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

ABSTRACT

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 <<auditory processing>>, <>, <behavior of sensory processing>> and <affect the emotional responses>> 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 <record>> and <sensitivity>> 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 <language>> areas of the PCD-R showed more significant correlations with sections of the SP, while <<sensory processing related to the resistance/tone>> and <movement>> 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, 31 or 21, 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.

RESUMEN

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 31. Las secciones <<procesamiento auditivo>>, <>, <comportamiento del procesamiento sensorial>> 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 <<procesamiento sensorial relacionado a la resistencia/ tono>> y <movimiento>>, 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.