Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors / Avaliação cognitiva em crianças pré-termo usando Bayley-III: desenvolvimento no primeiro ano de vida e fatores associados

ABSTRACT Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

RESUMO Objetivo: Avaliar o desenvolvimento cognitivo de crianças pré-termo aos seis e 12 meses de idade corrigida e as associações com fatores perinatais e socioeconômicos. Métodos: O desenvolvimento cognitivo de 40 crianças (20 pré-termo e 20 a termo) foi avaliado aos seis e 12 meses de idade, utilizando a escala Bayley-III. Correlações entre resultados cognitivos e fatores associados foram avaliadas pelo teste de correlação de Spearman. A análise de regressão linear múltipla stepwise com covariância foi aplicada para identificar mudanças na pontuação cognitiva entre seis e 12 meses. Resultados: O escore cognitivo no grupo pré-termo foi significativamente menor que no grupo a termo aos seis e 12 meses. O peso ao nascer foi diretamente associado com o desempenho cognitivo aos seis meses e perímetro cefálico ao nascimento aos 12 meses, nas crianças a termo. A ocorrência de enterocolite necrosante foi inversamente associada ao desempenho cognitivo em pré-termos, aos 12 meses. Verificou-se aumento na pontuação cognitiva entre seis e 12 meses nos dois grupos, porém mais pronunciado no pré-termo. Conclusões: O estudo sugere que crianças pré-termo apresentam alguma capacidade de recuperação cognitiva no primeiro ano, apesar das restrições impostas pelo nascimento prematuro, e enfatizam a importância de acompanhamento dessa população desde os primeiros meses de vida.

Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors.

OBJECTIVE: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. METHODS: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. RESULTS: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. CONCLUSIONS: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

Catquest-9SF questionnaire: validation of the Portuguese version using the Rasch analysis / Questionário Catquest-9SF: validação da versão em português utilizando análise Rasch

ABSTRACT Purpose: The aim of this study was to validate the Portuguese version of Catquest-9SF through its application in a native Brazilian population with cataracts and to determine the correlation of the questionnaire scores with preoperative visual acuity. Methods: A prospective study was conducted to validate the Catquest-9SF questionnaire, which was translated and back-translated, generating a final version in Portuguese. A total of 120 Brazilian patients awaiting cataract surgery were recruited to answer the questionnaire and to document their preoperative data and visual acuity. The Rasch analysis was used to assess the instrument's psychometric properties. Results: The Portuguese version of Catquest-9SF demonstrated an acceptable adjustment of the items (item fit statistics ranging from 0.7 to 1.3), unidimensionality (principal component analysis), and good organization in the item response categories (thresholds of the categories: -2.79, 0.57, and 2.22, respectively). The questionnaire contains items with stable relationships if considered at the same level of visual impairment in the comparison between the two groups (absence of differential item functioning). The separation of people (person separation index, 3.07) was adequate. The visual acuity in the logarithm of the minimum angle of resolution (logMAR) in the best eye with the best optical correction showed a statistically significant correlation with the Catquest-9SF logit score (r=0.282 and p=0.004). Conclusions: The Portuguese version of Catquest-9SF presents evidence of validity and reliability, in addition to being linguistically and culturally understandable for Portuguese-speaking patients born in Brazil. The questionnaire is easy to understand and quick to apply, as it could adequately estimate the subjective visual functioning in patients with cataracts. We found a significant correlation between visual acuity and the questionnaire score.

RESUMO Objetivos: Validar a versão em português do Catquest-9SF através de sua aplicação em uma população nativa do Brasil com catarata e determinar a correlação da pontuação obtida no questionário com a acuidade visual pré-operatória. Métodos: Realizou-se um estudo prospectivo para validação de questionário. O Catquest-9SF foi traduzido e retro traduzido gerando uma versão final em português. Um total de 120 pacientes brasileiros que aguardavam realização de cirurgia de catarata foram recrutados para responder ao questionário e para documentação de dados pré-operatórios e acuidade visual. Análise Rasch foi utilizada para acessar as propriedades psicométricas do instrumento. Resultados: A versão em português do Catquest-9SF demonstrou ajuste aceitável dos itens (item fit statistics variando entre 0,7 e 1,3), unidimensionalidade (Principal Component Analisis) e boa organização nas categorias de resposta dos itens (limiares das categorias: -2,79; 0,57; 2,22). O questionário contém itens com relação estável, se considerado um mesmo nível de deficiência visual, na comparação entre dois grupos (ausência de differential item functioning). Existe adequada separação de pessoas (Person Separation Index 3,07). A acuidade visual em LogMAR no melhor olho com melhor correção óptica mostrou correlação estatisticamente significativa com a pontuação em logit do Catquest-9SF (r=0,282 e p=0,004). Conclusões: A versão em português do Catquest-9SF apresenta evidência de validade e confiabilidade, além de ser linguística e culturalmente compreensível para pacientes de língua portuguesa naturais do Brasil. Trata-se de questionário de fácil entendimento e rápida aplicação, sendo capaz de estimar de maneira adequada o funcionamento visual subjetivo em pacientes com catarata. Existe correlação significativa com a acuidade visual e a pontuação obtida no questionário.

Catquest-9SF questionnaire: validation of the Portuguese version using the Rasch analysis.

PURPOSE: The aim of this study was to validate the Portuguese version of Catquest-9SF through its application in a native Brazilian population with cataracts and to determine the correlation of the questionnaire scores with preoperative visual acuity. METHODS: A prospective study was conducted to validate the Catquest-9SF questionnaire, which was translated and back-translated, generating a final version in Portuguese. A total of 120 Brazilian patients awaiting cataract surgery were recruited to answer the questionnaire and to document their preoperative data and visual acuity. The Rasch analysis was used to assess the instrument's psychometric properties. RESULTS: The Portuguese version of Catquest-9SF demonstrated an acceptable adjustment of the items (item fit statistics ranging from 0.7 to 1.3), unidimensionality (principal component analysis), and good organization in the item response categories (thresholds of the categories: -2.79, 0.57, and 2.22, respectively). The questionnaire contains items with stable relationships if considered at the same level of visual impairment in the comparison between the two groups (absence of differential item functioning). The separation of people (person separation index, 3.07) was adequate. The visual acuity in the logarithm of the minimum angle of resolution (logMAR) in the best eye with the best optical correction showed a statistically significant correlation with the Catquest-9SF logit score (r=0.282 and p=0.004). CONCLUSIONS: The Portuguese version of Catquest-9SF presents evidence of validity and reliability, in addition to being linguistically and culturally understandable for Portuguese-speaking patients born in Brazil. The questionnaire is easy to understand and quick to apply, as it could adequately estimate the subjective visual functioning in patients with cataracts. We found a significant correlation between visual acuity and the questionnaire score.

Can tactile reactivity in preterm born infants be explained by an immature cortical response to tactile stimulation in the first year? A pilot study.

This study aimed to compare preterm (PT) and full-term (FT) infants' adaptive behavior and functional cortical response to tactile stimulus, as measured by Test of Sensory Functions in Infants and functional Near-Infrared Spectroscopy (fNIRS). Outcome measures were taken at 6 (PT = 26/FT = 21 infants) and 12 months (PT = 15/FT = 14 infants). At 6 months, poorer tactile reactivity was observed in PT, but not confirmed at 12 months. At 6 months, cortical response to tactile stimulus was found in the primary sensorimotor cortex and differences between groups did not reach significance. At 12 months, cortical response was found in the primary sensorimotor cortex and premotor area and in the somatosensory associative area, with significant less frequent response in premotor area in PT. The findings reinforce fNIRS as a tool to complement the knowledge of tactile adaptive behaviors in PT in early life.

Terapia motora cognitiva: descrição e análise clínica de crianças com Transtorno do Desenvolvimento da Coordenação (TDC), / Cognitive motor therapy: description and clinical analysis of children with Developmental Coordination Disorder (DCD)

Resumo Introdução Estima-se que 6% das crianças em idade escolar apresentam Transtorno do Desenvolvimento da Coordenação (TDC), caracterizado por dificuldades motoras que restringem a participação em casa, na comunidade e na escola. A Cognitive Orientation to Daily Occupational Performance Approach (CO-OP) é efetiva para melhorar o desempenho funcional dessas crianças, mas há poucos dados clínicos sobre variações na resposta à intervenção. Objetivo Identificar e descrever as características mais relevantes de crianças com TDC que influenciam sua resposta à CO-OP. Método Estudo de caso conduzido com quatro crianças com TDC submetidas à CO-OP: as duas que obtiveram maior e menor ganho com a intervenção. Os dados obtidos no estudo foram categorizados e sintetizados para compor uma descrição clínica das características dos participantes. Resultados Os pais das crianças com melhor desempenho apresentaram melhor estilo parental. A observação não estruturada das pesquisadoras durante as coletas identificou que as famílias das crianças com maior progresso compareceram mais vezes às coletas e eram mais engajadas. Maior apoio familiar parece proporcionar mais confiança às crianças, além de aumentar a motivação para alcançar os objetivos em terapia. Conclusão O apoio oferecido pelos pais é fator relevante para o bom desempenho de crianças com TDC na intervenção usando a CO-OP. A descrição clínica de crianças com TDC auxilia o raciocínio durante a prática profissional por identificar características que podem influenciar o progresso na intervenção.

Abstract Introduction It is estimated that 6% of school-age children have Developmental Coordination Disorder (DCD), characterized by motor difficulties that restrict participation at home, in the community and at school. The Cognitive Orientation to Daily Occupational Performance Approach (CO-OP) is effective in improving the functional performance of these children, but there is little clinical data on variations in the response to the intervention. Objective To identify and describe the most relevant characteristics of children with DCD that influence their response to CO-OP. Method Case study conducted with four children with DCD who underwent CO-OP: the two who had the highest gain and the two who had the lowest gain with the intervention. The data obtained in this study were categorized and synthesized to compose a clinical description of the participants' characteristics. Results Parents of children with better performance showed better parenting style. Unstructured observation of the researchers during the collections showed that the families of the children with greater progress attended the collections more often and were more engaged. Greater family support seems to provide children with more confidence, as well as increase motivation to achieve goals in therapy. Conclusion The support offered by parents is a relevant factor for the good performance of children with DCD in the intervention using the CO-OP. The clinical description of children with DCD assists in the reasoning during professional practice because it identifies characteristics that can influence progress in the intervention.

Survey of Well-Being of Young Children (SWYC): Preliminary Norms for Screening for Developmental Delay in Brazilian Children Younger than 65 Months.

OBJECTIVE: The objective of this study was to investigate the reliability and validity of the Developmental Milestones Questionnaire of the Survey of Wellbeing of Young Children Brazilian version (DM-SWYC-BR) and establish the preliminary norms to identify suspected developmental delay in Brazilian children up to 65 months. METHODS: A psychometric study was conducted on 1535 children from 3 Brazilian regions. The caregivers answered the Brazilian Portuguese cross-culturally adapted version of the DM-SWYC. We calculated the internal consistency and performed an exploratory factor analysis (EFA). The clinical threshold for the suspected developmental delay was set at 85% from the DM-SWYC-BR mean score for each age. The prevalence of suspected delay was calculated using current preliminary cutoffs and original norms. RESULTS: EFA confirmed the unidimensionality of the DM-SWYC-BR items (average variance extracted = 0.78). Cronbach's alpha was 0.97. At most ages, the difference between the cutoff points in the Brazilian and North American samples was lower than or equal to 2 points, except at 18, 23, 29, 44, 45, 46, and from 54 to 58 months. There was a marked divergence in the prevalence of suspected developmental delay by age ranges using the Brazilian or North American cutoff points. However, the general mean prevalence was quite similar (27.5% vs. 28.2%, respectively). CONCLUSIONS: We established the cutoff points to interpret the DM-SWYC-BR results when screening for developmental delays in Brazilian children. The satisfactory psychometric properties support its use for screening developmental delays in the public health system. Reliable assessment tools are critical to promoting child development effectively, ensuring timely intervention.

Efficacy of CO-OP Approach With and Without Parental Coaching: RCT Study Protocol: Efficacité de l'approche CO-OP avec et sans coaching parental : protocole d'essai clinique randomisé.

BACKGROUND.: Developmental coordination disorder (DCD) leads to decreased occupational performance and restricted participation. Cognitive Orientation to daily Occupational Performance Approach (CO-OP) is effective, and as parental support is a key element, it seems relevant to investigate. PURPOSE.: To describe a study protocol that will compare CO-OP with and without Occupational Performance Coaching (OPC) on activity and participation of children with DCD. METHOD.: Randomized controlled with seven to 12-year-olds, assigned to either experimental (CO-OP+OPC) or control (CO-OP) group, both receiving traditional CO-OP, with four additional parental group sessions for the experimental group. KEY ISSUES.: Actual and perceived occupational performance and satisfaction of children's chosen goals and participation, motor performance and executive function. Measures will be obtained at baseline, post-intervention, and at 3-month follow-up. IMPLICATIONS.: Detailed description of an intervention protocol may help further replication and may contribute to clarify if a boost on parents' participation promotes better outcomes for children with DCD. TRIAL REGISTRATION.: Clinical Trials, NCT02893852. (https://clinicaltrials.gov/ct2/show/NCT02893852).

Relação entre integração visomotora e destreza manual em crianças com transtorno do desenvolvimento da coordenação / Relationship between visual-motor integration and manual dexterity in children with developmental coordination disorder

Resumo O objetivo deste estudo foi examinar as habilidades de integração visomotora e destreza manual em crianças com Transtorno do Desenvolvimento da Coordenação (TDC). Estudo descritivo transversal com 22 crianças de 7 a 11 anos com TDC, avaliadas com o Developmental Coordination Disorder Questionnaire (DCDQ-Brasil), Movement Assessment Battery for Children Second Edition (MABC-2) e Beery-Buktenica Developmental Test of Visual-Motor Integration Sixth Edition (VMI). A amostra contou com 4 meninas e 18 meninos. Considerando o percentil 25 no VMI como ponto de corte, 12 crianças apresentaram desempenho abaixo da média no domínio integração visomotora, 13 no domínio visual e 19 no domínio de coordenação motora. Foi observada correlação significativa entre o percentil de destreza motora e o percentil total do MABC-2, mas não entre os escores do MABC-2 e os diferentes domínios avaliados com o VMI. Os resultados sugerem que é necessário e importante o uso combinado de testes para melhor avaliação das crianças com TDC, a fim de detectar suas possíveis dificuldades na integração visomotora e destreza manual e suas implicações no desempenho de tarefas funcionais das crianças no dia a dia.

Abstract This study aimed to examine the visual-motor integration and manual dexterity skills in children with Developmental Coordination Disorder (DCD). A cross-sectional descriptive study of 22 children aged 7 to 11 years old with DCD, assessed with the Brazilian version of the Developmental Coordination Disorder Questionnaire (DCDQ-Brazil), Movement Assessment Battery for Children Second Edition (MABC-2) and Beery-Buktenica Developmental Test of Visual-Motor Integration Sixth Edition (VMI). Four girls and 18 boys participated. Considering the 25th percentile in VMI as the cutoff point, 12 children presented a below-average performance in the visual-motor integration domain, 13 in the visual domain, and 19 in the motor coordination domain. We observed a statistically significant correlation between the motor dexterity and the total MABC-2 percentiles, but not between the MABC-2 percentiles and the different domains evaluated with the VMI. The results suggest that the combined use of tests for better assessment of children with DCD is needed and important to detect their real difficulties in both visuomotor integration and manual dexterity and their implications on the performance of children's daily activities.

Effects of early interventions focused on the family in the development of children born preterm and/or at social risk: a meta-analysis.

OBJECTIVE: To verify whether early intervention focused on the family improves the cognitive, motor, and language development of children born preterm and/or at social risk in the first 3 years of life. SOURCE OF DATA: Meta-analysis of clinical trials published between 2008 and 2018, in the following databases: CINAHL, MEDLINE - PubMed, MEDLINE - BVS, LILACS - BVS, IBECS - BVS, PEDro and Cochrane Reviews. Experimental studies on early interventions focused on the family, whose target groups were children born preterm and/or at social risk, with assessment of cognitive and/or motor and/or language development up to 3 years were included. The studies were rated using the PEDro Scale. DATA SYNTHESIS: Twelve studies were included from a total of 3378 articles. Early intervention focused on the family contributed to the development of the cognitive (Standardized Mean Difference - SMD=0.48, 95% CI: 0.34-0.61) and motor (SMD=0.76, 95% CI: 0.55-0.96) domains of preterm infants. Regarding cognitive development, performance improvement was observed at 12, 24 and 36 months, while in the motor domain, the effect was observed only at 12 months in preterm infants. There was no benefit of the intervention in the cognitive, motor, and language outcomes of children with the social risk factor associated to biological risk. CONCLUSION: Early intervention focused on the family has a positive effect on the cognition of preterm infants. The effect on motor development was lower, possibly due to the emphasis on interventions in family-child interaction. The effect of interventions on the development of children at social risk and on the language domain was inconclusive, due to the scarcity of studies in the area.

Brazilian versions of the Measure of Processes of Care-20 and Measure of Processes of Care-Service Providers: translation, cross-cultural adaptation and reliability.

BACKGROUND: The Measure of Processes of Care (MPOC) questionnaires evaluate Family-Centered Practice (FCP) in services for children with developmental disorders. The MPOC-20 and MPOC-SP are completed by parents and by rehabilitation professionals, respectively, and are widely used in several countries. OBJECTIVES: To translate and cross-culturally adapt the MPOC-20 and MPOC-SP to Brazilian Portuguese and evaluate their reliability and internal consistency. METHODS: this study included translation, back-translation, cognitive interviews, testing of the pre-final versions, analysis of reliability and of internal consistency of the final versions. Respondents included parents and rehabilitation professionals from rehabilitation centers in four capital cities in Brazil. RESULTS: Translation and cultural-adaptation procedures ensured the Brazilian versions were understandable and semantically equivalent to the original MPOC-20 and MPOC-SP. Pre-final and final versions were analyzed and vetted by the original authors. The MPOC-20 internal consistency Cronbach's alpha varied between 0.61 and 0.91 (n=107), the test-retest reliability ICC varied between 0.44 and 0.83 and the standard error of measurement varied between 0.66 and 0.85 (n=50). The MPOC-SP internal consistency Cronbach's alpha varied between 0.52 and 0.83 (n=92), the test-retest reliability ICC between 0.83 and 0.90, and the standard error of measure between 0.34 and 0.46 (n=62). CONCLUSION: The Brazilian versions of the MPOC-20 and the MPOC-SP are in general stable and sufficiently reliable. They are relevant to the evaluation of FCP and provide information that can improve health services and ensure better care.

Influência do uso de jogos do Microsoft Kinect® sobre o desempenho motor e funcional de criança com transtorno do desenvolvimento de coordenação / Influence of the Microsoft Kinect® games on the motor and functional performance of a child with developmental coordination disorder

Resumo: Introdução Boa coordenação motora é essencial para que crianças sejam capazes de desempenhar diversas atividades cotidianas na escola, em casa e em outros ambientes sociais. Algumas crianças, no entanto, apresentam Transtorno do Desenvolvimento da Coordenação (TDC) o que dificulta tais atividades. Abordagens de realidade virtual (RV) vêm sendo utilizadas em diversos contextos da reabilitação, com destaque para o uso de jogos baseados no movimento. Objetivo Investigar a influência do uso de jogos do Microsoft Kinect® sobre o desempenho motor e funcional de uma criança de 8 anos, com TDC, com treinamento individual. Método Antes e após o treino, a coordenação motora, o condicionamento físico, o equilíbrio e o desempenho funcional nas atividades selecionadas foram avaliados com uso do Questionário de Transtorno do Desenvolvimento da Coordenação (DCDQ-Brasil), do Movement Assessment Battery for Children -2ª edição (MABC-2), do Perceived Efficacy and Goal Setting System (PEGS), da Medida Canadense de Desempenho Ocupacional (COPM) e do teste de caminhada de 2 minutos. Resultados A criança obteve ganho clinicamente significativo nos resultados da COPM, aumento na pontuação nos itens relacionados à habilidades motora grossa no DCDQ-Brasil, bem como melhora no condicionamento físico durante a intervenção, que não foram mantidos na fase pós-intervenção, sugerindo que jogos do Microsoft Kinect® devem ser melhor explorados como estratégia terapêutica para crianças com TDC. Conclusão As limitações do estudo de caso são discutidas com vistas a subsidiar estudos futuros.

Abstract: Introduction A good motor coordination is essential to children to be able to perform daily activities at school, at home, and in other social environments. However, some children have Developmental Coordination Disorder (DCD), which makes it difficult to perform these activities. As a new approach, virtual reality is being used in different rehabilitation contexts, with an emphasis on the use of motion-based games. Objective The aim of this case study was to investigate the influence of the use of Microsoft Kinect® games on the motor and functional performance of an eight years old child with DCD, trained individually. Method Pre and post-assessment of motor coordination, physical fitness, balance, and functional performance in selected activities were conducted using the Developmental Coordination Disorder Questionnaire (DCDQ-Brazil), the Movement Assessment Battery for Children, 2nd edition (MABC-2), the Perceived Efficacy and Goal Setting System (PEGS), the Canadian Occupational Performance Measure (COPM), and the 2-minute walk test. Results The child presented clinically significant gains in the COPM, increased scores on items related to gross motor skills in the DCDQ-Brazil, as well as improvement in physical conditioning during the intervention, which was not maintained in the post-intervention phase, suggesting that the use of Microsoft Kinect® games should be further explored as therapeutic strategy for children with DCD. Conclusion The limitations of the case study are discussed as a means to subsidize future studies.

Nível cognitivo e transtorno do desenvolvimento da coordenação: estudo com escolares de 7 a 10 anos de idade / Cognitive level and developmental coordination disorder: study with schoolchildren aged 7 to 10 years old

Resumo Introdução Crianças com Transtorno do Desenvolvimento da Coordenação (TDC) apresentam dificuldades para aprender tarefas motoras, o que sugere alteração cognitiva, mas evidências sobre a relação entre desempenho motor e nível cognitivo ainda são inconclusivas. Objetivo Investigar a relação entre nível cognitivo e desempenho motor em crianças de 7 a 10 anos de idade com e sem TDC. Método Foram avaliadas 402 crianças de escolas públicas com o teste de coordenação motora Movement Assessment Battery for Children 2ª ed. (MABC-2) e o teste cognitivo Matrizes Progressivas de Raven (Raven). Os pais preencheram o Developmental Coordination Disorder Questionnaire (DCDQ-Brasil), o Critério Brasil de classificação econômica e um histórico de saúde da criança. Os dados foram analisados com uso de estatística descritiva e testes de associação, comparação e correlação. Resultados Das 402 crianças avaliadas, 35 (8,7%) foram identificadas com TDC. Não foi encontrada diferença nos percentis cognitivos entre crianças com e sem TDC (p = 0,223), mas houve associação significativa entre desempenho motor e nível cognitivo no grupo TDC (p=0,023), com tendência para percentis cognitivos mais altos no grupo não-TDC. Houve associação significativa (p=0,009) entre o percentil global no MABC-2 e o Raven na amostra total. Nos grupos com TDC, houve correlação negativa significante apenas entre o MABC-2 e a idade. Conclusão Houve maior associação entre as pontuações nos testes motor e cognitivo do que entre TDC e nível cognitivo. Os resultados reforçam o perfil heterogêneo das crianças com TDC tanto no domínio motor como cognitivo.

Abstract Introduction Children with Developmental Coordination Disorder (DCD) have difficulties learning motor tasks, which suggests cognitive alteration, but evidence about the relationship between motor performance and cognitive level are still inconclusive. Objective To investigate the relationship between the cognitive level and motor performance of children 7 to 10 years old with and without DCD. Method We evaluated 402 children from public schools with the motor coordination test, Movement Assessment Battery for Children 2nd ed. (MABC-2) and the cognitive test, Raven's Progressive Matrices (Raven). Parents completed the Developmental Coordination Disorder Questionnaire (DCDQ-Brazil), the Brazil Criterion for Economic Classification and a child's health history. Data were analyzed using descriptive statistics and association, comparison and correlation tests. Results Of the 402 children evaluated, 35 (8,7%) were identified with DCD. No difference was found in cognitive percentiles among children with and without DCD (p = 0,223), but there was a significant association between motor performance and cognitive level in the DCD group (p = 0,023), with a trend towards higher cognitive percentiles in the non-DCD group. There was a significant association (p = 0,009) between the global percentile in MABC-2 and Raven in the total sample. In groups with DCD, there was a significant negative correlation only between MABC-2 and age. Conclusion There was a greater association between motor and cognitive tests' scores than between DCD and cognitive level. The results reinforce the heterogeneous profile of children with DCD in both motor and cognitive domain.

Cross-cultural adaptation of the child development surveillance instrument "Survey of Wellbeing of Young Children (SWYC)" in the Brazilian context / Adaptação Transcultural do instrumento de vigilância do desenvolvimento infantil "Survey of Wellbeing of Young Children (SWYC)" no contexto brasileiro

INTRODUCION: Due to the scarcity of culturally adapted, validated and feasible instruments for assessing child development for use in clinical practice in Brazil, more investment is needed to provide resources with good psychometric properties for clinical and scientific use. OBJECTIVE: To analyze the cross-cultural adaptation process of the Child Development Surveillance Instrument "Survey of Wellbeing of Young Children (SWYC)" in the Brazilian context. METHODS: SWYC is an instrument for monitoring development, behavior and risk factors for children younger than 65 months, consisting of questionnaires - Developmental Milestones, Parent's Observations of Social Interactions (POSI), Baby Pediatric Symptom Checklist (BPSC), Preschool Pediatric Symptom Checklist (PPSC) e Family Questions. The cross-cultural adaptation followed the steps recommended in the literature and 45 parents from the first pre-test and 27 from the second pre-test participated. For the analysis of the properties of measurement was used factor analysis (Kaiser-Meyer-Olkin-KMO), calculation of convergent validity (Average Variance Extracted - AVE) and reliability (Internal consistency - Cronbach's Alpha - CA. RESULTS: In the first pre-test, parents comprised only 31% of the items. The panel of experts reviewed and modified the questionnaires. In the second pre-test, the comprehension index was 77%, giving rise to the final version. The questionnaires Developmental Milestones, BPSC and PPSC were considered unidimensional (KMO = 0.62 to 0.95) and had AVE of 0.52 to 0.73 and CA = 0.55 to 0.97. CONCLUSION: Analysis of the quality of the items, the convergent validity and the Internal consistency of the Brazilian version of the SWYC revealed satisfactory measurement properties, showing a promising instrument for clinical use and in research with children in Brazil.

INTRODUÇÃO: Diante da escassez de instrumentos de avaliação do desenvolvimento infantil adaptados culturalmente, validados e viáveis para uso na prática clínica no Brasil, é necessário maior investimento para disponibilização de recursos com boas propriedades psicométricas para uso clínico e cientifico. OBJETIVO: Analisar o processo de adaptação transcultural do instrumento de vigilância do desenvolvimento infantil "Survey of Wellbeing of Young Children (SWYC)" no contexto brasileiro. MÉTODO: O SWYC é um instrumento de vigilância do desenvolvimento infantil, comportamento e fatores de risco para crianças menores de 65 meses, constituído pelos questionários - Developmental Milestones, Parent's Observations of Social Interactions (POSI), Baby Pediatric Symptom Checklist (BPSC), Preschool Pediatric Symptom Checklist (PPSC) e Family Questions. A adaptação transcultural seguiu as etapas recomendadas pela literatura e participaram 45 pais do primeiro pré-teste e 27 do segundo pré-teste. Para análise das propriedades de medida foi utilizada análise fatorial (Kaiser-Meyer-Olkin-KMO), cálculo da validade convergente (Average Variance Extracted - AVE) e confiabilidade (consistência interna - Cronbach's Alpha - CA. RESULTADOS: No primeiro pré-teste, os pais compreenderam apenas 31% dos itens. O comitê de especialistas reanalisou e modificou os questionários. No segundo pré-teste, o índice de compreensão foi 77%, dando origem a versão final. Os questionários Developmental Milestones, BPSC e PPSC foram considerados unidimensionais (KMO = 0,62 a 0,95) e apresentaram AVE = 0,52 a 0,73 e CA = 0,55 a 0,97. CONCLUSÃO: Análise da qualidade dos itens, da validade convergente e da consistência interna da versão brasileira do SWYC revelou propriedades de medida satisfatórias, mostrando-se um instrumento promissor para uso clinico e em pesquisas com crianças no Brasil.

Efficacy of the cognitive orientation to daily occupational performance with Brazilian children with developmental coordination disorder.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) have difficulties performing daily activities which reflects negatively on participation, impacting their lives. OBJECTIVES: To examine the effects of the cognitive orientation to daily occupational performance Approach (CO-OP Approach) protocol on occupational performance and satisfaction of Brazilian children who have DCD; to examine whether children could transfer strategies and skills learned during CO-OP to untrained goals. METHODS: A pre-post group comparison design with eight boys aged 6-10 years old. Children participated in 12 CO-OP sessions with their parents twice a week, with an extra session added to the protocol for parents´ orientation. The Canadian Occupational Performance Measure and the Performance Quality Rating Scale were used as outcome measures. The study was registered by the United States Institutes of Health at ClinicalTrials.gov (NCT03112746). RESULTS: Intervention resulted in higher, clinically and statistically significant, occupational performance measures according to parents, children's, and external evaluators' perspectives. All children improved occupational performance on their selected goals and five children could transfer the ability to use cognitive strategies to tasks not addressed in therapy. CONCLUSIONS: This study provides initial directions for future research to investigate the applicability and to implement CO-OP approach on pediatric settings in Brazil.

Validity and reliability of the Perceived Efficacy and Goal Setting System (PEGS) for Brazilian children / Validade e confiabilidade do Perceived Efficacy and Goal Setting System (PEGS) para crianças brasileiras

Abstract Introduction: The engagement in client-centered practice requires instrumentation that allows the participation of the child and family in the definition of treatment goals. Objective: The aim of the present study was to pilot a translated version of the Perceived Efficacy and Goal Setting System (PEGS) and determine its validity and reliability for clinical use with Brazilian children. Method: Eighty children six to nine years old (40 public school children and 40 private school children), as well as their caregivers and teachers, completed the PEGS. Results: The children understood the pictures and interview procedures. Caregivers and teachers reported no difficulties in understanding the questionnaires. Gender, age, and type of school had no significant influence over the children's scores. Cultural influence on the response to two items was identified but could be resolved with extra explanation. Stability of the goals was supported and the children, caregivers, and teachers appear to share views regarding the overall abilities of the children. Conclusion: The PEGS has potential for clinical use with Brazilian children, but clinicians should be aware that some items require further instructions. The usefulness of the PEGS as a tool to promote client-centered practice among Brazilian occupational therapists should be investigated.

Resumo Introdução: O envolvimento da prática centrada no cliente requer instrumentação adequada que permita as participações da criança e da família na definição das metas de tratamento. Objetivo: O objetivo do presente trabalho foi realizar estudo piloto da versão traduzida Perceived Efficacy and Goal Setting System (PEGS), assim como determinar a validade e a confiabilidade deste instrumento para uso clínico com crianças brasileiras. Método: Oitenta crianças de seis a nove anos de idade (40 crianças de escolas públicas e 40 crianças de escolas particulares), bem como seus cuidadores e professores, completaram o PEGS. Resultados: As crianças compreenderam tanto as figuras quanto os procedimentos da entrevista. Cuidadores e professores não relataram dificuldades na compreensão dos questionários. Gênero, idade e tipo de escola não tiveram influência significativa nas pontuações das crianças. Porém, as respostas à dois itens do estudo piloto, parecem ter sido influenciadas pela cultura, ; mas pôde ser resolvida com explicação extra. A estabilidade das metas foi mantida, e as crianças, cuidadores e professores pareceram compartilhar pontos de vista em comum com relação às habilidades gerais das crianças. Conclusão: O PEGS tem potencial para uso clínico com crianças brasileiras; no entanto, os profissionais devem estar conscientes de que alguns itens requerem instruções adicionais. A utilidade do PEGS, como ferramenta para promover a prática centrada no cliente entre terapeutas ocupacionais brasileiros, deve ser investigada.

Clinical application of the Newborn Behavioral Observation (NBO) System to characterize the behavioral pattern of newborns at biological and social risk / Aplicação clínica do Newborn Behavioral Observation (NBO) System para caracterizar o padrão comportamental dos recém-nascidos de risco biológico e social

Abstract Objective To compare the behavior of preterm newborns and full-term newborns using the Newborn Behavioral Observation and to evaluate the mothers' experience when participating in this observation. Method This was a cross-sectional study performed at a referral hospital for high-risk births, involving mothers and neonates before hospital discharge. The mothers answered the sociodemographic questionnaire, participated in the Newborn Behavioral Observation session, and evaluated the experience by answering the parents' questionnaire at the end. The characteristics of the preterm newborn and full-term newborn groups and the autonomic, motor, organization of states, and responsiveness scores were compared. Linear regression was performed to test the association of the characteristics of mothers and neonates with the scores in the autonomic, motor, organization of states, and responsiveness domains. Results The Newborn Behavioral Observation was performed with 170 newborns (eight twins and 77% preterm newborns). Approximately 15% of the mothers were adolescents and had nine years of schooling, on average. The groups differed regarding weight for gestational age, age at observation, APGAR score, feeding, and primiparity. The linear regression adjusted for these variables showed that only prematurity remained associated with differences in the scores of the motor (p = 0.002) and responsiveness (p = 0.02) domains. No statistical difference was observed between the groups in the score attributed to one's own knowledge prior to the session (p = 0.10). After the session, these means increased in both groups. This increase was significantly higher in the preterm newborn group (p = 0.02). Conclusions The Newborn Behavioral Observation increased the mothers' knowledge about the behavior of their children, especially in mothers of preterm newborns, and identified differences in the behavior of preterm newborns and full-term newborns regarding the motor and responsiveness domains.

Resumo Objetivo Comparar o comportamento de recém-nascidos pré-termo e a termo utilizando a Newborn Behavioral Observation e avaliar a experiência das mães em participar dessa observação. Método Estudo transversal realizado em hospital de referência para partos de risco, envolvendo mães e neonatos antes da alta hospitalar. As mães responderam ao questionário sociodemográfico, participaram da sessão de Newborn Behavioral Observation e ao final avaliaram a experiência e responderam ao questionário de pais. As características dos grupos de recém-nascidos pré-termo e recém-nascidos termo e os escores dos domínios autonômico, motor, organização dos estados e responsividade foram comparados. Realizou-se regressão linear para testar a associação de características das mães e neonatos com os escores nos domínios autonômico, motor, organização dos estados e responsividade. Resultados A Newborn Behavioral Observation foi realizada com 170 recém-nascidos (oito gemelares e 77% pré-termo). Cerca de 15% das mães eram adolescentes e estudaram em média por 9 anos. Os grupos diferiram quanto ao peso para idade gestacional, idade na observação, APGAR, alimentação e primiparidade. A regressão linear ajustada para essas variáveis mostrou que apenas a prematuridade manteve-se associada a diferenças nos escores dos domínios motor (p = 0,002) e responsividade (p = 0,02). Não houve diferença estatística entre os grupos na pontuação atribuída ao próprio conhecimento antes da sessão (p = 0,10). Após a sessão estas médias subiram em ambos os grupos. Esse aumento foi significativamente maior no grupo de recém-nascidos pré-termo (p = 0,02). Conclusões A Newborn Behavioral Observation aumentou o conhecimento das mães sobre o comportamento dos filhos, principalmente para as mães de recém-nascidos pré-termo, e identificou diferenças no comportamento de recém-nascidos pré-termo e recém-nascidos termo nos domínios motor e responsividade.

Evasão em ambulatório de seguimento do desenvolvimento de pré-termos: taxas e causas / Drop out in a clinic of preterm development follow-up: rates and causes

[{"text": "Objetivo: Realizar levantamento da taxa de evasão e investigar suas possíveis causas em programa\r\nde acompanhamento do desenvolvimento de recém-nascidos pré-termo. Método: Estudo descritivo, com uso de\r\nmetodologia quanti-qualitativa, desenvolvido em ambulatório multidisciplinar de acompanhamento de crianças\r\nnascidas pré-termo. Foi feito levantamento das evasões ocorridas de janeiro de 2009 a dezembro de 2015. Pais de\r\ncrianças que se evadiram foram entrevistados sobre o motivo da evasão. Para comparar características dos grupos de\r\ncrianças de evasão e em seguimento foram usados teste-t (variáveis contínuas) e qui-quadrado (variáveis categóricas),\r\ne análise de conteúdo foi usada para os dados obtidos nas entrevistas. Resultados: A taxa global de evasão ao\r\nlongo dos sete anos foi de 43,7%, atingindo 60,5% quando se considera apenas as crianças que entraram em 2009.\r\nHouve diferenças significativas entre os grupos de evasão e de seguimento em relação à idade e grau de instrução\r\ndas mães. As entrevistas permitiram identificar motivos para evasão relacionados a aspectos socioeconômicos e à\r\norganização do serviço de saúde. Conclusão: Melhor organização do serviço, estabelecimento de rotinas e objetivos\r\ncompartilhados por toda equipe podem contribuir para manter a adesão ao seguimento. Equipes multidisciplinares\r\nde programas de seguimento, como do ACRIAR, devem reconhecer os desafios sociais e familiares enfrentados\r\npela população atendida, sendo importante manter trabalho constante de sensibilização das famílias acerca da\r\nnecessidade do acompanhamento.", "_i": "pt"}, {"text": "Objective: To make a survey of the dropping out rate and investigate its possible causes in preterm\r\ninfants follow-up program. Method: Descriptive study, using quantitative and qualitative methodology, developed\r\nin a follow-up preterm born children ambulatory. A survey of evasions occurred from January 2009 to December\r\n2015 was done. Parents of children who dropped out were interviewed about the reason of evasion. To compare\r\ncharacteristics of children groups of drop out and follow-up, t-test (continuous variables) and chi-square test (categorical\r\nvariables) were used, and content analysis was used for the data obtained in the interviews. Results: The overall rate\r\nof evasion over the seven years was 43.7%, reaching 60.5% when considering only children who entered in 2009.\r\nThere were significant differences between drop out and follow-up groups in relation to age and education of the\r\nmothers. The interviews enable to identify reasons for evasion related to socioeconomic factors and health service\r\norganization. Conclusion: Better service organization, establishing routines and shared goals for the whole team,\r\ncan contribute to maintain the adhesion to the follow-up program. Multidisciplinary teams of follow-up programs,\r\nsuch as ACRIAR should recognize the social and family challenges faced by population served, being important to\r\nmaintain a constant awareness work to raise awareness of the families about the necessity of the follow-up program.", "_i": "en"}]

Observação do comportamento neonatal: adaptação transcultural do newborn behavioral observations / Observation of neonatal behavior: cross-cultural adaptation of the newborn behavioral observations

RESUMO Objetivo: Realizar a adaptação transcultural para a língua portuguesa brasileira dos protocolos do sistema Newborn Behavioral Observations (NBO), novo recurso para observação do comportamento do bebê e compartilhamento de informações com os pais. Métodos: Estudo metodológico de tradução e adaptação transcultural do sistema NBO, que inclui o Formulário de Registro, com 18 itens, o Guia de Registro, com instruções para pontuação de cada item, o Sumário para os Pais, para registro de sugestões e orientações decorrentes da observação, e o Questionário de Pais, para avaliação da experiência. Foram seguidas as recomendações internacionais para adaptação transcultural de protocolos da área de saúde, o que incluiu solicitação de autorização para tradução aos autores, tradução, retrotradução e pré-teste, seguido de avaliação externa por painel de especialistas, que avaliou a qualidade da adaptação de cada item, com cálculo do índice de concordância entre os avaliadores quanto à equivalência conceitual e cultural. Resultados: A avaliação do painel de especialistas evidenciou que a versão adaptada transculturalmente do sistema NBO foi bem compreendida conceitualmente e adequada culturalmente, com 140 (77,8%) itens apresentando índice de concordância maior que 90% quanto à equivalência conceitual e cultural. Itens que não obtiveram níveis adequados de concordância foram revisados conforme sugestões dos especialistas. Conclusões: A versão brasileira do sistema NBO pode ser utilizada com segurança, já que a metodologia empregada foi rigorosa, garantindo equivalência entre o original e a tradução. O sistema NBO está pronto para ser usado clinicamente, podendo contribuir para a melhora de qualidade da assistência materno-infantil.

ABSTRACT Objective: To conduct the cross-cultural adaptation for Brazilian Portuguese of the Newborn Behavioral Observations (NBO), a new resource for observing neonatal behavior and sharing information with parents. Methods: Methodological study of translation and cultural adaptation of the NBO system, which includes the Recording Form, with 18 items, the Recording Guidelines, with instructions to score each item, the Summary Form, to record suggestions based on the observation, and the Parent Questionnaire, to record the parents' experiences. The adaptation process followed international recommendations for cross-cultural adaptation of health care protocols, which included requesting permission from the authors, translation, back translation and pre-test, followed by external evaluators who scored the quality of the adaptation, which was analyzed quantitatively. The quality of the adaptation of the instruments' items was evaluated by the index of agreement between evaluators for conceptual and cultural equivalence. Results: Expert panel evaluation showed that the cross-cultural adaptation of the NBO protocols was both well understood conceptually and culturally appropriate, with 140 (77.8%) items presenting concordance index higher than 90% for conceptual and cultural equivalence. Items that did not reach adequate level of agreement were revised according to experts' suggestions. Conclusions: The Brazilian version of the NBO system can be safely used, since the methodology was rigorous enough to ensure equivalence between the original and translated versions. The NBO should be tried in clinical practice, as it can contribute to improve the quality of maternal and child care.