Effectiveness of a home-based early cognitive-motor intervention provided in daycare, home care, and foster care settings: Changes in motor development and context affordances.

BACKGROUND: Appropriate opportunities within the context are crucial to affect the motor trajectory positively. OBJECTIVE: To investigate the effectiveness of professional-parental/caregivers' early motor-cognitive intervention on infants' motor development in Daycare (DC), Home Care (HC), and Foster Care (FC). Secondary objectives were to examine if parents and caregivers modified the context to meet the infants' needs and if making modifications was positively associated with infants' development. METHODS: Participants were 176 infants (DC = 48; HC = 58, FC = 70). Infants' were randomly assigned to intervention (IG) or comparison (CG) groups within each context. The Alberta Infant Motor Scale and Affordances in the Daycare and Home Environment for Motor Development were used. A cognitive-motor intervention was provided for infants in the intervention groups; and, a home-based support protocol for all caregivers and parents. RESULTS: IGs showed higher motor scores at post-test than CGs (p values from 0.018 to 0.026) and positive changes were observed from the pre-to-post intervention for all IGs (p ≤ .0001), and for two CGs (DC p ≤ .0001; HC p = .028). Maternal daily care and home opportunities improved for all infants. CONCLUSIONS: Parents/caregivers' protocol combined with the cognitive-motor intervention lead to better motor outcomes and changes in the context for the IGs. Only the parent/caregivers' protocol was not strong to improve CGs motor outcomes, although changes in context were found. Intensive intervention is need for infants living in vulnerability.

Neurodevelopment of Nonmicrocephalic Children, After 18 Months of Life, Exposed Prenatally to Zika Virus.

The aim of this work was to evaluate the cognitive, language, and motor development, after 18 months of life, of nonmicrocephalic children born to mothers with Zika virus infection during pregnancy. Participants were 37 children aged 18-29 months divided into 2 groups: 17 nonmicrocephalic children born to mothers who had Zika virus infection during pregnancy (ZIKVG) and 20 nonmicrocephalic children with no maternal history of infection matched by sex and age (control group). A semistructured interview and the Bayley Scale of Infant and Toddler Development (Bayley III) were used for their evaluation. One child in the ZIKVG presented low cognitive score, the same in the control group. There were no statistical differences between the 2 groups regarding cognitive, language, and motor development. This sample, although small, showed that a significant proportion of nonmicrocephalic children exposed prenatally to Zika virus had normal development. A longer follow-up is necessary to observe if no other adverse outcomes will appear in the future.

Effect of early intervention in an interdisciplinary group of children with Down syndrome in a special integration center / Efeito da estimulação precoce em grupo interdisciplinar de crianças com síndrome de Down em um centro de integração especial

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)