Cognitive, language and motor development of infants exposed to risk and protective factors.

INTRODUCTION: Risk factors are biological or environmental characteristics increasing the likelihood of delays in child development. Meanwhile, protective factors are conditions that can minimize risks and favor the acquisition of skills. Infants with risk indicators for hearing loss (RIHL) tend to live in less stimulating environments which may lead to lower cognitive, language, and motor development. OBJECTIVE: To compare the cognitive, language, and motor development of infants under the influence of risk and protective factors. METHOD: A cross-sectional observational study in which 259 infants aged 8-10 months were assessed for cognitive, language, and motor development using the Bayley Scales of Infant and Toddler Development - Third Edition (BSITD-III). The groups were formed according to the presence or absence of RIHL and the quality of the resources, being: SG-AE (Study Group with Adequate Environment), SG-IE (Study Group with Inadequate Environment), CG-AE (Compared Group with Adequate Environment)) and CG-IE (Compared Group with Inadequate Environment). Affordances were assessed using the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The groups were compared using the Chi-square test or the Kruskal-Wallis test, followed by Dunn's multiple comparison test. The level of significance adopted was 5%. RESULTS: Infants from the CG-AE performed better than the other groups in cognition and motor skills. The CG-AE language was statistically superior to the SG-IE. SG-IE showed the highest frequency of delays in all domains. CG-IE and SG-AE showed a similar frequency of delays. Adequate environment associated with the absence of RIHL (CG-AE) leads to better cognitive, language, and motor performances. CONCLUSION: Biological and environmental risk factors have a similar impact on development, but the accumulation of both tends to increase the risks of developmental delay. The absence of RIHL and quality environments worked as protective factors and favored the acquisition of skills.

Home environment of infants with risk indicators for hearing loss tends to be less stimulating.

OBJECTIVE: To verify the home opportunities to the motor development offered to infants with and without risk indicators for hearing loss (RIHL). METHODS: Observational transversal study was done with infants between 8 and 10 months, being 77 with RIHL (Study Group-SG) and 77 without RIHL (Control Group-CG) The instrument used to characterize the sample and obtain information about the home affordances was the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The results of the AHEMD-IS between the groups were compared using the Mann-Whitney and Chi-Squared tests. The significance test adopted for the study was 5%. RESULTS: Absolute values in the frequency of homes considered "moderately adequate" and "less than adequate" were greater in the SG in the most part of the categories, except the item Toys for Fine Motricity. It was possible to observe a statistically significant difference in the Total Score of the groups (p-value = 0.01346). Even with better results when compared with the SG, the number of homes of the CG group with affordances below expected is more than half of the sample. CONCLUSIONS: It was possible to verify that home of infants with risk indicators for hearing loss have statistically less affordances when compared to the homes of infants without the indicators. The results alert us to the need of orientation to the infant's responsible/caretakers regarding to the importance of a favorable environment with stimulation of the infant motor development.

Desenvolvimento de lactentes com indicador de risco para deficiência auditiva e classificação ambiental / Development of infants with a risk indicator for hearing loss associated to living enviroment

INTRODUCTION: Infants with a risk indicator of hearing loss (RIHL) are more likely to have delays in their development. Besides the biological risk, the infant's environment may determine the outcome of their development. OBJECTIVE: To compare the motor, cognitive and language development of infants with and without RIHL and to know the affordances of the home environment of those infants. METHODS: This was an observational research exploratory, cross-sectional and quantitative study, in which the development of 77 infants with RIHL (Study Group) were compared to 77 infants without RIHL (Compared Group). Cognition, language and motricity were evaluated according to the Bayley Scale of Infant Development, and the home environment according to the Affordability of the Home Environment for Motor Development - Baby Scale questionnaire. RESULTS: The most frequent risk indicators were family history (25.6%) and hyperbilirubinaemia (24.4%). In the Study Group, 13 (16.8%) infants presented delays in at least one domain and in the Control Group 3 (3.9%) infants presented delays. There was a statistically significant difference in the motor (p = 0.0001), cognitive (p = 0.001) and language (p = 0.0304) domains, with a better score in the Control Group. Regarding the home environment, 70.2% of houses in the Study Group were classified as less than adequate or mildly adequate, while in the Control Group this was 50.7%. CONCLUSION: The average development of the infants with risk indicators for hearing loss is below the average development of infants without them. Also, the number of environments below adequate is higher in the group with infants with risk indicators.

INTRODUÇÃO: Lactentes com indicadores de risco para deficiência auditiva (IRDA) têm maior probabilidade de apresentar atrasos do desenvolvimento. Além dos indicadores de risco biológicos, o ambiente em que o lactente está inserido pode determinar o desfecho do desenvolvimento infantil. OBJETIVO: Comparar o desenvolvimento motor, cognitivo e de linguagem de lactentes com e sem indicadores de risco para deficiência auditiva e conhecer as affordances no ambiente domiciliar dos lactentes com e sem indicadores de risco. MÉTODO: Pesquisa observacional exploratória, transversal e quantitativa, na qual o desenvolvimento de 77 lactentes com IRDA (GE- Grupo de Estudo) foi comparado ao de 77 lactentes sem os indicadores (GC- Grupo Comparado). Avaliou-se a cognição, linguagem e motricidade por meio das Escalas Bayley de Desenvolvimento Infantil e o ambiente domiciliar pelo questionário Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê. RESULTADOS: Os indicadores de risco mais frequentes foram histórico familiar (25,6%) e hiperbilirrubinemia (24,4%). No GE, 13 (16,8%) dos lactentes apresentaram atrasos em pelo menos um domínio do desenvolvimento e no GC 3 lactentes (3,9%). Houve diferença estatisticamente significativa nos domínios motor (p = 0,0001), cognitivo (p = 0,001) e de linguagem (p = 0,0304), com melhor desempenho no GC. Quanto ao ambiente domiciliar, 70,2% dos domicílios do GE classificou-se em "Menos que o adequado" ou "Moderadamente adequado", enquanto no GC o valor foi de 50,7%. CONCLUSÃO: O desenvolvimento médio dos lactentes com IRDA está abaixo comparado aos lactentes sem indicadores e o número de ambientes abaixo do esperado é maior no grupo de lactentes com IDRA

Treino materno para estimulação domiciliar sugere melhora no desenvolvimento motor de prematuros / Maternal training for home stimulation suggests an improvement in the motor development of preterm infants

Objetivo: Avaliar o desenvolvimento motor de lactentes pré-termo no primeiro mês de idade cronológica e comparar com o desempenho no primeiro e no terceiro mês de idades corrigidas, após treinamento materno para estimulação domiciliar. Métodos: Selecionaram-se seis lactentes, com idade gestacional média de 33,6 semanas, peso ao nascimento médio de 1853 g e APGAR ≥ 7 no quinto minuto. Realizou-se treinamento em cinco encontros, sendo utilizada uma cartilha para auxiliar orientações. Para avaliação, usou-se a Escala Motora Infantil de Alberta. Resultados: Os lactentes obtiveram pontuações abaixo do esperado com um mês cronológico, evidenciando a necessidade de correção da idade. Houve aumento significativo na pontuação da amostra no primeiro mês de idade corrigida, e manutenção no terceiro mês de idade corrigida. Conclusão: Verificou-se que há uma tendência à melhora do desempenho motor dos lactentes prematuros cujas mães realizam a estimulação precoce domiciliar e essa pode ser mais uma estratégia terapêutica utilizada pelos profissionais.

Objective: To evaluate the motor development of newborn babies with one month of chronological age and compare with the development in the first and third months of corrected age, after maternal training of home stimulation. Methods: We selected six infants born with 33,6 weeks in average, average weight of 1853 g and APGAR ≥ 7 in the fifth minute. The training was performed in five meetings and a book was used to help with home stimulation. The Alberta Infant Motor Scale was used to evaluate development. Results: Lower scores in the scale were observed at the chronological age, evidencing the necessity of age correction. An improvement in the score was observed at the first month of corrected age and it was maintained at the third month. Conclusion: The proposed methodology suggests a tendency to improve motor development of premature infants whose mother performs the premature home stimulation and this may be another therapeutic strategy used by professionals.

Stretching intervention for pediatric caregivers in a University Hospital / Intervenção com alongamento aos acompanhantes pediátricos de Hospital Universitário

This study aimed to provide an interaction time among pediatric caregivers performing group stretching activities, and to verify the effectiveness of a stretching session to improve flexibility. Caregivers of the pediatric ward of a university hospital participated in a group activity, with 17 static postures of self-stretching techniques, held each position for 30 seconds. Muscle flexibility was assessed before and after the stretching session, using the Bank of Wells, capable of measuring the flexibility of the posterior muscle chain. After a single series of global stretching, the elongation of the posterior muscle chain of the subjects significantly increased, with a gain of 18.05%. Furthermore, participants reported reduction in muscle pain and greater willingness to perform the tasks throughout the day, with a moment of leisure to help them cope with the situation they were in. Therefore, the program of stretching activities for hospital caregivers improved the flexibility in only one session, and represents an important intervention for the promotion of welfare and physical interaction between caregivers and staff, since it is one more possibility for physical therapists to work within the hospital context.

Este estudo teve como objetivo proporcionar momentos de interação entre os acompanhantes pediátricos com a realização atividade de alongamento em grupo e verificar a eficácia de uma sessão de alongamento na melhora da flexibilidade. Acompanhantes da enfermaria de pediatria de um hospital universitário realizaram atividade em grupo, com técnicas de autoalongamento estático em 17 posturas, mantido em cada postura por 30 segundos. A flexibilidade muscular foi avaliada antes e após a sessão de alongamentos, utilizando o banco de Wells, capaz de mensurar a flexibilidade da cadeia muscular posterior. Observou-se que, após uma única série de alongamento global, houve aumento significativo do alongamento da cadeia muscular posterior dos indivíduos estudados, com um ganho de 18,05%. Além disso, os participantes referiram melhora da dor muscular e disposição para realização das tarefas ao longo do dia, sendo um momento de lazer dentro do ambiente hospitalar, importante para amenizar a difícil situação em que se encontravam. Portanto, o programa de atividades com alongamentos para acompanhantes hospitalares melhorou a flexibilidade em apenas uma sessão, bem como representa uma intervenção importante na promoção do bem-estar físico e interação entre acompanhantes e equipe de profissionais, tratando-se de mais uma possibilidade de atuação de fisioterapeutas no contexto hospitalar.