Hybrid developmental follow-up for preterm infants in Brazil: A feasibility study.

INTRODUCTION: The low attendance of families in child developmental follow-up programs for at-risk preterm children is a challenge in Brazil. OBJECTIVE: This study evaluates the feasibility of implementing a developmental follow-up program for Brazilian preterm infants in a hybrid format. METHODS: This is an observational, prospective cohort study, involving preterm infants. Longitudinal developmental test results, the participation frequency in the program, and the number of referrals to early intervention programs were used to assess feasibility. The General Movements (GMs) assessment, Alberta Infant Motor Scale (AIMS) and, Survey of Wellbeing of Young Children (SWYC) Milestones were administered via telehealth. The Bayley-III was administered in-person. RESULTS: Thirty-four preterm infants attended the follow-up until 12 months of corrected age and 18 (52.9 %) concluded all follow-up assessments. Twenty-six (76.5 %) attended all assessments via telehealth, and 26 (76.5 %) attended the in-person assessment. Eighteen (52.9 %) infants showed at least one altered result in development tests. Infants exhibiting abnormal results in the GMs assessment, motor developmental delay according to the AIMS, or developmental delay based on Balley-III were promptly referred to early intervention services. CONCLUSION: This study demonstrated high participation rate and low dropout in a developmental follow-up program employing a hybrid format. The substantial number of identified infants with developmental delay emphasizes the importance of timely detection of motor delays to referral to early intervention services.

Predictive validity of the Denver developmental screening test (Denver-II) to detect risk of developmental coordination disorder in preterm children.

INTRODUCTION: The Denver-II is widely used as a screening tool, however, no studies were found about its validity to predict the risk of Developmental Coordination Disorder (DCD) in preterm children. OBJECTIVE: To verify the predictive validity and accuracy of the Denver-II to identify the risk of DCD in preterm children. METHODS: Methodological study with 121 preterm children, evaluated with the Denver-II at ages 1, 2, 3, 4 and/or 5 years and with the Movement Assessment Battery for Children (MABC-2) at 7 years. Univariate binary logistic regression analyses were performed and ROC curves were derived. RESULTS: Children classified as suspect by Denver-II at 2, 3, and 4 years were, respectively, 3.45, 7.40 and 6.06 times more likely to have a risk of DCD on the MABC-2 (p < 0.05). The area under the ROC curve was considered fair for ages 2 (0.60, 95 % CI 0.50-0.70), 3 (0.61, 95 % CI 0.51-0.71) and 4 (0.64, 95 % CI 0.54-0.74) years. The greater the number of suspects in Denver-II over time, the greater the probability of risk of DCD in the MABC-2 (p < 0.001). CONCLUSIONS: Global developmental assessment with the Denver-II at ages 2 to 4 years is considered to have fair accuracy to discriminate risk of DCD at school age in children born preterm.

Cross-cultural validation of the Brazilian Little Developmental Coordination Disorder Questionnaire (LDCDQ-BR) for preschool children.

INTRODUCTION: Motor difficulties associated with Developmental Coordination Disorder (DCD) are frequently apparent before the accepted diagnostic age of 5. Tools to support identification of DCD markers would allow provision of early intervention to reduce negative sequelae. OBJECTIVE: Establish psychometric properties and define preliminary cut-off scores for the Brazilian Little Developmental Coordination Disorder Questionnaire - Brazil (LDCDQ-BR). METHODS AND PROCEDURES: Parents of 3- and 4-year-old children (n = 312; 154 girls) from Belo Horizonte/MG, Brazil, completed the LDCDQ-BR, the Brazil Economic Classification Criterion and a demographic questionnaire. One sub-set of children (n = 119) was assessed with the Movement Assessment Battery for Children-2nd Edition; another sub-set (n = 77) completed the LDCDQ-BR a second time. RESULTS: Rasch analysis indicated good item functioning with only one erratic item, suggesting unidimensionality. Item calibration reliability was excellent (0.97), children's measures reliability was low (0.72), but implying separation of 2.46 motor ability levels. Significant, low correlations were found between the LDCDQ-BR and MABC-2 (r = 0.30, p < 0.01). Test-retest reliability was 0.77 (total score) and 0.44-0.78 (individual items). ROC curve analysis revealed sensitivity of 68% at a cut-off score of 64. CONCLUSION: The LDCDQ-BR shows promising psychometric properties to support early identification of DCD.

Evaluation of the Reliability and Validity of the Brazilian Version of the Here's How I Write: A Child's Self-Assessment and Goal Setting Tool.

OBJECTIVE: Our objective was to translate the Here's How I Write: A Child's Self-Assessment and Goal Setting Tool (HHIW) to Portuguese; adapt it to the Brazilian culture; and analyze its reliability, validity, and clinical feasibility. METHOD: The study was developed in two steps: adaptation of the HHIW to Brazilian Portuguese, followed by experimental application to examine its validity and reliability. The participants were 60 children and their teachers, divided into two groups: Group 1, whose members had handwriting difficulties, and Group 2, whose members did not. RESULTS: Children with poor handwriting scored lower on the HHIW for both self- and teacher report. Test-retest reliability of the children's (.96) and teachers' (.93) questionnaires as well as internal consistency (.91 and .95, respectively) were excellent. There was good agreement (.74) between the children's and teachers' total scores. CONCLUSIONS: This study adds further evidence of validity and reliability and supports the international use of the HHIW. The HHIW is a useful resource to engage children and teachers in a collaborative relationship to improve handwriting.

Assessing gross motor development of Brazilian infants.

PURPOSE: To determine whether the Alberta Infant Motor Scale (AIMS) requires reference values specific for Brazilian infants. METHODS: A total of 660 (330 girls) healthy full-term infants from Belo Horizonte were assessed using the AIMS. Scores and percentile curves were compared with the Canadian reference values. RESULTS AND DISCUSSION: Differences were found in the 5th percentile (9-<10 and 10-<11 months) and the 10th percentile (4-<5, 9-<10, and 10-<11 months) curves. No significant differences were found between sexes on the basis of the economic classification or the criteria of the Human Development Index. CONCLUSION: Primarily because of the corrections made to the 5th and 10th percentile curves, we recommend the use of the Brazilian infant data curves reported here for further studies conducted in Brazil. Because the Human Development Index of Belo Horizonte is similar to that for Brazil as a whole, the results of this study should be relevant for clinicians throughout Brazil.