ABSTRACT
BACKGROUND: Due to multiple factors, left-behind children in rural areas suffer from neurodevelopment delay and their caregivers suffer from depressive symptoms. This study aimed to analyze the effect of caregivers' depressive symptoms on left-behind children's neurodevelopment, with early stimulation and responsive care mediating. METHODS: We conducted a cross-sectional survey in five counties in China. A total of 904 left-behind children aged 0-3 and their primary caregivers were enrolled. The Zung Self-rating Depression Scale (ZSDS) was used to measure caregivers' depressive symptoms. The Ages and Stages questionnaires-third edition (ASQ-3), which contains five domains: communication (CM), gross motor (GM), fine motor (FM), problem-solving (CG), and personal social (PS), was used to screen children for suspected developmental delay (SDD). RESULTS: 31.4 % of left-behind children suffered from SDD, while 39.7 % of left-behind children's caregivers experienced depressive symptoms. Caregivers' ZSDS scores were positively correlated with the SDD on four domains (FM, GM, CG, and PS), while Early stimulation and responsive care was negatively correlated with the SDD on four domains (CM, FM, CG, and PS). LIMITATIONS: The cross-sectional design limited the ability to ascertain causal relations. Besides, the findings may not be generalized to all regions of China due to the heterogeneity of the study population. CONCLUSIONS: Left-behind children under three years old in rural China were at high risk of SDD, while a substantial proportion of their caregivers had depressive symptoms. Caregivers' depressive symptoms may negatively affect the SDD of left-behind children through caregivers providing less early stimulation and responsive care.
Subject(s)
Caregivers , Depression , Humans , Child , Child, Preschool , Cross-Sectional Studies , China , CommunicationABSTRACT
INTRODUCTION: Deep brain stimulation (DBS) is a life-changing treatment for patients with Parkinson's disease (PD) and gives the unique opportunity to directly explore how basal ganglia work. Despite the rapid technological innovation of the last years, the untapped potential of DBS is still high. AREAS COVERED: This review summarizes the developments in the mechanistic understanding of DBS and the potential clinical applications of cutting-edge technological advances. Rather than a univocal local mechanism, DBS exerts its therapeutic effects through several multimodal mechanisms and involving both local and network-wide structures, although crucial questions remain unexplained. Nonetheless, new insights in mechanistic understanding of DBS in PD have provided solid bases for advances in preoperative selection phase, prediction of motor and non-motor outcomes, leads placement and postoperative stimulation programming. EXPERT OPINION: DBS has not only strong evidence of clinical effectiveness in PD treatment but technological advancements are revamping its role of neuromodulation of brain circuits and key to better understanding PD pathophysiology. In the next few years, the worldwide use of new technologies in clinical practice will provide large data to elucidate their role and to expand their applications for PD patients, providing useful insights to personalize DBS treatment and follow-up.
Subject(s)
Deep Brain Stimulation , Parkinson Disease , Subthalamic Nucleus , Humans , Parkinson Disease/therapy , Basal Ganglia , Treatment OutcomeABSTRACT
A operação de suposição de sujeito compreende um dos quatro eixos que fundamentam a pesquisa IRDI e consiste em uma antecipação realizada pelo agente da função materna de um sujeito no bebê, que não se encontra ainda constituído. Este trabalho se propõe a apresentar um relato de caso que teve como objetivo investigar como a operação de suposição de sujeito ocorre em um contexto de internação em uma Unidade de Terapia Semi-Intensiva Neonatal. Para isso, foram realizadas uma entrevista semiestruturada, a aplicação do protocolo IRDI (Indicadores Clínicos de Risco para o Desenvolvimento Infantil) e do instrumento Denver II. Observou-se que a suposição de sujeito pode ocorrer, mas neste caso clínico apresenta dificuldades para se sustentar e operar, já que a relação mãe-bebê possivelmente foi influenciada pela limitação física do bebê, sua internação prolongada e aspectos emocionais da mãe.
Subject assumption operation is one of the four axes that underlie research using Clinical Indicators of Risk for Child Development (IRDI) and consists of an anticipation performed by the maternal agent on the behalf of a not yet constituted subject - the baby. This paper presents a case report that aimed to investigate how the subject assumption operation occurs in a neonatal semi intensive care unit. To do so, a semi-structured interview was conducted followed by application of the IRDI protocol and the Denver II instrument. Results showed that the subject assumption can occur, but, in this clinical case, it was unsustainable and non-operational, since the mother-child relation was possibly influenced by the physical limitation of the baby, their prolonged hospitalization, and emotional aspects of the mother.
L'opération d'"assomption sujet" comprend l'un des quatre axes qui sous-tendent la recherche utilisant les indicateurs cliniques de risque pour le développement de l'enfant (IRDI) et consiste en une anticipation effectuée par l'agent maternel pour le compte d'un sujet qui n'est pas encore constitué. Cet article présente un rapport de cas qui visait à étudier comment cette opération se déroule dans une unité de soins semi-intensifs néonatals. Pour ce faire, un entretien semi-directif a été mené, suivi de l'application du protocole IRDI et de l'instrument Denver II. Les résultats ont montré que l'hypothèse du sujet peut se produire, mais, dans ce cas clinique, elle était insoutenable et non opérationnelle, puisque la relation mère-enfant était probablement influencée par la limitation physique du bébé, son hospitalisation prolongée et les aspects émotionnels de la mère.
La operación de la suposición del sujeto es uno de los cuatro ejes que sostienen el estudio con indicadores clínicos de riesgo para el desarrollo infantil (IRDI) y consiste en una anticipación realizada por el agente de la función materna de un sujeto en el bebé, que todavía no se encuentra constituido. Este trabajo propone presentar el reporte de caso con el objetivo de investigar cómo la operación de suposición de sujeto ocurre en el contexto de hospitalización en una Unidad de Cuidados Semiintensivos Neonatal. Para eso, se realizaron una entrevista semiestruturada, la aplicación del protocolo IRDI y el instrumento Denver II. Se ha notado que la suposición de sujeto puede ocurrir, pero todavía en este caso clínico se muestran dificultades para que se sustente y opere, una vez que la relación madre-bebé posiblemente fue influenciada por limitaciones físicas del bebé, su hospitalización prolongada y aspectos emocionales de la madre.
ABSTRACT
RESUMEN Introducción: la estimulación temprana favorece el desarrollo del bebé y tiene importantes beneficios. Objetivo: diseñar una intervención educativa sobre la estimulación temprana durante el período de gestación y hasta el primer año de vida, a gestantes pertenecientes al Hogar Materno del municipio Consolación del Sur. Materiales y métodos: se realizó un estudio cuasiexperimental, de intervención educativa, con una muestra constituida por 20 gestantes, a partir de un muestreo no probabilístico de manera intencional. Se tuvieron en cuenta los criterios de inclusión y exclusión. Resultados: la mayoría de las gestantes se encontraban entre 14 y 18 años; el 50 % pertenecían al nivel de escolaridad secundario. Antes de la intervención predominó un nivel de conocimiento bajo en el 50 % de ellas, y luego de la misma el 90 % de las gestantes presentaron un nivel de conocimiento alto. Conclusiones: con la implementación de la intervención educativa propuesta se logró incrementar los conocimientos sobre la estimulación temprana en las gestantes.
ABSTRACT Introduction: early stimulation favors baby development and has important benefits. Objective: to design an educational intervention on early stimulation during the pregnancy period and up to the first year of life to pregnant woman belonging to the Maternal Home of Consolación del Sur municipality. Materials and methods: a quasi-experimental study of educational intervention was carried out in a sample formed by 20 pregnant women, from an intentional non-probabilistic sampling. The inclusion and exclusion criteria were taken into account. Results: most of the pregnant women were aged between 14 and 18 years; 50 % had a secondary school scholarship. Before the intervention, a low level of knowledge prevailed in 50 % of them, and then 90 % of pregnant women had a high level of knowledge. Conclusions: with the implementation of the proposed educational intervention, an increase of knowledge on early stimulation in pregnant women was achieved.
ABSTRACT
Verificar a influência da Atenção Precoce (AP) no desenvolvimento de bebês nos aspectos motores, cognitivos e sociais de bebês de risco que participam do programa de intervenção motora precoce (PIMP). Materiais e Métodos: Trata-se de um estudo ex post facto. A coleta de dados foi realizada em uma Clínica de Fisioterapia e a amostra foi composta por sete bebês de ambos os sexos que realizaram por quatro meses atendimentos de AP, duas vezes por semana, por 50 minutos. As atividades realizadas perfazem o campo motor, cognitivo e social. Resultados: O grupo foi homogêneo em relação às características. As atividades referentes à postura e deslocamento melhorou em 85% dos bebês, exploração de objetos manualmente em 71% e o reconhecimento da função de objetos 57%. A atividade de execução de tarefas a pedido foi a que menos os bebês evoluíram (57%). Conclusão: A intervenção precoce traz benefícios sobre o desenvolvimento motor e social dos bebês de risco. O desenvolvimento cognitivo, que representa tarefas com mais redes neuronais envolvidas, necessita de mais tempo para ser avaliada. (AU)
To verify the influence of Early Attention (AP) on the development of infants in the motor, cognitive and social aspects of at-risk babies participating in the Early Motor Intervention Program (PIMP). Materials and Methods: This is an ex post facto study. Data collection was performed at a Physiotherapy Clinic and the sample consisted of seven infants of both sexes who underwent AP appointments twice a week for 50 minutes. The activities carried out comprise the motor, cognitive and social fields. Results: The group was homogeneous in relation to the characteristics. The activities related to posture and displacement, improved in 85% of the babies, exploitation of objects manually by 71% and recognition of the function of objects by 57%. The on-task task activity was the one with the least babies (57%). Conclusion: Early intervention brings benefits to the motor and social development of at-risk babies. Cognitive development, which represents tasks with more neural networks involved, requires more time to be evaluated. (AU)
Subject(s)
Humans , Male , Female , Infant , Child Development , Early Intervention, Educational , Posture , Risk , Physical Therapy Modalities , Biological Evolution , Social Evolution , Nervous SystemABSTRACT
BACKGROUND: Hundreds of millions of children living in poverty worldwide are not reaching their full, developmental potential. Programs to promote nurturing and responsive caregiving, such as those in which community health workers (CHWs) conduct home visits to support optimal early childhood development (ECD), have been effective in small trials, but have not achieved similar success at scale. This study will explore two approaches to scale-up: converting a home-visiting model to a group-based model; and integrating the ECD curriculum into an existing government program. The objectives of the study are to: 1) Measure how the integration of ECD activities affects time and task allocation of CHWs and CHW psychosocial wellbeing; 2) Examine how the integration of ECD activities affects caregiver-child dyad participation in standard health and nutrition activities; and 3) Explore how the availability of age-appropriate play materials at home affects caregiver-child dyad participation rates in a group-based ECD program. METHODS: We will randomize 75 communities in rural Madagascar into three arms: 1) [C], which is the status quo (community-based health and nutrition program); 2) [T], which is C + ECD group sessions [T]; and 3) [T +], which is T with the addition of an enhanced play materials package for home use. All children between 6-30 months old at the time of the intervention launch will be eligible to participate in group activities. The intervention will last 12 months and is comprised of fortnightly group sessions in which the CHWs provide caregiver-child dyads with information relating to ECD; CHWs will also include structured time for caregivers to practice the play and child stimulation activities they have learned. We will administer monthly surveys to measure CHW time use and task allocation, and we will leverage administrative data to measure caregiver-child dyad participation in the group sessions. DISCUSSION: The results from the trial will provide the evidence base required to implement an integrated package of nutrition, health and ECD promotion activities at scale in Madagascar, and findings may be relevant in other low-income countries. TRIAL REGISTRATION: This trial is registered on the AEA Social Science Registry (AEARCTR-0004704) on November 15, 2019 and on ClinicalTrials.gov (NCT05129696) on November 22, 2021.
Subject(s)
Child Development , Community Health Workers , Child Development/physiology , Child, Preschool , House Calls , Humans , Infant , Poverty , Randomized Controlled Trials as Topic , Rural PopulationABSTRACT
Introduction: The psychomotor development of the child depends on the parents, butmainly the brothers and grandparents participate. Objective: To describe the participation of thefamily in the early psychomotor stimulation of older infants living in a marginal urban area.Methods: Qualitative ethnographic study. The sample was represented by 15 mothers of olderinfants who attend the growth and development control at their local health center; The data werecollected in their homes through the interview, participant observation and field diary and wereprocessed through thematic analysis. Results: a) Stimulation of fine and gross motor skills, b)Stimulation of language and cognitive learning c) Socio-affective stimulation and learning ofvalues. Conclusions: In this study, the family members stimulate the older infant in their dailylives through play, using materials from the home, toys, technological equipment such astelevision, radio and cell phones. However, cell phone use should be controlled to avoid eye,cognitive and addictive problems. Therefore, it is recommended that the primary care nurse assesstheir practices at home before providing health education on infant stimulation.
Introducción: El desarrollo psicomotor del niño depende de los padres, pero participasobre todo los hermanos y abuelos. Objetivo: Describir la participación de la familia en laestimulación temprana psicomotriz de los lactantes mayores que viven en una zona urbanomarginal. Métodos: Estudio cualitativo etnográfico. La muestra estuvo representada por 15madres de lactantes mayores que asisten al control de crecimiento y desarrollo en el centro desalud de su localidad; los datos se recolectaron en sus hogares a través de la entrevista,observación participante y diario de campo y fueron procesados mediante análisis temático.Resultados: a) Estimulación de la motricidad fina y gruesa, b) Estimulación del lenguaje y elaprendizaje cognitivo c) La estimulación socioafectiva y el aprendizaje de valores. Conclusiones:En este estudio los miembros de la familia estimulan al lactante mayor en su cotidiano a travésdel juego, usan materiales propios del hogar, juguetes, equipos tecnológicos como el televisor, laradio y los teléfonos celulares. Sin embargo, se debe controlar el uso del celular para evitarproblemas oculares, cognoscitivos y adictivos. Por tanto, se recomienda que la enfermera deatención primaria valore las prácticas que tienen en el hogar antes de brindar la educación sanitariasobre estimulación infantil.
Introdução: O desenvolvimento psicomotor da criança depende dos pais, masprincipalmente dos irmãos e avós. Objetivo: Descrever a participação da família na estimulaçãopsicomotora precoce de crianças maiores de uma zona marginal urbana. Métodos: Estudoetnográfico qualitativo. A amostra foi representada por 15 mães de bebês maiores que frequentamo controle de crescimento e desenvolvimento em seu posto de saúde local; os dados foramcoletados em seus domicílios por meio de entrevista, observação participante e diário de campoe processados por meio de análise temática. Resultados: a) Estimulação das habilidades motorasfinas e grossas, b) Estimulação da linguagem e aprendizagem cognitiva c) Estimulaçãosocioafetiva e aprendizagem de valores. Conclusões: Neste estudo, os familiares estimulam olactente em seu cotidiano por meio de brincadeiras, utilizando materiais do lar, brinquedos,equipamentos tecnológicos como televisão, rádio e telefone celular. No entanto, o uso do telefone208Cultura de los Cuidados. 1º Cuatrimestre 2022. Año XXVI. nº 62celular deve ser controlado para evitar problemas oculares, cognitivos e viciantes. Por tanto,recomenda-se que o enfermeiro da atenção básica avalie suas práticas em casa antes de realizareducação em saúde sobre estimulação infantil.
Subject(s)
Humans , Infant , Psychomotor Performance , Family Relations , Social Isolation , Child DevelopmentABSTRACT
RATIONALE: The first two to three years of life are critical for early child development (ECD), which affects later life trajectories in health, development, and earning potential. Global calls for early stimulation activities to support optimal development among young children are increasing and there is a need to better understand the factors associated with maternal engagement in early stimulation activities, particularly maternal mental health. OBJECTIVE: This study examined important factors associated with early stimulation activities performed by mothers of children ages 0-2 in rural Kenya. METHODS: Baseline cohort data from an evaluation of an integrated maternal mental health and an ECD intervention included 374 interviews with mothers of children under 24 months. Descriptive and multivariable analyses were performed. RESULTS: Maternal mental health was not associated with maternal early stimulation activities. Having worked in the past week was associated with more frequent early stimulation activities. At the child level, female sex was associated with more frequent early stimulation activities but prematurity at birth was associated with less frequent early stimulation activities. At the household level, ownership of children's toys and books was associated with more frequent early stimulation activities. CONCLUSIONS: This study indicates that both mothers and families could benefit from availability of ECD-friendly resources such as homemade toys and children's books (particularly for low-income families), and tailored messaging to support early stimulation activities for both girl and boy children and for those prematurely-born. Local governments and community-based programs can aim to both raise awareness about the importance of early childhood development and educate caregivers on specific age-appropriate early stimulation activities that promote optimal growth. Future research should also explore the reciprocal and temporal relationships between maternal mental health and early stimulation activities to inform and elucidate their potential synergistic impact on ECD.
Subject(s)
Mental Health , Mothers , Child , Child Development , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Kenya , Male , Maternal HealthABSTRACT
BACKGROUND: Maternal mental health is linked to early childhood development; yet there is a gap in evidence-based interventions for low-resource settings. This study estimates the impact of 'Integrated Mothers and Babies Course and Early Childhood Development' (iMBC/ECD), a cognitive-behavioral, group-based intervention, on maternal depression and early childhood social-emotional development in Siaya County, Kenya. METHODS: This quasi-experimental study enrolled 417 pregnant women and mothers of children under age 2 across two sub-counties in Siaya County. The intervention area had 193 women in 23 groups implementing iMBC/ECD and the control area had 224 women in 30 groups exposed to ECD only content. Mother/index child dyads were followed for two years. To estimate the causal treatment effect from the non-randomized design, we implemented the propensity score weighting method with inverse probability weights. RESULTS: At baseline, 10.2% of participants endorsed moderate/severe depressive symptoms. At 14-months post-intervention, 7.4% endorsed moderate/severe depression. Overall, iMBC/ECD intervention did not have a significant impact on reducing maternal depression or improving children's social and emotional development. However, sub-group analyses revealed that iMBC/ECD was associated with lowered depressive symptoms among women with no/low education, four or more children and/or no experience of intimate partner violence in the past year. Women with high program attendance (more than half of 14 sessions) also experienced consistently fewer depressive symptoms compared to those with lower attendance. LIMITATIONS: Non-randomized study, sub-group analyses are exploratory. CONCLUSIONS: The iMBC/ECD program may have the potential to improve maternal mental health and early child development for more targeted vulnerable populations.
Subject(s)
Child Development , Counselors , Female , Humans , Infant , Kenya , Longitudinal Studies , Mental Health , Mothers , PregnancyABSTRACT
INTRODUÇÃO: Desde a gestação até o nascimento, o desenvolvimento neuropsicomotor é influenciado por diversos fatores biopsicossociais. Tal influência pode ser ainda mais acentuada em recém-nascidos pré-termo devido a internação na Unidade de Terapia Intensiva Neonatal, por isto, bebês pré-termos estão mais susceptíveis a essas influências. OBJETIVO: Analisar sob a ótica do fisioterapeuta o desenvolvimento neuropsicomotor de pré-termos em ambulatório multidisciplinar de um hospital público. METODOLOGIA: Estudo observacional e longitudinal, ambispectivo, de 19 crianças nascidas prematuras de 0 a 12 meses de idade corrigida, sendo critério de exclusão crianças com alterações cognitivas e/ou genéticas ou não terem assinado o termo de consentimento. Os dados foram coletados por meio da análise de prontuários entre agosto de 2017 e dezembro de 2018, o desenvolvimento avaliado por meio do Teste Triagem Denver II, em dois momentos: A1 e A2, em sua admissão e retorno ao serviço após a alta da Unidade de Terapia Intensiva Neonatal e para análise da relação entre mãe e bebê foi utilizada a Avaliação Vínculo Mãe/filho apenas em A1. As estimulações eram realizadas por meio de orientações e folder educativo para os pais e responsáveis. Os dados foram analisados, por meio de média, desviopadrão, frequência absoluta e relativa, mediana, minimo e máximo e Teste de Wilcoxon para os domínios do Teste Denver II A1 em comparação a A2, utilizando o programa SPSS versão 20.0. RESULTADOS: Foram acompanhadas 19 crianças, destas 79% foram classificadas com desenvolvimento normal no A1. As crianças que apresentaram déficits no A1 (10,5%), superaram no A2. Porém, no segundo atendimento, algumas passaram a apresentar dificuldade em novas tarefas/domínio (motor, motor fino e pessoal-social), de modo que 31,5% apresentaram desenvolvimento geral anormal em A2. Foi encontrada diferença significativa (p=0,02) ao comparar as classificações gerais de Denver II nos dois momentos de avaliação. O vínculo mãe-filho foi classificado como fraco (média de 5,8 pontos). CONCLUSÃO: Observou-se que os bebês superaram os atrasos identificados na primeira avaliação, embora os resultados no Denver tiveram variações ao longo do tempo. Dessa forma, acredita-se que o perfil familiar identificado nesta pesquisa somada a abordagem multiprofissional possa ter favorecido o desenvolvimento neuropsicomotor dos bebês prematuros com até 12 meses de idade corrigida.
INTRODUCTION: From gestation to birth, neuropsychomotor development is influenced by several biopsychosocial factors. This influence can be even more accentuated in preterm newborns due to their admission to the Neonatal Intensive Care Unit, so preterm babies are more susceptible to these influences. OBJECTIVE: To analyze the neuropsychomotor development of preterm babies in a multidisciplinary outpatient clinic of a public hospital. METHODOLOGY: Observational and longitudinal, ambispective study of 19 children born prematurely from 0 to 12 months of corrected age, being exclusion criteria children with cognitive and/or genetic alterations or not having signed the consent form. The data were collected through the analysis of medical records between August 2017 and December 2018, the development evaluated through the Denver II Triage Test, in two moments: A1 and A2, on their admission and return to service after discharge from the Neonatal Intensive Care Unit and for analysis of the relationship between mother and baby the Evaluation Mother/Son bond only in A1 was used. The stimulations were carried out employing orientation and educational folder for parents and guardians. The data were analyzed by means of mean, standard deviation, absolute and relative frequency, median, minimum and maximum, and Wilcoxon Test for the domains of Denver II A1 compared to A2, using the SPSS program version 20.0. RESULTS: 19 children were accompanied, and 79% of these were classified with normal development in A1. The children who presented deficits in A1 (10.5%), surpassed in A2. However, in the second attendance, some started to present difficulties in new tasks/domains (motor, fine motor, and personal-social), so that 31.5% presented abnormal general development in A2. A significant value was found when comparing the Denver II general classification in A1 with A2 (p=0.02). The mother-child bond was classified as weak (average of 5.8 points). CONCLUSION: It was observed that babies overcame the delays identified in the first evaluation, although the results in Denver had variations over time. Thus, it is believed that the family profile identified in this research plus the multi-professional approach may have favored the neuropsychomotor development of premature babies up to 12 months of corrected age.
Subject(s)
Child Development , Infant, Newborn , Physical Therapy ModalitiesABSTRACT
BACKGROUND: Per UNICEF's Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana. METHODS: This cross-sectional study used data from a cluster-randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors was the primary outcome which was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and/or talking about family to her belly. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis. RESULTS: About half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors. CONCLUSION: Research on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development. TRIAL REGISTRATION: Clinical Trials # NCT03665246 , August 29, 2018.
Subject(s)
Maternal-Fetal Relations , Object Attachment , Physical Stimulation/methods , Pregnant Women , Acoustic Stimulation/methods , Adolescent , Adult , Cross-Sectional Studies , Female , Ghana , Humans , Intimate Partner Violence/psychology , Poisson Distribution , Pregnancy , Pregnant Women/psychology , Sex Offenses/psychology , Singing , Social Support , Speech , Touch , Young AdultABSTRACT
Introducción: La estimulación temprana es el conjunto de acciones que se brindan a un niño o niña en los primeros años de vida para evitar retraso en el desarrollo psicomotor. Objetivo: Evaluar el impacto de la estimulación temprana en el desarrollo psicomotor de lactantes. Métodos: Se realizó un estudio observacional, descriptivo y prospectivo de 60 lactantes con estimulación temprana, atendidos por el Grupo Básico de Trabajo 1, perteneciente al área de salud Camilo Torres Restrepo de Santiago de Cuba, desde junio del 2016 hasta igual periodo del 2018. Resultados: Predominaron el sexo masculino (32 para 53,4 %) y el grupo etario de 1 a 3 meses (48 para 80 %). El antecedente prenatal con mayor influencia negativa fue la anemia carencial presente en 36 madres (60,0 %) y el apgar bajo, como antecedente natal, se halló en 17 lactantes (28,3 %), siendo necesario el uso de oxígeno en 20 de ellos (33,3 %). Las principales alteraciones presentadas resultaron ser la tortícolis (25 para 41,6 %) y la hipotonía (23 para 38,3 %). La mayoría de los pacientes evolucionaron favorablemente (54 para 90,0 %). Conclusiones: El impacto de la estimulación temprana en el desarrollo psicomotor fue positivo, pues se logró la evolución favorable de los lactantes.
Introduction: The early stimulation is the group of actions that are offered to a boy or girl in the first years of life to avoid delay in the psychomotor development. Objective: To evaluate the impact of the early stimulation in the psychomotor development of infants. Methods: An observational, descriptive and prospective study of 60 infants with early stimulation was carried out, they were assisted by the 1 Work Basic Group, belonging to the health area of Camilo Torres Restrepo in Santiago de Cuba, from June, 2016 to the same period in 2018. Results: There was a prevalence of the male sex (32 for 53.4 %) and the 1 to 3 months age group (48 for 80 %). The prenatal record with more negative was the deficiency anemia present in 36 mothers (60.0 %) and the low apgar, as natal record, was found in 17 infants (28.3 %), being necessary the oxygen use in 20 of them (33.3 %). The main disorders presented were the torticollis (25 for 41.6 %) and the hypotonia (23 for 38.3 %). Most of the patients had a favorable clinical course (54 for 90.0 %). Conclusions: The impact of the early stimulation in the psychomotor development was positive, because the favorable clinical course of the infants was achieved.
Subject(s)
Psychomotor Performance , Child Development , Early Intervention, Educational , Primary Health Care , InfantABSTRACT
O artigo apresenta uma pesquisa de orientação psicanalítica sobre atendimentos educacionais/terapêuticos realizados na Educação Precoce, serviço educacional especializado oferecido pela Secretaria de Educação do Distrito Federal a crianças de zero a três anos e onze meses de idade, com atraso no desenvolvimento neuro-psicomotor. Neste estudo, duas crianças com Síndrome de Down foram observadas em atendimento. Os Indicadores Clínicos de Risco para o Desenvolvimento Infantil (IRDI) foram aplicados e as mães dos bebês foram entrevistadas. A finalidade do estudo e do presente artigo é salientar que determinadas intervenções educativas podem reproduzir junto aos pais o saber de especialistas advindos do discurso da ciência, o qual, em muitas circunstâncias, não só anula o saber parental como também eclipsa o lugar de sujeito da criança. O estudo destaca que a psicanálise pode apresentar-se como um aporte conceitual relevante para os profissionais que atuam na Educação Precoce e na Educação Infantil, pois os convoca à atitude de abertura à escuta, à fala e às observações das interações mãe-criança, de modo a localizar a posição que a criança ocupa na dinâmica materna e familiar, levando em conta a singularização dos pequenos sujeitos e subvertendo a lógica da padronização, da medicalização e da patologização.
El artículo presenta una investigación de orientación psicoanalítica sobre asistencia educativa/terapia realizada en educación temprana, servicio educativo especializado ofrecido por el Departamento de Educación del Distrito Federal - Brasil, a niños de 0 a 3 años y 11 meses de edad con retraso en el desarrollo. En este estudio dos niños con síndrome de Down, se aplicaron el protocolo IRDI o los indicadores clínicos de riesgo para el desarrollo infantil y se entrevistó a las madres de los bebés. El propósito del estudio es señalar que las intervenciones educativas también pueden reproducir con los padres el conocimiento de especialistas del discurso de la ciencia que, no solo anula el conocimiento de los padres, sino que también eclipsa la posición de sujeto del niño. El estudio destaca que el psicoanálisis puede presentarse como una contribución conceptual relevante para los profesionales que trabajan en la educación temprana, sino también en la educación de la primera infancia, ya que los llama a la actitud de apertura a la escucha, al habla y a las observaciones de las interacciones madre-hijo, de para ubicar la posición que ocupa el niño en la dinámica materna y familiar, teniendo en cuenta la singularización de los sujetos pequeños y subvirtiendo la lógica de estandarización, medicalización y patologización.
The article presents a psychoanalytic research about educational/therapeutic attendance, carried out at early Education, a specialized educational service offered by the Federal District Department of Education - Brazil, to children from 0 to 3 years and 11 months of age with neuropsychomotor developmental delay. In this study two children with Down syndrome were observed. The IRDI protocol or clinical indicators of risk for child development were applied and the mothers of the babies were interviewed. The purpose of this study is point out that Educational interventions can also reproduce with parents the knowledge of specialists from the discourse of science, which, in many circumstances, not only nullifies parental knowledge, but also eclipses the child's subject position. The study highlights that psychoanalysis can present itself as a relevant conceptual support for professionals who work in early education, because it calls them to the attitude of openness to listening, speech and observations of mother-child interactions in order to locate the place, the position that the child occupies in the maternal and family dynamics, taking into account the singularization of small subjects and subverting the logic of standardization, medicalization and pathologization.
Subject(s)
Humans , Female , Infant , Psychoanalysis , Down Syndrome , Early Intervention, Educational , Child Development , Clinical Protocols , Risk FactorsABSTRACT
Resumen El estudio de la estimulación de las funciones ejecutivas (FE) en la infancia ha generado un creciente interés investigativo en la última década, especialmente por su relación con el desempeño académico y éxito escolar. De acuerdo a esto, el presente estudio tiene por objetivo estudiar el efecto de un programa de estimulación de las FE sobre el desempeño ejecutivo y el rendimiento académico de una muestra de 43 estudiantes de primero básico de la comuna de Valparaíso (Chile), de edades entre 6 y 7 años. Para ello, se implementó un diseño factorial mixto. La intervención duró 12 semanas y se llevó a cabo en el aula, dirigida por un educador diferencial y con el apoyo de la profesora del curso. Los resultados evidencian la existencia de un efecto significativo del programa implementado en la mejora del desempeño ejecutivo de los participantes, particularmente del grupo experimental. Tales efectos no fueron replicados en el rendimiento académico, lo que podría encontrar una posible explicación en los factores contextuales relacionados con las condiciones de precariedad de la institución educativa. Se observó además un efecto diferenciado del programa sobre el componente de control inhibitorio. Los hallazgos generales ponen de manifiesto la relevancia de la estimulación de las FE en la infancia temprana y los beneficios que esto puede reportar en contextos educativos. Además, sugiere el potencial aporte de la incorporación de este tipo de intervenciones en las prácticas docentes cotidianas.
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Abstract Introduction: Down syndrome (DS) is a genetic disorder characterized mainly by ligament laxity and hypotonia. Infants with this syndrome have substantial motor retardation also with crawling. To reach this motor milestone, postural control and head and neck control in the prone position are necessary. Seeking to avoid atypical muscular synergies and facilitate the execution of functional activities, the Bobath Concept aims to stimulate weight transfers, promoting motor acquisitions in the prone, supine, sitting and standing positions. Objective: To evaluate and compare crawling before and after the intervention through the Bobath Concept method in infants with DS. Method: A longitudinal, prospective, evaluative and interventional study was carried out. The sample was composed of 4 infants with DS, aged 7 to 24 months. There were three stages of treatment: evaluation in accordance with the Alberta Infant Motor Scale (AIMS); short term intervention by the Bobath Concept; and re-evaluation using the same scale. Results: According to statistical analysis, there was no significant difference between pre- and post-treatment (t -3.1705, p=0.0504). However, the results obtained by evaluation and reevaluation, showed progress in infants' activity, the greatest progress being in the prone position. Infant 4 had the most satisfactory result, in percentage, as much as in the prone position (evolving 9.5%), as in general (evolving 22.4%). Conclusion: Infants submitted to intervention with the Bobath Concept obtained evolution in motor development, when comparing before and after therapy.
Resumo Introdução: A Síndrome de Down (SD) é uma alteração genética caracterizada principalmente pela frouxidão ligamentar e hipotonia. Os lactentes portadores dessa síndrome possuem atraso motor significativo, incluindo no engatinhar. Para alcançar este marco motor, é necessário controle postural, controle de cabeça e pescoço na posição prona. Buscando evitar as sinergias musculares atípicas e facilitar a execução de atividades funcionais, o Conceito Bobath permite estimular as transferências de peso, promovendo aquisições motoras nas posturas de prono, supino, sentado e em pé. Objetivo: Avaliar e comparar o engatinhar antes e após a intervenção através do Conceito Bobath em lactentes com SD. Método: Foi realizado um estudo longitudinal, prospectivo, avaliativo e intervencionista. A amostra foi composta por 4 lactentes de 7 a 24 meses com diagnóstico de SD. Foram realizadas 3 etapas de tratamento: avaliação através da escala AIMS; intervenção à curto prazo através do Conceito Bobath; e reavaliação pela mesma escala citada anteriormente. Resultados: Ao realizar a análise estatística não foi observada diferença significativa no pré e pós-tratamento (t: -3.1705, p: 0,0504). Entretanto, nos resultados obtidos por meio da avaliação e reavaliação, foi observado que houve progressão das atividades dos lactentes, sendo o maior progresso obtido na postura prono. O lactente 4 foi o que obteve resultado mais satisfatório, em percentis, tanto na posição prona (evoluindo 9,5%), quanto no geral (evoluindo 22,4%). Conclusão: Os lactentes submetidos à intervenção com o Conceito Bobath obtiveram evolução no desenvolvimento motor, quando comparados antes e após terapia.
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RESUMEN Introducción: la salud infantil constituye una de las prioridades de nuestra sociedad. El bajo peso al nacer (BPN) es el índice predictivo más importante de la mortalidad infantil, debido a su asociación con altos niveles de mortalidad. Objetivo: evaluar el impacto de un programa educativo de estimulación temprana del neurodesarrollo, determinar su crecimiento y desarrollo durante el primer año de vida. Método: se realizó un estudio de intervención con una estrategia de atención temprana del neurodesarrollo, a 43 niños BPN en el Policlínico José Martí Pérez, de Gibara, Holguín. Se evaluó el nivel de conocimiento de las madres antes y después de la intervención. Se determinaron los índices de correspondencia peso-talla, para la obtención de la valoración nutricional y el desarrollo psicomotor por trimestres, durante el primer año de edad. Los datos fueron obtenidos, previo consentimiento informado, de las historias clínicas individuales y la encuesta. Resultados: el nivel de conocimiento de las madres se catalogó de inadecuado antes de la intervención (35 madres, 83,72%), y después adecuado (41 madres, 95,34%), lo cual tuvo significación estadística. En la mayoría de los niños predominó la valoración nutricional de normopeso y el desarrollo psicomotor normal. Conclusiones: se consideró la intervención educativa como efectiva. Se recomienda la generalización del estudio en otras áreas de salud del municipio.
ABSTRACT Introduction: infantile health is considered one of the social priorities in Cuba. Weight when being born is the most important infantile mortality predictive index related to elevated mortality risks. Objective: to evaluate the early stimulation educational program impact on the neurological development, according to later growth and development during the first year of subject´s life. Method: an intervention study of 43 LBW newborns and a neurological development early attention strategy at "José Martí Pérez" Polyclinic in Gibara, Holguín, Cuba were carried out. Mothers' knowledge level was evaluated before and after program intervention. The weight-size indexes were determined, after nutritional and psychomotor development evaluations, during first year of age. Data were obtained from individual clinical histories and a survey, both with subjects' approval. Results: mothers' knowledge level was inadequate before the intervention (35 mothers, 83.72%) and after appropriate (41 mothers, 95.34%), this last with statistical significance. Nutritional evaluation prevailed in most normal weigh and psychomotor development children. Conclusions: this educational intervention was considered effective. We recommend the expiation of this study other health areas of the municipality.
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INTRODUÇÃO: A prematuridade é reconhecida como fator de risco para distúrbios do desenvolvimento motor, uma vez que promove interrupção na progressão do desenvolvimento das estruturas cerebrais. OBJETIVO: Consiste em analisar o processo de estimulação precoce em crianças com defasagem no desenvolvimento neuropsicomotor de até 2 anos de idade corrigida, através do olhar multidisciplinar. METODOLOGIA: Uma revisão integrativa desenvolvida no período de março a maio de 2018, utilizando as bases de dados LILACS, PUBMED, SCIELO e PEDro. Critérios para inclusão: artigo disponível na íntegra, publicados entre 2009 a 2018, em idioma inglês, português ou espanhol, abordando intervenção precoce, deficiência do desenvolvimento, desenvolvimento infantil e destreza motora, como temática central. Artigos que não atendessem aos critérios pré-definidos e não fossem artigos originais foram excluídos. RESULTADOS: Encontrados 45 artigos com descritores e recorte temporal, selecionados 28 para leitura completa, destes 12 foram eliminados, por não atender aos critérios de inclusão e exclusão, tendo para elegibilidade do estudo 16 artigos. Dentre alguns estudos observou-se que o acolhimento e o cuidado a essas crianças e a suas famílias, além da estimulação são essenciais para maior ganho funcional possível nos primeiros anos de vida. CONCLUSÃO: No âmbito da prematuridade à interdisciplinaridade, considerando que o atraso nessas crianças, são decorrentes não só da falta de estímulos adequados, mas pelo não desenvolvimento de estruturas neurológicas, a estimulação precoce oferece novas experiências, promovendo melhoras significativas e garantindo-lhes uma melhor qualidade de vida.
INTRODUCTION: Prematurity is recognized as a risk factor for motor development disorders, as it promotes interruption in the progression of the development of brain structures. OBJECTIVE: It consists of analyzing the process of early stimulation in children with impaired neuropsychomotor development up to 2 years of age corrected, through a multidisciplinary approach. METHODOLOGY: An integrative review developed from March to May 2018, using the databases LILACS, PUBMED, SCIELO and PEDro. Criteria for inclusion: an article available in full, published between 2009 and 2018, in English, Portuguese or Spanish, addressing early intervention, developmental disability, child development and motor skills, as the central theme. Articles that did not meet the pre-defined criteria and were not original articles were excluded. RESULTS: 45 articles with descriptors and temporal clipping were selected, 28 of which were selected for complete reading. Of these, 12 were eliminated because they did not meet the inclusion and exclusion criteria, and 16 articles were eligible for the study. Among some studies, it has been observed that the reception and care of these children and their families, besides the stimulation, are essential for greater functional gain in the first years of life. CONCLUSION: In the context of the prematurity to interdisciplinarity, considering the delay in these children are due not only to the lack of adequate stimuli, but to the non-development of neurological structures, early stimulation offers new experiences, promoting significant improvements and ensuring a better quality of life.
Subject(s)
Physical Therapy Specialty , Rehabilitation , ChildABSTRACT
Objective: To verify the effects of early stimulation on the motor and cognitive development of children with Down syndrome taking part of an interdisciplinary early stimulation group at a Special Child Integration Center. Methods: Prospective Observational Study carried out at a Special Child Integration Center with children from 0 to less than 1 year of age, taking part of an early stimulation group and who were not participating in any other intervention. Children included were evaluated in the rehabilitation sector of the institution. The instrument used was the Child Behavior Development Scale and the data were presented descriptively with percentage based on the answers of individual behavior and on the group average pre- and post-intervention. Results: The group was homogeneous regarding the characteristics and possible factors associated to developmental delay. In the motor and cognitive performance, individually all children had an improvement on their performance equal or greater than 50% in comparison to the initial assessment, and the group had a 62.5% growth in comparison to the initial evaluation. Conclusion: In group early stimulation brings benefits on the motor and cognitive development of children with Down syndrome in interdisciplinary care. (AU)
Objetivo: Verificar os efeitos da estimulação precoce sobre o desenvolvimento motor e cognitivo de crianças com síndrome de Down que participam do grupo interdisciplinar de estimulação precoce oferecido em um Centro de Integração da Criança Especial. Métodos: Estudo observacional prospectivo. Foi realizado em um Centro de Integração da Criança Especial com crianças de zero a um ano incompleto, que estivessem participando do grupo de estimulação precoce e que não participassem anteriormente de outra intervenção. As crianças incluídas foram avaliadas no setor de reabilitação da instituição. O instrumento utilizado foi a Escala do Desenvolvimento do Comportamento da Criança e os dados foram apresentados de forma descritiva com percentual baseado nas respostas do comportamento individual e da média do grupo pré e pós-intervenção. Resultados: O grupo foi homogêneo em relação às características e possíveis fatores associados ao atraso do desenvolvimento. No desempenho motor e cognitivo, individualmente todas as crianças obtiveram um crescimento em seu desempenho igual ou superior a 50% comparado com a avaliação inicial e o grupo obteve crescimento de 62,5% comparado com a avaliação inicial. Conclusão: A estimulação precoce em grupo traz benefícios sobre o desenvolvimento motor e cognitivo de crianças com síndrome de Down em atendimento interdisciplinar. (AU)
Subject(s)
Humans , Child , Down Syndrome , Early Intervention, Educational , Psychomotor Performance , Child , Child DevelopmentABSTRACT
Esta investigación fue realizada para saber si la estimulación táctil/kinestésica postnatal es efectiva en revertir el estrés prenatal, en la citoarquitectura de CA3 del hipocampo, en crías hembras. 12 crías de ratas hembras de la cepa Sprague-Dawley, fueron distribuidas en Grupo Control (GC), Grupo con Estrés Prenatal por restricción (EP) y Grupo Estrés prenatal con Estimulación Táctil/Kinestésica postnatal (EP-ETK). El estrés prenatal en crías hembras aumentó la densidad neuronal en las áreas CA3b y CA3c (p<0,001). Cuando se compararon las crías con estrés prenatal con las que recibieron estimulación táctil/kinestésica temprana, disminuyeron las densidades neuronales en las áreas CA3b y CA3c, (p < 0,001). La estimulación táctil/kinestésica postnatal logró revertir los efectos del estrés prenatal, al reducir la densidad neuronal en las áreas CA3b y CA3c del hipocampo.
This investigation was undertaken in order to know whether the postnatal tactile/kinesthetic stimulation is effective in reversing the Prenatal Stress, in the cytoarchitecture of the CA3 region of the hippocampus, in female pups. 12 pups of female rats from the Sprague-Dawley strain were distributed to Control Group (GC), the Prenatal Maternal Stress by restriction group (EP) and Prenatal Maternal Stress with postnatal tactile/ kinesthetic stimulation Group (EP-ETK). The Prenatal Maternal Stress in female pups increased neuronal density in CA3b and CA3c areas (p<0.001). When compared to Prenatal Maternal Stress, pups prenatal stress who received early tactile/kinesthetic stimulation showed a decrease in neuronal density in CA3b and CA3c areas (p < 0,001). Postnatal tactile/kinesthetic stimulation was shown to successfully reverse the Prenatal Maternal Stress effects by decreasing neuronal density in CA3b and CA3c hippocampal areas.
Subject(s)
Animals , Female , Pregnancy , Rats , Physical Stimulation , Stress, Physiological , Hippocampus/pathology , Prenatal Exposure Delayed Effects/pathology , Touch , Rats, Sprague-Dawley , Animals, NewbornABSTRACT
OBJECTIVE: To examine the impact of quality of early stimulation on cognitive functioning of toddlers living in a developing country. METHODS: The developmental functioning of 150 toddlers in the age range of 12-30 mo (53% boys; Mean = 1.76 y, SD = 0.48) was assessed by the mental developmental index of the Developmental Assessment Scale for Indian Infants (DASII). The StimQ questionnaire- toddler version was used to measure cognitive stimulation at home. The questionnaire consists of four subscales including availability of learning materials (ALM), reading activities (READ), parent involvement in developmental activities (PIDA), and parent verbal responsivity (PVR). Multivariate regression analysis was used to predict cognitive scores using demographic (age of child), socio-economic status (SES) (income, parental education), and home environment (subscale scores of StimQ) as independent variables. RESULTS: Mean Mental Development Index (MDI) score was 91.5 (SD = 13.41), nearly one-fifth (17.3%) of the toddlers had MDI scores less than 80 (cognitive delay). Children with cognitive delay, relative to typically developing (TD, MDI score ≥ 80) cohort of toddlers, had significantly lower scores on all the subscales of StimQ and the total StimQ score. Despite the overall paucity of learning materials available to toddlers, typical developing toddlers were significantly more likely to have access to symbolic toys (P = 0.004), art materials (P = 0.032), adaptive/fine motor toys (P = 0.018), and life size toys (P = 0.036). Multivariate regression analysis results indicated that controlling for confounding socio-economic status variables, higher parental involvement in developmental activities (PIDA score) and higher parental verbal responsivity (PVR score) emerged as significant predictors of higher MDI scores and explained 34% of variance in MDI scores (F = 23.66, P = 0.001). CONCLUSIONS: Disparities in child development emerge fairly early and these differences are not all linked to economic disparities. There is a need to develop evidence-based parenting interventions for primary prevention of developmental problems, especially in resource poor countries.