Home participation and personal and environmental factors in children and adolescents with Down syndrome.

AIM: To describe current home participation (frequency, involvement) and caregiver's desire for change in home participation of children and adolescents with Down syndrome, as well as home environmental factors, and to explore the associations of personal and environmental factors with current participation and caregiver's desire for change. METHOD: Eighty-two caregivers (mean age = 45 years 10 months) of children and adolescents with Down syndrome (mean age = 10 years 7 months) were surveyed about the child's home participation and environmental factors using the Participation and Environment Measure-Children and Youth. Furthermore, children's personal and environmental factors were collected. Results are reported using descriptive analysis and correlations (Spearman's rank correlation coefficients and Mann-Whitney U test) to describe the relationship between current participation and caregiver's desire for change, with personal and environmental factors as ordinal and nominal variables respectively (p < 0.05). RESULTS: Children's participation was highest with regard to personal care management and lowest with regard to school-related activities. Most caregivers desired change in homework and household chores. Greater frequency was associated with male sex, caregiver less rigorous social distancing due to the COVID-19 pandemic, and children receiving therapies. Greater involvement was associated with younger age in children and higher environmental support. Older age in children was associated with caregiver's greater desire for change. INTERPRETATION: Personal and environmental factors correlated with participation in specific ways. Creative strategies to promote participation that consider caregiver's wishes should be undertaken.

The processes and outcomes related to 'family-centred care' in neuromotor and functional rehabilitation contexts for children with cerebral palsy: A scoping review.

OBJECTIVE: The aim of this study is to identify the main processes and outcomes related to family-centred care (FCC) in neuromotor and functional rehabilitation of preschool children with cerebral palsy (CP). BACKGROUND: FCC is considered a reference for best practices in child rehabilitation. CP is the most common cause of physical disability in childhood with repercussions on functionality. There is a gap in knowledge of the practical principles of FCC, and it is necessary to develop a reference model for the practice of child rehabilitation professionals. METHODS: In this scoping review, the main databases selected were as follows: LILACS; Pubmed; Embase; The Cochrane Library; CINAHL (EBSCO); Scopus; Web of Science; PEDro (Physiotherapy Evidence Database); Open Gray and other banks of thesis. The terms combined in the search strategy were as follows: 'Family-centered', 'Family-centred' and 'CP'. Inclusion criteria are as follows: studies on preschool-aged children with CP, undergoing family-centred functional therapeutic interventions (FCFTI) with outcomes on bodily structures and functions and/or activities and/or participation. RESULTS: The main participatory care methods identified were home intervention, environmental enrichment, collaborative realistic goal setting, planning of home-based activities and routine, child assessment feedback, family education/training, family coaching, encouraging discussion, observation of therapist and supervised practice. The main relational care qualities identified were as follows: respect, active listening, treat parents as equals, clear language, respect parents' ability to collaborate, demonstrate genuine care for the family, appreciate parents' knowledge and skills, demonstrate competence, experience and commitment. The main outcomes identified in children were improvement in motor and cognitive function and the child's functional ability. The main parentaloutcomes identified were empowerment, feeling of competence, self-confidence, motivation and engagement. CONCLUSION: The main differences in FCFTI programs refer to the parental education/guidance component and the amount of intervention carried out by parents. It is possible that the elements chosen by the therapist in a FCFTI depend on characteristics of the child and caregivers.

Association between participation at home and functional skills in children and adolescents with Down syndrome: A cross-sectional study.

BACKGROUND: According to a biopsychosocial approach to health and disability, participation at home and functional skills are important components of the functioning. Therefore, knowledge about interactions between these components allows for targeting specific interventions. OBJECTIVE: This study investigated whether participation opportunities (frequency and involvement) for children/adolescents with Down syndrome (DS) in a realistic environment at their own home are associated with the functional skills related to the domains of Daily Activities, Mobility, Social/Cognitive and Responsibility. METHODS: This was an observational study. Forty-eight children/adolescents with DS participated (mean age: 10.73 ± 3.43; n = 27 females). Participants were evaluated using the Participation and Environment Measure for Children and Youth (PEM-CY) home environment setting (raw frequency and engagement scores) and Pediatric Evaluation of Disability Inventory speedy version (PEDI-CAT-SV) (continuous score). RESULTS: Significant and positive correlations were found between the frequency of participation at home with Daily Activities (ro = 0.320), Social/Cognitive (ro = 0.423) and Responsibility (ro = 0.455). For involvement, significant and positive correlations were found with Daily Activities (ro = 0.297), Social/Cognitive (ro = 0.380) and Responsibility (ro = 0.380). For the PEDI-CAT-SV Mobility, no significant correlation was found. CONCLUSIONS: Higher frequency and involvement of participation at home are associated with greater functional skills assessed, except for Mobility. This study provided pioneering insights about the relationships between the level of home participation and functional skills in DS, generating evidence that could guide approaches to participation-focused intervention.

Construct validity of the Child-Initiated Pretend Play Assessment-For 3-year-old Brazilian children.

INTRODUCTION: Play is an indication of children's development and how they function. In occupational therapy it is regarded as an important occupation of childhood. Assessment of a child's play should be included in the test batteries of occupational therapists, who understand the construct validity of the assessment they have chosen. Our aim was to provide evidence of reliability, internal consistency and hypotheses testing of the construct validity of the cross-culturally adapted version of the Child-Initiated Pretend Play Assessment. METHODS: Two hundred typically developing Brazilian children aged 3 years were evaluated individually using the Child-Initiated Pretend Play Assessment. RESULTS: The internal consistency showed a Cronbach's alpha coefficient to Percentage of Pretend Play Actions (PEPA) of 0.86 and NOS of 0.81. There were significant differences between the younger children (aged 36-41 months) and the older children (aged 42-47 months) for elaborate play across both conventional-imaginative play (p = .002), symbolic play (p = .012), and the combined score (p = .005). There were significant differences between younger and older girls for elaborate play with symbolic play materials (p = .009) and elaborate play overall (p = .039). There were significant differences between young and older boys for elaborate play with conventional toys (p = .006) and elaborate play overall (p = .025). There were no significant differences for object substitution or imitated actions. CONCLUSION: The measurement properties of the cross-culturally adapted version of the Child-Initiated Pretend Play Assessment for 3-year-old Brazilian children identified evidence for response processes, internal structure, with discussion of consequences of testing for 3-year-old Brazilian children.

An investigation of the quality of pretend play ability in children with cerebral palsy.

BACKGROUND: Cerebral palsy (CP) describes a group of permanent disorders in the development of movement and posture due to non-progressive disturbances during foetal or infant brain development that can result in activity limitations, including engagement in pretend play. METHODS: Twenty children aged four to seven years with spastic CP participated in this descriptive qualitative study. The Child-Initiated Pretend Play Assessment (ChIPPA) clinical observations were analysed from five categories: Time, Interaction with the examiner, Imitation, Theme and Story. RESULTS: Seventy per cent (70%) of the children completed the assessment (Time), and 90% of children interacted socially with the examiner during the play (Interaction with the examiner). All children initiated their pretend play without requiring examiner demonstration (Imitation). Sixty per cent (60%) of the children were appropriate to their stage of development for Theme. Finally, 60% of the children set up a scenario, but did not develop a narrative (Story). CONCLUSION: Qualitative aspects of the children's pretend play performance were satisfactory, showing typical play indicators in all the categories, except for 'Story'. 'Story' represents more complexity in a child's pretend play ability. Therefore, a play intervention is suggested to stimulate and expand the pretend play ability of preschool children with CP.

The influence of epilepsy on children's perception of self-concept.

The diagnosis of epilepsy can lead to changes in the patient's perception due to factors such as learning and behavioral problems, lack of academic motivation, and low self-esteem. This study aimed to evaluate and compare the knowledge of self-concept in children with epilepsy and those with typical development and verify whether gender and age influence this perception. Eighty children of both sexes, aged between 8 and 14years, participated in this study. The children were divided into two groups: the epilepsy group, which consisted of 40 children diagnosed with epilepsy, and the control group, which consisted of 40 children with typical development and comparable to group 1 according to sex and age. The Piers-Harris Children's Self-Concept Scale, translated and adapted for the Brazilian population, was used as the evaluation instrument. In total, there were 23 boys and 17 girls in each group, with a mean age of 10.7years. There were significant differences in the overall score (p=0.000) and the subareas "behavior" (p=0.006), "intellectual and academic status" (p=0.001), and "popularity" (p=0.004). The group of children with epilepsy had a lower average score in self-concept. Children with epilepsy were observed to perceive themselves as clumsy, without many friends, with low academic performance and problems at school, and to experiencing feelings of unhappiness. These findings suggest that, in addition to the treatment of the clinical manifestations of epilepsy, it is extremely important to provide treatment focused on improving the self-concept of school-aged children with this condition.

Puppets as a strategy for communication with Brazilian children with cancer.

Children are considered competent social actors. Although they are able to express their opinions, they may have some difficulties in answering direct verbal questions, requiring researchers and health professionals to enter their world by using auxiliary resources for communication. This study presents the experience of using finger puppets as a playful strategy for improving interaction and communication with hospitalized children with cancer, aged seven to 12. It describes the strategy of making and using puppets as an auxiliary tool to communicate with children with cancer and presents the results and limitations of using puppets in clinical practice. The use of the puppets, creatively and in accordance with the children's motor, cognitive, and emotional development, showed benefits, such as allowing the children to freely express themselves; respecting their autonomy; and minimizing the hierarchical adult-child relationship. The use of puppets is an appropriate strategy to communicate with hospitalized children. This tool can also enrich clinical practice, as it encourages children with cancer to report their experience of being ill and also helps the health team during evaluation and intervention.

Coping strategies used by hospitalized children with cancer undergoing chemotherapy.

PURPOSE: To analyze coping strategies used by children with cancer undergoing chemotherapy during hospitalization. DESIGN AND METHODS: This was an exploratory study to analyze qualitative data using an inductive thematic analysis. Semistructured interviews using puppets were conducted with 10 children with cancer, between 7 and 12 years old, who were hospitalized and undergoing chemotherapy. FINDINGS: The coping strategies to deal with chemotherapy were: understanding the need for chemotherapy; finding relief for the chemotherapy's side effects and pain; seeking pleasure in nourishment; engaging in entertaining activities and having fun; keeping the hope of cure alive; and finding support in religion. CONCLUSIONS: Children with cancer undergoing chemotherapy need to cope with hospitalizations, pain, medication side effects, idle time, and uncertainty regarding the success of treatment. These challenges motivated children to develop their own coping strategies, which were effective while undergoing chemotherapy. CLINICAL RELEVANCE: By gaining knowledge and further understanding about valid coping strategies during chemotherapy treatment, health professionals can mobilize personal and material resources from the children, health teams, and institutions aiming to potentiate the use of these strategies to make treatments the least traumatic.

[Playful strategies for data collection with child cancer patients: an integrative review]. / Estratégias lúdicas de coleta de dados com crianças com câncer: revisão integrativa.

Children are the best sources of information on their experiences and opinions, and qualitative studies have favored the development and application of techniques that facilitate their self-expression and approaching the researcher. Through an integrative literature review, the objective of this research was to identify playful resources used in qualitative research data collection with child cancer patients, and their forms of application. Systemized searches of electronic databases and a virtual library were undertaken, which, combined with a non-systemized sample, totaled 15 studies spanning the period from 2000 and 2010. Drawing, toys, puppets, photography and creativity and sensitivity dynamics were identified which, in association with interviews or not, were shown to directly or indirectly facilitate data collection, thereby broadening the interaction with the children, and permitting further expression of their feelings. The advantages and limitations of using these resources are presented thus contributing to planning research with children.

Cultural adaptation and reliability assessment of the Hammersmith neonatal neurological examination for Brazilian newborns at risk of cerebral palsy.

BACKGROUND: Reliable instruments that lead to early diagnosis for CP are extremely important so that these children are referred for early stimulation, benefiting their development. OBJECTIVE: To perform a cross-cultural adaptation and reliability assessment of a Brazilian version of the Hammersmith Neonatal Neurological Examination (HNNE), expanded and summarized. METHODS: A methodological, cross-sectional, nonexperimental quantitative analysis was conducted in two phases as follows: cultural adaptation of the HNNE, expanded and summarized, and reliability assessment of the Brazilian version of the HNNE. Phase one was developed in five stages (initial translation, synthesis of the translation, a committee of experts, backtranslation, and submission to the author), with the semantic questions, content, and face validity being evaluated. Phase two included 143 newborns and we analyzed the internal consistency, stability, and equivalence (intra- and interexaminer) of the instrument. Internal consistency was calculated using Cronbach's alpha, and intra- and interexaminer reliability and reproducibility assessed through test-retest were calculated using the intraclass correlation coefficient RESULTS: Although internal consistency, assessed using Cronbach's alpha, showed unsatisfactory results, the results of inter-and intraexaminer equivalence showed a high agreement between the evaluations in all domains. The test-retest also showed excellent agreement between the domains. CONCLUSIONS: The Brazilian HNNE expanded and summarized versions can be considered to be adapted and reliable for the neurological assessment of Brazilian newborns to identify changes in neurological development and early referral to the stimulation or early rehabilitation units and as a promising option to be used in the context of primary care in Brazil.

ANTECEDENTES: As avaliações neurológicas que levam ao diagnóstico precoce permitem o acesso oportuno à intervenção em um período em que os maiores ganhos são possíveis devido à neuroplasticidade. OBJETIVOS: Realizar a adaptação transcultural e avaliação da confiabilidade da versão brasileira do Hammersmith Neonatal Neurological Examination (HNNE), ampliada e resumida. MéTODOS: Foi realizada análise quantitativa metodológica, transversal e não experimental em duas fases: adaptação cultural do HNNE, ampliada e resumida, e avaliação da confiabilidade da versão brasileira do HNNE. A primeira fase foi desenvolvida em cinco etapas (tradução inicial, síntese da tradução, comitê de especialistas, retrotradução e submissão ao autor), sendo avaliadas as questões semânticas, conteúdo e validade de face. A fase dois incluiu 143 recém-nascidos e foram analisadas a consistência interna, estabilidade e equivalência (intra e interexaminador) do instrumento. A consistência interna foi calculada pelo alfa de Cronbach, e a confiabilidade e reprodutibilidade intra e interexaminadores avaliadas por meio do teste-reteste foram calculadas pelo coeficiente de correlação intraclasse. RESULTADOS: Embora a consistência interna, avaliada pelo alfa de Cronbach, tenha apresentado resultados insatisfatórios, os resultados da equivalência inter e intraexaminadores mostraram alta concordância entre as avaliações em todos os domínios. O teste-reteste também apresentou excelente concordância entre os domínios. CONCLUSõES: As versões brasileiras ampliadas e resumidas do HNNE podem ser consideradas adaptadas e confiáveis para avaliação neurológica de recém-nascidos brasileiros por identificar alterações no desenvolvimento neurológico e encaminhamento precoce para unidades de estimulação ou reabilitação precoce e como uma opção promissora para uso no contexto da atenção básica no Brasil.

The use of virtual reality in the stimulation of manual function in children with cerebral palsy: a systematic review.

OBJECTIVE: To identify in national and international literature the use of virtual reality to develop manual skills of children with cerebral palsy. METHODS: This is a systematic review carried out in the PubMed database, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and the Online System for Search and Analysis of Medical Literature (Ovid Medline) using the keywords "cerebral palsy", "virtual reality", "occupational therapy", "child", "daily activities/activities of daily living", in English and in Portuguese. The selected articles had their methodological quality evaluated through the Physiotherapy Evidence Database (PEDro scale). RESULTS: 228 studies were selected, as they included children with cerebral palsy undergoing treatment with exposure to virtual reality to improve manual function in daily activities. Studies on other themes, incomplete, and duplicated reviews were excluded. Three evaluators conducted the study selection process and included 14 articles in the analysis. CONCLUSIONS: The findings suggest that virtual reality therapy has contributed to an improvement in the manual function of children with cerebral palsy, constituting a useful resource for a supporting intervention to enhance traditional therapies.

Cross-Cultural Adaptation and Reliability of the Toddler Sensory Profile 2 for Brazilian Children Aged 7 to 35 Months.

Aim: To organize a cross-cultural adaptation study and analyze the reproducibility and test-retest reliability of a Brazilian version of the Toddler Sensory Profile 2 (TSP2Br) for children aged 7-35 months. Methods: The English language version of the profile was translated and culturally adapted into Brazilian Portuguese, administered to 168 caregivers of toddlers aged 7-35 months, and then re-administered to a portion of the sample (39 caregivers; 23%) for 7-14 days for test-retest reliability. The internal consistency and test-retest reliability was analyzed using the Cronbach's alpha and kappa coefficient, respectively. As it is a norm-referenced standardized assessment, the cut-off scores used were 1.0 and 2.0 standard deviations above and below the mean for each group of items established as the preliminary cut-off scores for the Brazilian children. Results: The TSP2Br showed good internal consistency (>0.70) when measured on the total scale; however, when it was analyzed for sensory areas, five to seven areas presented alpha values <.70. By quadrants, alpha was <.70, for all items. The test-retest values fell into the category of near-perfect agreement (.89-.97). The preliminary cut-off points of the Brazilian scores were distinct from those of the Americans. Conclusions: The TSP2Br showed preliminary reliability and validity in the identification of sensory processing problems in Brazilian children aged 7-35 months; however, it would be necessary to increase the sample size to generalize our findings to the general Brazilian population.

Functional outcomes in children related to self-care, mobility, and social function after stroke in early childhood: a cohort study.

BACKGROUND: Stroke has been increasingly recognized as an important morbidity and mortality factor in neonates and children. Children have different and more diverse risk factors than adults, commonly related to an underlying disease. Stroke may compromise functional capacity in children. Few studies have focused on functional outcomes related to activities and participation. OBJECTIVES: To investigate post-stroke functionality of children related to self-care, mobility, and social function. METHODS: We assessed the functional outcome of 14 children younger than 7.5 years who suffered a stroke in early childhood through the use of the Pediatric Evaluation of Disability Inventory (PEDI). RESULTS: The average age of the sample at assessment was 3.6 ± 1.4 years (2 - 6 years). The average scores in the PEDI functional domains of self-care, mobility, and social function were, respectively, 37.6 ± 15.4, 36.2 ± 15.4, and 48.7 ± 11.1. Children showed age-appropriate functional outcomes in the PEDI functional domains: 71.4% of them in self-care and mobility and 92.9% in social function. Children with bilateral injuries (p = 0.05) and longer hospital stays (r = -0.79, p = 0.001) showed the worst scores in ​​PEDI's social function domains. CONCLUSIONS: Overall, our sample of preschool children showed age-appropriate functional outcomes on self-care, mobility, and social function domains after stroke. However, children with bilateral injuries and longer hospital stays showed the worst scores in social function domains. We recommend focusing on functional rehabilitation to promote activities and participation and to monitor the development of children's social skills after stroke.

Pretend play of children with cerebral palsy.

BACKGROUND AND PURPOSE: Evaluate self-initiated pretend play of children with cerebral palsy. METHOD: Twenty preschool children participated in the study. Pretend play ability was measured by using the child-initiated pretend play assessment culturally adapted to Brazil. RESULTS: There were significant negative correlations between the children's motor severity level and their elaborateness of play with conventional-imaginative and symbolic play materials and a number of object substitutions in symbolic play. This indicated that children with greater motor limitations had diminished play ability. In this sample, 35% of the children showed typical play styles, identified by good scores in elaborate pretend play actions, number of object substitutions, and ability to self-initiate play, whereas 65% showed delay in their play. IMPLICATIONS: The type of pretend play deficits that might be expected in children with cerebral palsy were described. Furthermore, suggested directions for therapeutic intervention to enhance pretend play performance in cerebral palsy children were proposed.

Play preference of children with ADHD and typically developing children in Brazil: a pilot study.

BACKGROUND/AIM: Children with attention deficit hyperactivity disorder (ADHD) have been reported to have play deficits, which can cause problems in occupational development. The aim of this paper was to report research findings on children with ADHD and typically developing children in relation to preference of play partners, play places, toys and type of play. METHODS: Thirty-two school aged children from low socioeconomic status were divided into two groups. One group of 16 children with ADHD were matched with 16 typically developing children. RESULTS AND CONCLUSION: There were no significant differences between the two groups in relation to play partners, with classmates being the most frequent play partner for both groups. There were significant differences between the two groups in preferred place to play. Children with ADHD preferred to play in school and typically developing children preferred to play on the street. There were significant differences in relation to toys and type of play engaged in with children with ADHD preferring educational materials and typically developing children preferring electronic games. These findings add to knowledge of Brazilian children with ADHD and their play preferences. Comparisons are made with research with Australian children with and without ADHD.

[Playing in the waiting room of a children's outpatient clinic: the view of health professionals]. / O brincar em sala de espera de um Ambulatório Infantil: a visão dos profissionais de saúde.

The objective of this study was to understand, from the perspective of health professionals, the meaning of playing/toys in the waiting room of a children's outpatient clinic. Semi-structured interviews were performed with 11 workers. A quantitative analysis of the data was performed around two themes: acknowledging the importance of playing/toys and dealing with limitations. Playing is seen as a care strategy towards children, as it alleviates the waiting time in this environment, changes behavior in a positive way, and values the children's development process, besides improving the communication and interaction with health professionals. It is, however, necessary for the hospital to have adequate physical structure, allied to the health professionals and to the management team, which are sensitive regarding the inclusion of new care strategies, such as playing, with a view to humanize children's health care.

Validation of the Revised Knox Preschool Play Scale for the Brazilian Population.

BACKGROUND: Play is essential to child development, and its evaluation is considered valid to indicate the stage of development of the child and indicate possible lagging. The Revised Knox Preschool Play Scale (RKPPS) provides an evolving description of the typical play behavior of preschool children, in six-month periods from zero to three years of age and then in annual periods up to six years of age. The RKPPS has already undergone the process of cultural adaptation for use in the Brazilian population, and it is necessary to analyze its applicability. AIMS: To verify the reliability and internal consistency of the RKPPS for Brazilian children. METHOD: 135 children participated in the study, divided into different age groups with 15 in each group, and were filmed during free play in school or home contexts. Two independent raters evaluated the footage from two different times. Based on these evaluations, a statistical analysis was carried out in order to ascertain the reliability and the internal consistency of the Brazilian version of the RKPPS. RESULTS: Intra- and interrater reliability showed a predominance of near-perfect to moderate agreement; however, some dimensions of certain age groups presented reasonable to poor agreement. The internal consistency was found to be satisfactory for most of the items evaluated; however, there were items with poor results in some dimensions of certain age groups. CONCLUSIONS: There is a need for further analysis of these items by a committee of experts to ensure the reproducibility of the instrument.

Cultural adaptation and reliability assessment of the Hammersmith neonatal neurological examination for Brazilian newborns at risk of cerebral palsy / Adaptação cultural e avaliação da confiabilidade do exame neurológico neonatal de Hammersmith para recém-nascidos brasileiros com risco de paralisia cerebral

Abstract Background Reliable instruments that lead to early diagnosis for CP are extremely important so that these children are referred for early stimulation, benefiting their development. Objective To perform a cross-cultural adaptation and reliability assessment of a Brazilian version of the Hammersmith Neonatal Neurological Examination (HNNE), expanded and summarized. Methods A methodological, cross-sectional, nonexperimental quantitative analysis was conducted in two phases as follows: cultural adaptation of the HNNE, expanded and summarized, and reliability assessment of the Brazilian version of the HNNE. Phase one was developed in five stages (initial translation, synthesis of the translation, a committee of experts, backtranslation, and submission to the author), with the semantic questions, content, and face validity being evaluated. Phase two included 143 newborns and we analyzed the internal consistency, stability, and equivalence (intra- and interexaminer) of the instrument. Internal consistency was calculated using Cronbach's alpha, and intra- and interexaminer reliability and reproducibility assessed through test-retest were calculated using the intraclass correlation coefficient Results Although internal consistency, assessed using Cronbach's alpha, showed unsatisfactory results, the results of inter-and intraexaminer equivalence showed a high agreement between the evaluations in all domains. The test-retest also showed excellent agreement between the domains. Conclusions The Brazilian HNNE expanded and summarized versions can be considered to be adapted and reliable for the neurological assessment of Brazilian newborns to identify changes in neurological development and early referral to the stimulation or early rehabilitation units and as a promising option to be used in the context of primary care in Brazil.

Resumo Antecedentes As avaliações neurológicas que levam ao diagnóstico precoce permitem o acesso oportuno à intervenção em um período em que os maiores ganhos são possíveis devido à neuroplasticidade. Objetivos Realizar a adaptação transcultural e avaliação da confiabilidade da versão brasileira do Hammersmith Neonatal Neurological Examination (HNNE), ampliada e resumida. Métodos Foi realizada análise quantitativa metodológica, transversal e não experimental em duas fases: adaptação cultural do HNNE, ampliada e resumida, e avaliação da confiabilidade da versão brasileira do HNNE. A primeira fase foi desenvolvida em cinco etapas (tradução inicial, síntese da tradução, comitê de especialistas, retrotradução e submissão ao autor), sendo avaliadas as questões semânticas, conteúdo e validade de face. A fase dois incluiu 143 recém-nascidos e foram analisadas a consistência interna, estabilidade e equivalência (intra e interexaminador) do instrumento. A consistência interna foi calculada pelo alfa de Cronbach, e a confiabilidade e reprodutibilidade intra e interexaminadores avaliadas por meio do teste-reteste foram calculadas pelo coeficiente de correlação intraclasse. Resultados Embora a consistência interna, avaliada pelo alfa de Cronbach, tenha apresentado resultados insatisfatórios, os resultados da equivalência inter e intraexaminadores mostraram alta concordância entre as avaliações em todos os domínios. O teste-reteste também apresentou excelente concordância entre os domínios. Conclusões As versões brasileiras ampliadas e resumidas do HNNE podem ser consideradas adaptadas e confiáveis para avaliação neurológica de recém-nascidos brasileiros por identificar alterações no desenvolvimento neurológico e encaminhamento precoce para unidades de estimulação ou reabilitação precoce e como uma opção promissora para uso no contexto da atenção básica no Brasil.

The use of virtual reality in the stimulation of manual function in children with cerebral palsy: a systematic review / A utilização da realidade virtual na estimulação da função manual em crianças com paralisia cerebral: uma revisão sistemática

Abstract Objective: To identify in national and international literature the use of virtual reality to develop manual skills of children with cerebral palsy. Methods: This is a systematic review carried out in the PubMed database, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and the Online System for Search and Analysis of Medical Literature (Ovid Medline) using the keywords "cerebral palsy", "virtual reality", "occupational therapy", "child", "daily activities/activities of daily living", in English and in Portuguese. The selected articles had their methodological quality evaluated through the Physiotherapy Evidence Database (PEDro scale). Results: 228 studies were selected, as they included children with cerebral palsy undergoing treatment with exposure to virtual reality to improve manual function in daily activities. Studies on other themes, incomplete, and duplicated reviews were excluded. Three evaluators conducted the study selection process and included 14 articles in the analysis. Conclusions: The findings suggest that virtual reality therapy has contributed to an improvement in the manual function of children with cerebral palsy, constituting a useful resource for a supporting intervention to enhance traditional therapies.

Resumo Objetivo: Identificar na literatura nacional e internacional o uso da realidade virtual no desenvolvimento de habilidades manuais de crianças com paralisia cerebral. Métodos: Revisão sistemática realizada nas bases de dados United States National Library of Medicine (PubMed), Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e no Sistema Online de Busca e Análise de Literatura Médica (Ovid Medline) utilizando as palavras-chave "paralisia cerebral", "realidade virtual", "terapia ocupacional", "criança", "atividades diárias/ atividades cotidianas", em inglês e português. A qualidade metodológica dos artigos selecionados foi avaliada pela Physiotherapy Evidence Database (escala PEDro). Resultados: Foram selecionados 228 estudos que incluíam crianças com paralisia cerebral em tratamento com exposição à realidade virtual para a melhora da função manual nas atividades diárias, sendo excluídos os que estavam fora da temática, os incompletos e os duplicados. Três juízes conduziram o processo de seleção dos trabalhos, incluindo 14 artigos na análise. Conclusões: Os achados sugerem que a terapia com realidade virtual tem contribuído para a melhora na função manual de crianças com paralisia cerebral, constituindo-se em recurso útil de intervenção coadjuvante potencializadora das terapias tradicionais.

Tradução e Adaptação Cultural do School Companion Sensory Profile 2 para Crianças e Jovens Brasileiros / Translation and Cultural Adaptation of the School Companion Sensory Profile 2 for Brazilian Children and Youths

RESUMO: Este estudo objetivou adaptar culturalmente, verificar a confiabilidade e sugerir um escore normativo do School Companion Sensory Profile 2 (SCSP-2) para crianças e jovens brasileiros de 3 a 14 anos e 11 meses. O SCSP-2 foi adaptado culturalmente para o Brasil seguindo as etapas de tradução inicial (dois tradutores independentes), tradução conciliada (dois integrantes do comitê técnico), análise de equivalência (quatro especialistas em integração sensorial), retrotradução (dois tradutores de língua materna inglesa), aprovação da autora e pré-teste. O pré-teste verificou a clareza e a compreensão (desdobramento cognitivo/validade de face) e a confiabilidade (equivalência interexaminadores, consistência interna e reprodutibilidade) da versão traduzida, com a participação de 74 professores que responderam ao questionário referente a 146 crianças. Os itens apresentaram índice de concordância acima de 75% no desdobramento cognitivo. A equivalência interexaminadores e teste-reteste apresentaram K ≥ 0,88 em todos os itens pesquisados. Observaram-se valores aceitáveis de consistência interna em quase todas as áreas sensoriais, quadrantes de procura sensorial e sensibilidade sensorial e no fator escolar 2. Os escores preliminares brasileiros são distintos dos americanos. O SCSP-2 adaptado para o Brasil apresenta evidências de validade baseada no conteúdo, além de boa consistência interna, possibilitando identificar problemas de processamento sensorial em crianças e jovens brasileiros.

ABSTRACT: This study aimed to adapt culturally, verify the reliability, and suggest a normative score for the School Companion Sensory Profile 2 (SCSP-2) for Brazilian children and youths aged 3 to 14 years and 11 months. The SCSP-2 was culturally adapted for Brazil following the steps of initial translation (two independent translators), reconciled translation (two members of the technical committee), equivalence analysis (four experts in sensory integration), back-translation (two English mother tongue translators), author approval and pre-test. The pre-test verified the clarity and understanding (cognitive unfolding/face validity) and reliability (inter-examiner equivalence, internal consistency, and reproducibility) of the translated version, with the participation of 74 teachers who answered the questionnaire referring to 146 children. The items showed an agreement rate above 75% in cognitive unfolding/face validity. The inter-examiner and test-retest equivalence showed K ≥ 0.88 in all items surveyed. Acceptable internal consistency values were observed in almost all sensory areas, quadrants of sensory seeking and sensory sensitivity, and in the school factor 2. The Brazilian preliminary scores are different from the American ones. The SCSP-2 adapted for Brazil presents evidence of content-based validity and good internal consistency, making it possible to identify sensory processing problems in Brazilian children and youths.