The molecular profile of the inflammatory process differs among various neurodevelopmental disorders with or without cognitive component: A hypothesis of persistent systemic dysfunction and hyper-resolution.

Introduction: Challenges of diverse origin in childhood can alter the growth and development of the central nervous system, affecting structures and functions. As a consequence of the damage suffered during the perinatal period, long periods of dysfunctionality may occur, such as regulatory disorders, which may result in remaining in a process of low-grade inflammation. We previously found that perinatal risks and neurological signs are associated with long-term changes in circulating concentrations of molecules of the inflammatory process, findings that are consistent with the postulate that long periods of dysfunction may condition long-lasting low-grade inflammation or parainflammation. The aim of this study was to assess whether different expressions of neurological disorders show variations in their inflammatory molecule profiles or whether there is a common pattern. Methods: We included screening for (a) caregiver-perceived risk detection of regulatory disturbances, using the DeGangi instrument; (b) dysautonomia or asymmetries, through neurodevelopmental assessments; (c) cognitive developmental disturbances (using the Bailey instrument). We assessed protein molecules on a multiplex system, and lipid molecules by ELISA. Results: We found a similar, although not identical, pattern of cytokine profiles with the presence of risk of regulatory disturbances, dysautonomia and asymmetries; but an opposite inflammatory profile was associated with cognitive impairment. Discussion: Our results suggest that there are diverse, probably limited, molecular footprints associated with impaired function, and that these footprints may depend on the response requirements necessary to adjust to the altered internal environment. Here we propose a theoretical model that suggests possible scenarios for inflammatory outcomes associated with chronic challenges.

The Severity of Neurological Dysfunction in Preschool Children, Secondary to Damage Generated During the Perinatal Period, is Associated With a Pro-Inflammatory Pattern of Serum Molecules.

Disorders in the child's neurological development caused by perinatal risks can lead to long-term altered neurological signs that begin at an early age and involve persistent functional disorders. Recent data suggest that tissue dysfunction, not just acute damage, may initiate or perpetuate an inflammatory response. The aim of this study was to find out if any neurological dysfunction in preschool children secondary to damage generated during the perinatal period is associated with the magnitude of perinatal risks and long-term modifications in the serum concentrations of inflammatory molecules. The participants, aged 1-4 years, were on neurodevelopmental follow-up and rehabilitation therapy from the first three months of life and had no acute disease data. We classified the children into three groups according to the importance of their perinatal risks: low, medium, and high. The results show that 1) the magnitude of perinatal risks correlated with the severity of neurological dysfunction; 2) the greatest changes in the concentrations of the molecules of the inflammatory process were associated with the most altered neurological signs. This suggests that persistent nervous system dysfunction keeps inflammatory responses active even in the absence of an acute process of infection or damage.

Interacción madre-hijo durante la alimentación en niños con hipotiroidismo congénito / Mother-infant interaction during feeding time in children with congenital hypothyroidism

La interacción madre-hijo es un elemento esencial para el desarrollo integral del niño, especialmente durante los primeros años de vida y en presencia de enfermedades como el hipotiroidismo congénito o condiciones socioemocionales del cuidador y la familia. Objetivo: Evaluar la interacción madre-hijo durante la alimentación en díadas con niños con hipotiroidismo congénito e intervención temprana, y compararla respecto a díadas con niños sanos. Material y métodos: Estudio observacional, comparativo, transversal y prospectivo. Se formaron tres grupos: 1) díadas con niños con hipotiroidismo congénito e intervención temprana bajo tratamiento hormonal sustitutivo; 2) díadas con niños sanos sin intervención temprana; 3) díadas con niños sanos (sin hipotiroidismo) con intervención temprana. La edad de los niños fue de 0 a 12 meses. Se visitaron los hogares para videograbar la interacción durante la alimentación del niño. Se comparó la interacción entre los tres grupos con las puntuaciones totales y por subescalas de la Nursing Caregiver Assessment Feeding Scales. Resultados: El Grupo 1 obtuvo califi caciones más altas en la interacción, seguido por el Grupo 3 y con menores puntajes el Grupo 2. Conclusiones: La intervención temprana favorece la interacción madre-hijo. Las diferencias esperadas en la interacción por la condición socioeconómica o la escolaridad materna fueron menores ante la exposición a la intervención temprana

Mother-infant interaction is essential for the overall infant development, especially during the fi rst years of life, and in the presence of diseases such as congenital hypothyroidism or socio-emotional adverse conditions of the caregiver or the family. Objective: To evaluate the mother-infant interaction during feeding sessions in dyads with children with congenital hypothyroidism included in an early intervention program and compare dyads with healthy children. Materials and methods: Observational, comparative, cross-sectional and prospective study. Three groups were formed: 1) 159 dyads, children with congenital hypothyroidism who received early hormone replacement therapy and early intervention program; 2) 254 dyads with healthy children without early intervention program, and 3) 59 dyads with healthy children (no hypothyroidism) with early intervention program. The age of the children was 0-12 months. Dyads home were visited to videotape the interaction during feeding moment of the child. Interaction between three groups with total scores and subscales of Nursing Caregiver Assessment Feeding Scales was compared. Results: Group 1 scored higher on interaction, followed by Group 3 and Group 2, with lower scores. Birth order and maternal age had greater association with scores on the total test (p < 0.01). Conclusions: Major differences in the children’s scores were observed. Early intervention program strategies promote mother-infant interaction. The expected differences in interaction related with socioeconomic status or maternal education were lower with the effect of the exposure to an early intervention program

Edad de presentación de los reactivos del Test de Denver II en Niños de 0 a 4 años de edad del Estado de Morelos / Age of presentation of Denver Test items in the first 4 year of life of children from Morelos, Mexico

Uno de los instrumentos más utilizados a nivel internacional en la vigilancia del desarrollo del niño es la segunda versión del Denver Developmental Screening Test (DENVER II), del cual se han hecho evaluaciones y modificaciones en varios países, a partir de la estimación de la edad de presentación de los reactivos, pues constituye la base de su estructura y validez. Objetivo Identificar las edades y secuencias de presentación de los reactivos del Test Denver II en los cuatro primeros años de vida en niños de condición socioeconómica baja de una comunidad del Estado de Morelos, México. Método Se realizaron 2350 evaluaciones a niños de 0 a 48 meses de edad. Mediante un modelo de regresión logística se estimó la edad de presentación de cada reactivo para los percentiles 25, 50, 75 y 90. Se establecieron diferencias con los valores de referencia del instrumento con base en los intervalos de confianza al 95% para el percentil 90. Resultados De los 98 reactivos evaluados, 42 se presentaron con retraso; 23 no mostraron diferencias estadísticas y 33 se lograron antes por los niños del estudio. En las áreas Motor grueso y Personal-social predominaron los retrasos en 19/25 y 11/21 reactivos respectivamente. Por el contrario en Motor Fino-Adaptativo y Lenguaje predominaron los adelantos en 11 de 22 y 16 de 30 reactivos. Conclusiones Existen diferencias en las edades y secuencias de presentación de los reactivos del Test de Denver II en la población estudiada. Se recomienda realizar ajustes antes de implementar su uso en contextos socioculturales específicos.

The Denver Developmental Screening Test (Denver II) is the most used internationally tool for child development surveillance, from which assessments and changes have been made in several countries, from the estimate of the age of presentation of the items, because it constitutes the basis of its structure and validity. Objective To identify the age and sequences acquiring of each item of the Denver-II test during the first four years of life in children of low socioeconomic status from a community of Morelos State, Mexico. Method 2350 assessments were conducted to children from 0 to 48 months of age. A logistic regression model was used to estimate the age of presentation of each item to the centiles 25th, 50th, 75th and 90th. Differences were established with values of reference based on confidence intervals up to 95% for 90th centile. Results Of the 98 items evaluated, 42 were submitted delayed, 23 showed no statistical difference and 33 were acquired in earlier age in children of Morelos. In the Gross Motor and Personal-social areas predominated the delayed with 19/25 and 11/21 items, respectively. By contrast, in Fine Motor-Adaptive and Language predominated the advances, with 11/22 and 16/30 items. Conclusions There are differences in the age and sequence of presentation of the items of the Denver-II test in the population studied. Adjustments are recommended before implementing its use in specific socio-cultural contexts.

Experiencia de la aplicación y criterios para la interpretación de dos versiones del Inventario HOME para infantes de 0 a 3 años de vida / Application experience and criteria for the interpretation of two versions of Infant-Toddler HOME

The Home Observation for the Measurement of the Environment (HOME) Inventory is the most widely used tool in evaluating the environmental stimulation and family potential to provide necessary cognitive, social, and emotional support available to the child development. The HOME uses an observation/interview format to measure specific interactions between the caregiver and the child, various issues and events that might stimulate the child, and a variety of experiences provided at home or by family members that offer opportunity for growth and development. There are several versions to use from birth to age 3 (Infant-Toddler HOME), the most famous data come the late 60's (1968), it is composed by 45 items (HOME-45) clustered into six subscales. It has a back up of 40 years of publications, over 650 papers, associating with the children's language development, intellectual performance, and academic achievement or psychosocial and socioeconomic characteristics of the family. In Mexico, there are only two published version reports of the use of HOME-45. Most reports refer to the version of Cravioto from the late 60's, with 7 subscales and 62 items (HOME-62) from which there's poor information in the literature about the criteria for to interpreter the outcome results. The aim is to show the results of the implementation of both versions of HOME inventory, and provide criteria for interpretation in a sector of the Mexican population of low socioeconomic status. Material and methods We studied 1031 children and their homes from three communities of low socioeconomic status of central Mexico. Explaining the procedures and obtained informed consent, they were visited at home to implement the HOME Inventory and the socio-economic survey, with a 95% interobserver reliability. The procedures performed were approved by the Ethics and Research Committees from National Pediatric Institute. We applied the HOME-45 and HOME-62 in a integrated format to obtain the total score and each subscale from each version. It was also felt cut-off formed three groups with low stimulation (lowest fourth), middle stimulation (middle half) and high stimulation (upper fourth). The HOME-45 applies all the items to children 0 to 3 years; in the HOME-62 before 3 months old are evaluated only 50 items and after 3; 9; 12; 15 and 18 months old apply 54; 55; 57; 59 and 62 items respectively. Depending on the age, 26 to 36 items are common, representing from 58 to 80% of HOME-45 and 52 to 58% of HOME-62. There is no correspondence between the subscales of both versions, they have a different name and composition of items; so, we consider both versions as different. Social survey A modified version of the socio-economic interview of the National Pediatric Institute was applied, therefore three levels were established: medium low, low and very low social-economic status. Statistical analysis Four groups were formed by age range of children, to analyze the version HOME-45 and 6 groups for HOME-62 version, depending on the number of applicable items indicated in the format. The analysis related to HOME-62 considered only those items that the format indicates to apply for specific ages. Analyze was performed using JMP statistical software (version 5.01; SAS). We used ANOVA, Student's t test or Tukey Kramer's test to examine differences between means and chi square test to assess differences between proportions; p< 0.05 was considered statistical significance. Results 52.7% of the children were female, aged 1 to 35 months ( = 16.2 ± 9.3 months) mother was the primary caregiver of the child at 87.8%. The mean mother's age was 26.5 ± 5.7 years with a range of 14 to 43 years, the father's age was 29.8 ± 7.34 years. Mother's education mean was 9 years, 24% elementary school or less. HOME-45 Inventory achieved mean score in the population of 31.02 ± 5.68 points, equivalent to a hits proportion of 0.69 ± 0.13, with limits between 0.51 (variety) to 0.81 (responsibity). We found statistical significance differences in the total score of HOME-45 Inventory according to socioeconomic and marital status, birth order of children, education and age of parents. There were also found differences between all subscales of HOME-45 with the socioeconomic status and parent's education. With scores of HOME-45 Total difference was found between children younger than 6 months respect to older. There were also differences in the same sense in the subscales except for Acceptance and Organization subscales. It was considered the cutoff point for low, medium and high stimulation in the total population (0-35 months), to total scale and each subscale, the most important differences observed occurred in children under 6 months of age. HOME-62 Inventory (Cravioto) The total score and the subscales of HOME-62 also showed associations with sociodemographic variables such as education, age and marital status from parents, socioeconomic family status and birth order of children. Scores reached at the HOME-62 were equivalent to the hits proportion of 0.74 ± 0.1 , all subscales showed mean higher than 0.5 and three above 0.8. There were major differences in the total score of HOME-62 considering the age group proposed, similar differences were observed in most of the subscales. The cut-off points for types of stimulation of total HOME-62 tend to increase with the age of the child. The same happened with the subscales except Frequency and Stability of adult contact and Emotional climate, were descended. It was compared the relationship between the two versions of HOME once the criteria proposed was applied: 719 family environments were similarly characterized by both versions (69.7%) and 235 environments (22.8%) were defined by the HOME-45 with great stimulation while 80 environments (7.8%) were defined by the HOME-62 with great stimulation too. Discussion There are no benchmarks in the Mexican population for any of the two versions of HOME used. And the international benchmarks HOME-45 were obtained from American families for over 30 years, being important to have results related to its application and interpretation of HOME-45 in a sector of the Mexican population, allowing contrasting findings regarding those obtained in other latitudes. HOME-62 version is the most widely used in Mexico, but little has been reported about the achieved scores, because there are no criteria for interpretation. The values proposed in this paper can be used in future comparisons with the results of other studies. Differences in scores of each version of HOME according to the age of the children, make it necessary to show the results adjusted by age ranges, common procedure in several instruments. The results of HOME-45 in the population were similar to those obtained in other data, there were no statistical differences with the Little Rock values in the total score, and it existed with the subscales of Acceptance and Organization. Like in that population, the tendency to increase the total score of HOME-45 with age was due mainly to Learning materials and Variety subscales. The results of HOME-62 provide benchmarks for its interpretation in 6 age group and all subscales. If they are applied to the results of the Cravioto's investigation, they are able to differentiate families with a history of malnourished children in the early years of life. Both versions showed ability to discriminate socio-economic characteristics of family. It is necessary to report results of the implementation of HOME in different contexts in qualitative and quantitative terms for a proper comparison and interpretation of the differences between groups as well as analyzing the relationship between the specific results in the subscales of both versions with the development, behavior and welfare of children.

El instrumento más utilizado en la evaluación del potencial del ambiente familiar para brindar estimulación y apoyo necesario al desarrollo del niño, es el Inventario HOME (Home Observation for the Measurement of the Environment). La versión más conocida internacionalmente, para niños de cero a tres años, contiene 45 reactivos (HOME-45). En México la mayoría de reportes se refiere a una versión modificada por Cravioto con 62 reactivos (HOME-62), con poca información sobre los criterios para su interpretación. No existe correspondencia en el nombre de las subescalas de ambas versiones ni en los reactivos que las conforman, por lo que se consideran ambas versiones como distintas. No existen valores de referencia para la población mexicana de ninguna de las dos versiones utilizadas del HOME. Objetivo Mostrar los resultados de la aplicación de ambas versiones del inventario HOME y ofrecer criterios para su interpretación en un sector de la población mexicana de condición socioeconómica baja. Material y métodos Se estudiaron 1031 niños y sus hogares mediante visitas domiciliarias en tres comunidades del estrato socioeconómico bajo del centro de México. Los procedimientos tuvieron una confiabilidad interobservador del 95% y fueron aprobados por los Comités de Investigación y Ética del Instituto Nacional de Pediatría. Se obtuvo la puntuación para cada una de las versiones y se estimaron puntos de corte formándose tres grupos de estimulación, según la distribución cuartilar. Resultados El cincuenta y dos punto siete por ciento de los niños fue del sexo femenino, o = 16.2 ± 9.3 meses de edad, el cuidador principal del niño fue la madre en el 87.8%. La puntuación alcanzada por la población en el Inventario HOME-45 fue de 31.02 ± 5.68 puntos. Se encontraron diferencias significativas en la puntuación del HOME-45 y las subescalas según el orden de nacimiento del niño, la condición socioeconómica, el estado conyugal, la edad y escolaridad de los padres. Se estimó el punto de corte para la baja, media y alta estimulación observándose las diferencias más importantes en los menores de seis meses de edad. Inventario HOME-62 La puntuación total y la de las subescalas del HOME-62 también mostraron asociación con las variables sociodemográficas; la puntuación total del HOME-62 fue equivalente a una proporción de aciertos de 0.74±0.1. Se observaron diferencias en la puntuación total y en la mayoría de las subescalas del HOME-62 según los intervalos de edad propuestos. Los puntos de corte para los tipos de estimulación del HOME-62 tienden a incrementarse con la edad del niño e igual sucede con la mayoría de las subescalas. La relación entre ambas versiones del HOME, una vez aplicados los criterios propuesto, mostró 69.7% de ambientes familiares tipificados de igual manera por ambas versiones, 22.8% tipificados con mayor estimulación por el HOME-45 y 7.8% de ambientes tipificados con mayor estimulación por el HOME-62. Conclusiones Es importante contar con referentes para la interpretación del HOME-45 en habitantes de México, que permita contrastar los hallazgos respecto a los obtenidos en otras latitudes. El HOME-62 es la versión más utilizada en México, pero se han reportado poco las puntuaciones alcanzadas, en parte porque no hay criterios para su interpretación. Se presentaron los resultados ajustados a intervalos de edad, procedimiento común en diversos instrumentos. Los valores propuestos en el presente trabajo pueden usarse en futuras comparaciones con los resultados de otros estudios. Los resultados del HOME-62 aportan referentes para su interpretación en seis intervalos de edad en cada subescala. Ambas versiones muestran capacidad para discriminar características socioeconómicas de las familias. Es necesario reportar resultados de la aplicación del HOME en diversos contextos en términos cualitativos y cuantitativos para una adecuada comparación e interpretación de las diferencias entre grupos, así como analizar las relaciones entre los resultados específicos en las subescalas de ambas versiones con el desarrollo, comportamiento y bienestar del niño.

Asociación entre el perfil sensorial, el funcionamiento de la relación cuidador-niño y el desarrollo psicomotor a los tres años de edad / Association between the sensory profile, the quality of the infant-parent relationship and the child development, at three years of age

Since the beginning of the last century there were some differences in child-related difficulties in regulation that could not be included in the categories of diagnosis were counted, so they fitted within the learning problems, coordination problems and sometimes until the epilepsy. Decades later, each problem was subject of a separate diagnostic category, which favored the study of diseases, but fragmented the diagnosis for children who had a variety of symptoms that some of them were due to a single source. Then the diagnoses increased in coordination disorder, attention deficit disorder with and without hyperactivity (ADHD), the sensory integration dysfunction, language disorders, and so on. In order to complete the criteria of DSM-IV, in the case of children the Zero to Three/National Center for Clinical Programs for Infants developed a diagnostic classification for children from 0 to 3 years old (DC: O-3). The DC: 0-3, consists of five axes. The Axis I refers to the primary diagnosis, and includes the regulatory disorders and developmental disorders that affect different systems. Regulatory disorders are constitutional in nature, based on sensory problems, or sensorimotor processing, characterized by difficulties of the child to regulate their behavior, sensory, attention, motor and/or emotional, to organize positive affective states, warning or actions to calm down. The objective of the present research was to establish the association between the characteristics of the Sensory Profile, the parent-infant relationship and the psychomotor development of children. Materials and methods To assess the level of development of children was used the Conduct Development Profile, as revised (PCD-R). For the parent-infant relationship was used the Parent-Infant Relationship Global Assessment Scale (PIR-GAS). Thus, to recognize a regulatory disorder it was used the Sensory Profile which assess the child's sensory processing and its impact on the daily lives of children. To fit the relationship style in one of the categories, the children and their caregiver play for about 15 minutes with three types of toys, according to the classification of Florey. Statistical analysis For data analysis were conducted descriptive statistics of the general variables and those of primary interest, test Chi² for contingence tables test, correspondence analysis and comparison one-way variance analysis. Analyses conducted using SPSS 12.0 statistical software. Results The children had an average age of 43.2 ± 4.2 months, 50% were girls, development showed ratios of around 105 ± 15 points. The average ratios of development were higher in girls than in boys in all areas except manual skill. The characteristics of sensory profile were established on the basis of results obtained in the SP: 1 7 children (31 %) were located in the group with <> sensory profile, which refers to the scores within the parameters of typical performance or have up to two factors with likely difference; 21 children (39%) were located in the <> group when the subjects likely to exceed two factors with difference and up to 1 factor with definitive difference, and 1 6 children (30%) in the <> group formed by the cases that are more than three factors likely to dispute and/ or difference with more than two final (over four factors outside of the typical performance). Sections of <>, <>, <> and <> were those that had a higher frequency of profiles of children outside typical behavior (50%). The section of <> was the most frequent typical behavior among children (78%). In relation to the factors, the proportion of children who had values within the typical range in each of the factors of SP was 41 % to 83%, <> and <> were the most affected by having more than a half of the cases outside of the typical range, while <> and <> were the least altered, being over 75% of cases characterized as typical performance. At the regulatory disorders assessment boys showed more frequent regulatory disruptions, 44% respect to girls 15% (p <0.05). Additionally areas of PCD-R showed some degree of correlation with at least two areas of the SP, the <> and <> areas of the PCD-R showed more significant correlations with sections of the SP, while <> and <> sections, which were correlated with most of the development areas explored with the PCD-R. The variance analysis comparing the averages of development reached in the PCD-R, according to the SP results showed statistical differences between the averages in six of nine factors evaluated, being the regulatory disorder the group that makes a difference for the respect to two others. The results of the evaluation about the relationship between caregiver and child valued by the scale Parent-Infant Relationship Global Assessment Scale (PIR-GAS) DC: 0-3, did not show differences in the average ratios of development in the PCD-R among the three groups that were conducted. Nevertheless was noted that children with affected sensory profile presented problems more frequent in relation to the caregiver. Discussion Data from the study population showed values close to those reported by the respective instruments, discreetly above the expected variance similar to that described in the standardized tests. In the most of the development areas, the group of girls had the highest averages ratios. This results are similar with that are described in the literature. We also found an increased frequency of regulatory disorders in boys, 3:1 or 2:1, which could be related with by patterns of socialization. Respect the parent-infant relationship there not found differences that affect significantly the child development, evaluated with the PCD-R, unless when the relatioship was significantly affected. Differences in integrating sensory stimuli, when impact the daily life of children are related to development in different areas. The functioning of the parent-infant relationship was not a variable that changed the effect of the association between sensory profile and development, as it showed no relations with psychomotor development, but shows relations with the sensory profile of the child. In conclusion, differences in the integration of sensory stimuli, when impacting on the daily lives of children at three years old, have an association with the development so that there are areas of development that appear to be more sensitive than others in a any child who presents regulatory disorder. The functioning of the mother-child relationship showed no relations with psychomotor development, however it did with the sensory profile of the child.

Con la intención de complementar los criterios del DSM-IV, en el caso de los niños pequeños, el Zero to Three/Centro Nacional para Programas Clínicos para Infantes, desarrolló la Clasificación Diagnóstica para los niños de cero a tres años (DC: O-3). El DC: 0-3, constó de cinco ejes. El eje I se refiere al diagnóstico primario, e incluyó los trastornos regulatorios y los trastornos del desarrollo que influyen en diferentes sistemas. Los trastornos regulatorios son de naturaleza constitucional y de maduración, basados en problemas sensoriales, sensoriomotores o de procesamiento; se caracterizan por dificultades que presenta el niño para regular su comportamiento sensorial, atencional, motor y/o afectivo, así como para organizar estados afectivos positivos, de alerta o acciones para calmarse. El objetivo de la presente investigación fue establecer la asociación entre las características del perfil sensorial con el desarrollo psicomotor del niño. Metodología Para valorar el nivel de desarrollo de los niños se utilizó el Perfil de Conductas de Desarrollo, en su versión revisada (PCD-R). Para reconocer un trastorno regulatorio se utilizó el Sensory Profile que valora el procesamiento sensorial del niño y su repercusión en la vida cotidiana. También analizó el nivel de funcionamiento de la relación cuidador-niño con la escala Parent-Infant Relationship Global Assessment Scale (PIR-GAS) del DC: 0-3. Resultados Los niños tuvieron una edad de 43.2+4.2 meses, 50% fueron niñas, el desarrollo mostró coeficientes aproximados de 105+15 puntos y fueron más altos en las niñas que en los niños en todas las áreas excepto habilidad manual, con diferencias significativas en lenguaje expresivo, alimentación y praxis. De manera global el Perfil Sensorial (SP) mostró 17 niños (31 %) con perfil sensorial <>; 21 (39%) con sospecha y 16 (30%) en el grupo de <>. La relación de trastornos regulatorios entre niños y niñas se dio en una razón de 3:1. Las secciones <>, <>, <> y <> presentaron mayor frecuencia de perfiles de los niños por fuera del comportamiento típico (50%). Los factores <> e <> fueron los más afectados con más del 50% de casos por fuera del rango típico. Todas las áreas del PCD-R tuvieron algún grado de correlación al menos con dos secciones del SP, siendo las áreas emocional/ social y lenguaje expresivo del PCD-R las que mostraron mayor número de correlaciones significativas con las secciones y factores del SP. Las secciones de <> y <>, fueron las que se correlacionaron con la mayoría de áreas del PCD-R. En el análisis de varianza entre los resultados globales del SP y las medias de los coeficientes del desarrollo mostró diferencias significativas en seis de las nueve áreas evaluadas. La relación cuidador-niño valorada con la escala (PIR-GAS) del DC: 0-3, mostró relación adaptada en 20 casos (37%), relación levemente afectada en 15 casos (28%) y relación disfuncional en 19 casos (35%), no se observó asociación entre los coeficientes del desarrollo del PCD-R según estos tres grupos de funcionamiento de la relación. Mediante análisis de correspondencia se corroboró que a mayor afectación del perfil sensorial, mayor alteración en la relación cuidador-niño. Las diferencias en la integración de estímulos sensoriales, cuando impactan en la vida cotidiana de los niños, guardan una asociación con el desarrollo en diferentes áreas. El funcionamiento de la relación cuidador-niño no fue una variable que modificase el efecto de la asociación entre el perfil sensorial y el desarrollo, ya que no mostró relaciones con el desarrollo psicomotor, pero sí con el perfil sensorial del niño.