualitativas) foi utilizada. Temas de saúde em sala de aula foram abordados por 94% dos professores durante a intervenção. Metade dos alunos reportou terem participado de, pelo menos, uma aula de ginástica e utilizado os jogos durante a intervenção, mas dificuldades para armazenar material e falta de organização e de espaço foram relatadas. O conhecimento sobre o programa foi frequente entre professores, gestores e estudantes, mas não entre os pais. Em conclusão, a maioria das ações do programa tiveram uma implementação conforme planejada, contudo, dificuldades foram reportadas e devem ser consideradas em futuras propostas de um ambiente escolar que almeje promover atividade física e saúde.

ABSTRACT This study aimed to evaluate the implementation of an intervention program to promote active and healthy lifestyle in students. This was a evaluation study performed during the intervention, which included the school community (students, teachers, coordinators and parents), through interview or external observation. The evaluation matrix was constructed and validated with 32 measures in eight indicators: teacher training, modification in Physical Education classes, modification in regular classes, distribution of pamphlets, distribution of material, gymnastics in the school, visibility of the program and knowledge and distribution of material. Descriptive (quantitative) or content (qualitative) analysis was used. Health issues in the classroom were addressed by 94% of teachers during the intervention. Half of the students reported that they participated in at least one gym class and used the games during the intervention, but difficulties in storage of sports equipments and organization of places were reported. Knowledge about the program was frequent among teachers, managers and students, but not between parents. In conclusion, most of the program actions had an implementation as planned, however, difficulties were reported and should be considered in future proposals of a school environment that aims to promote physical activity and health.

Efficacy of communication DEALL: An indigenous early intervention program for children with autism spectrum disorders.

Objective To establish the efficacy of Communication DEALL, an indigenous early intervention program; in the management of children with autism spectrum disorders (ASD). Methods ABA design of pre intervention assessment, intervention and post intervention assessment was utilized, across an 8 month period. The first set of measures covered the assessment of developmental skills in the eight areas of gross motor skills, fine motor skills, activities of daily life skills, receptive language, and expressive language, cognitive, social and emotional skills. The second independent measure was the rating of each child on the Childhood Autism Rating Scale. Parental observations and parental estimation of the child’s progress were also recorded. The study was conducted in the Com DEALL units in Bangalore, including thirty subjects diagnosed with ASD. Main Outcome Measures were developmental skill gains and decrease in behavioral issues. Results Statistically significant increase in all eight developmental domains and statistically significant decrease in behavioral symptoms as measured by the CARS, were seen. Conclusions Thus, the Communication DEALL program shows promise as an effective early intervention program. It also indicates a need to further enhance the stabilization of the pre linguistic skills such as maintenance of eye contact, attention, sitting tolerance and compliance, in the program.

Características, efectividad y desafíos de la visita domiciliaria en programas de intervención temprana / The characteristics, effectiveness and challenges of home visiting in early intervention programmes

Se revisaron artículos publicados entre 1999 y 2009, en revistas indexadas en PubMED, EBSCO y ProQuest, sobre las características, efectividad y desafíos de los programas de visita domiciliaria orientados a la intervención en infancia temprana, clarificando los alcances y limitaciones de la investigación y sus ámbitos de aplicación. La visita domiciliaria se ha mostrado efectiva para una variedad de áreas relevantes, especialmente sobre el desarrollo de competencias parentales y la relación cuidadorinfante. En términos generales, los programas más efectivos comenzaban en el embarazo, duraban más de un año, contaban con personal especialmente entrenado y se focalizaban en construir una relación de confianza y en modelar la interacción cuidador-infante. Se identificó la importancia de considerar en su diseño las características de la población objetivo, del modelo de visita usado y del agente visitador. A pesar de la evidencia acumulada en estudios anglosajones, los costos asociados a estos programas pueden ser muy altos, implicando barreras que pueden hacer dificultosa su diseminación en los países latinoamericanos. Los autores plantean la necesidad de desarrollar y evaluar otras variantes (por ejemplo, incorporando monitoras comunitarias), ponderando su relación costo/efectividad.

The authors reviewed papers published between 1999 and 2009 in journals indexed in PsycInfo, PubMED, EBSCO and ProQuest concerning the characteristics, effectiveness and challenges of home visit programmes orientated towards early childhood intervention, clarifying the research's scope and limitations and its applications. Home visiting has been shown to be effective for a variety of relevant areas, especially for developing parent skills and child-caregiver relationships. The most effective programmes have started at pregnancy, lasted more than a year, had specially trained staff and have focused on building a trustworthy relationship and on modelling the infant-caregiver interaction. The importance of considering target population characteristics, the visiting model used and the visitor agent was identified in designing these programmes. In spite of the evidence accumulated in Anglo-Saxon studies, the costs associated with these programmes can be very high, thereby implying barriers which can make their dissemination difficult in Latin-American countries. The authors discuss the need for developing and evaluating other variants (i.e. including community agents), considering their cost/effectiveness ratio for treating early childhood problems, needs and characteristics in Latin-America.