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Fioroni Ribeiro da Silva C, Greco ALR, Castilho Cabrera Santos D, Sgandurra G, Tudella E. Association between Contextual Factors and Affordances in the Home Environment of Infants Exposed to Poverty. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1932. [PMID: 38136134 PMCID: PMC10742190 DOI: 10.3390/children10121932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Home environments of infants exposed to poverty exhibit fewer affordances for child development. This study aimed to investigate the association between contextual factors and affordances in the home environments of infants facing poverty. Term infants (n = 128) were divided into two groups: (1) exposed group (EG), comprising term infants exposed to poverty, and (2) comparison group (CG), consisting of term infants classified with medium and high socio-economic status. The main dependent variables were physical space, variety of stimulation, gross and fine motor toys, and the total score; measured using the Brazilian version of the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) questionnaire, named Affordances no Ambiente Domiciliar para o Desenvolvimento Motor-Escala Bebê. Statistical analysis employed independent sample t-tests or Mann-Whitney tests, chi-square tests, and stepwise multiple linear regression models to evaluate predictors of less adequate home environments. The EG presented significantly fewer affordances in gross motor toys (Cohen's r = 0.353; p < 0.01); fine motor toys (Cohen's r = 0.327; p < 0.01); and total score (Cohen's r = 0.377; p < 0.01). Binary logistic regression analysis showed a significant association (r2 = 0.828, p < 0.01) between the less than adequate home environment category and maternal age (p = 0.043, OR: 0.829 (0.692-0.994)), revealing that maternal age was associated with better quantity and quality of affordances for child development.
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Affiliation(s)
| | | | - Denise Castilho Cabrera Santos
- Human Movement Sciences Graduate Program, Methodist University of Piracicaba, Piracicaba 13423-170, Brazil;
- Department of Human Development and Rehabilitation, School of Medical Science, University of Campinas (UNICAMP), Campinas 13083-970, Brazil
| | - Giuseppina Sgandurra
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy;
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Pisa, Italy
| | - Eloisa Tudella
- Neuropediatrics and Motricity Studies Center (NENEM), Federal University of São Carlos, São Carlos 13565-905, Brazil;
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Lima CRG, Abreu RWFD, Verdério BN, Brugnaro BH, Santos MMD, Dos Santos AN, Morgan C, Rocha NACF. Early Intervention Involving Specific Task-Environment-Participation (STEP) Protocol for Infants at Risk: A Feasibility Study. Phys Occup Ther Pediatr 2022; 43:303-320. [PMID: 36329671 DOI: 10.1080/01942638.2022.2142084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aims: To verify the feasibility and preliminary effects of the STEP protocol, an intervention based on specific motor skills, environmental factors and participation, in infants at biological risk.Methods: Twenty-eight at-risk infants (STEP Protocol = 14; Standard Intervention = 14), aged 3-9 months and at risk for developmental delay. The following outcomes were assessed: motor skills (Alberta Infant Motor Scale-AIMS); frequency and involvement of participation (Young Children's Participation and Environment Measure-YC-PEM), and home environment opportunities (Affordances in the Home Environment for Motor Development-AHEMD-IS). For both groups, interventions were provided by parents. The intervention for group was based on the following principles: (1) standard intervention: stimulation of motor skills; (2) STEP: stimulation of motor skills, participation, mother-infant interaction, environmental enrichment. A mean comparison test was applied to verify difference between groups after the intervention.Results: The protocol showed good retention and recruitment rates. The STEP group had significantly higher outcomes after intervention on the AIMS (p = 0.014); frequency (p = 0.02) and engagement (p = 0.03) in participation, when compared to standard intervention.Conclusions: The results showed that the STEP protocol is feasible, and presents better results compared to the standard intervention, which reinforces the importance of promoting participation, specific motor skills and family involvement.
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Affiliation(s)
- Camila Resende Gâmbaro Lima
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | | | - Bruna Nayara Verdério
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | - Beatriz Helena Brugnaro
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | - Mariana Martins Dos Santos
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | | | - Catherine Morgan
- School of Medicine, Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
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Pádua RF, Sá CDSCD. Avaliação do desenvolvimento neuropsicomotor de lactentes expostos ao HIV a partir do modelo da CIF. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22008129042022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
RESUMO Este estudo objetivou sistematizar e construir um checklist com instrumentos de avaliação do desenvolvimento infantil de acordo com o modelo biopsicossocial da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) de lactentes nas idades entre 4 e 12 meses expostos ao HIV. Trata-se de um estudo observacional, analítico e longitudinal. Foram utilizados na avaliação e descritos de acordo com as categorias dos domínios da CIF a escala Bayley de desenvolvimento infantil III; o questionário Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê; o critério de classificação econômica Brasil; e a ficha de avaliação com histórico do lactente. Os instrumentos trabalhados neste estudo contemplam os componentes de estrutura e funções corporais; atividades e participação; e fatores ambientais e pessoais. A descrição dos instrumentos de avaliação do desenvolvimento infantil de lactentes expostos ao HIV, por meio dos constructos e domínios da CIF, permitiu construir um raciocínio clínico durante a avaliação, enfatizando a vigilância do desenvolvimento infantil e a funcionalidade no primeiro ano de vida.
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Pádua RF, Sá CDSCD. Assessment of the neuropsychomotor development of HIV-exposed infants using the ICF model. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22008129042022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
ABSTRACT This study aimed to systematize and build a checklist with tools to assess child development according to the biopsychosocial model of the International Classification of Functioning, Disability, and Health (ICF) of infants exposed to HIV, aged from 4 to 12 months. This is an observational, analytical, and longitudinal study. Bayley-III Scale of Infant and Toddler Development; Affordances in the Home Environment for Motor Development-Infant Scale; Brazilian Criteria of Economic Classification; and infant’s history used in the assessment were described according to the ICF domain categories. The tools used in this study include the components of body structure and functions; activities and participation; environmental and personal factors. The description of the assessment tools in the child development of infants exposed to HIV-by the constructs and domains of the ICF-allowed for the construction of clinical reasoning during the assessment, emphasizing the surveillance of child development and functioning in their first year of life.
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Harniess PA, Gibbs D, Bezemer J, Purna Basu A. Parental engagement in early intervention for infants with cerebral palsy-A realist synthesis. Child Care Health Dev 2022; 48:359-377. [PMID: 34622968 PMCID: PMC9298289 DOI: 10.1111/cch.12916] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 09/15/2021] [Accepted: 10/04/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Emphasis on parental engagement strategies within occupational therapy and physiotherapy early intervention (EI) programmes for infants at high risk of cerebral palsy (CP) has increased. This reflects consensus that increasing parent participation enhances treatment efficacy, potentially improving infant and parent outcomes. However, evaluation of parental engagement in EI is complex. Despite the growing application of parental engagement strategies, aligned with family-centred care practice, theoretical evaluation is currently lacking within the literature. This realist synthesis aimed to identify component theories underlying EI strategies to support parental engagement and to use empirical findings to evaluate how these work in practice. METHODS Realist synthesis: Databases Medline, Embase, Amed, CINAHL and PsychInfo were searched (from February 1985 - February 2020); further articles were sourced from reference lists. A data extraction form was used, and a Critical Appraisal Skills Programme tool was used to assess study rigour. RESULTS Twenty-six articles were included. Quality of relationships, parent education and intervention co-design were the key themes related to parental engagement strategies. Findings indicate that constructive parent reasoning mechanisms of trust, belief, sense of control, perceived feasibility of home programme delivery and ultimately motivation are linked to the underlying intervention resources afforded by specific strategies (e.g., coaching pedagogy). These responses are precursors to engagement outcomes that include increased parental self-efficacy and adherence. Importantly, parental self-efficacy can initiate a process of change leading to improved parental confidence and anxiety. CONCLUSIONS Sensitively designed programme strategies, centred on relational quality between parent, infant and therapist, are fundamental for effective parent connection, involvement and investment within EI for infants with CP.
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Affiliation(s)
- Phillip Antony Harniess
- Physiotherapy DepartmentGreat Ormond Street HospitalLondonUK,Institute of EducationUniversity College LondonLondonUK
| | - Deanna Gibbs
- Children's ResearchBarts Health NHS TrustLondonUK
| | - Jeff Bezemer
- Institute of EducationUniversity College LondonLondonUK
| | - Anna Purna Basu
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK,Department of Paediatric NeurologyNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
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Araujo DM, Cabrera Santos DC, Marconi Pinheiro Lima MC. Cognitive, language and motor development of infants exposed to risk and protective factors. Int J Pediatr Otorhinolaryngol 2020; 138:110353. [PMID: 32920449 DOI: 10.1016/j.ijporl.2020.110353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Risk factors are biological or environmental characteristics increasing the likelihood of delays in child development. Meanwhile, protective factors are conditions that can minimize risks and favor the acquisition of skills. Infants with risk indicators for hearing loss (RIHL) tend to live in less stimulating environments which may lead to lower cognitive, language, and motor development. OBJECTIVE To compare the cognitive, language, and motor development of infants under the influence of risk and protective factors. METHOD A cross-sectional observational study in which 259 infants aged 8-10 months were assessed for cognitive, language, and motor development using the Bayley Scales of Infant and Toddler Development - Third Edition (BSITD-III). The groups were formed according to the presence or absence of RIHL and the quality of the resources, being: SG-AE (Study Group with Adequate Environment), SG-IE (Study Group with Inadequate Environment), CG-AE (Compared Group with Adequate Environment)) and CG-IE (Compared Group with Inadequate Environment). Affordances were assessed using the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The groups were compared using the Chi-square test or the Kruskal-Wallis test, followed by Dunn's multiple comparison test. The level of significance adopted was 5%. RESULTS Infants from the CG-AE performed better than the other groups in cognition and motor skills. The CG-AE language was statistically superior to the SG-IE. SG-IE showed the highest frequency of delays in all domains. CG-IE and SG-AE showed a similar frequency of delays. Adequate environment associated with the absence of RIHL (CG-AE) leads to better cognitive, language, and motor performances. CONCLUSION Biological and environmental risk factors have a similar impact on development, but the accumulation of both tends to increase the risks of developmental delay. The absence of RIHL and quality environments worked as protective factors and favored the acquisition of skills.
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Affiliation(s)
- Danielle Mendonça Araujo
- University of Campinas, School of Medical Sciences, R. Tessália Vieira de Camargo, 126, Campinas, SP, 13083-887, Brazil.
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Valadi S, Gabbard C, Hooshyari F. Effects of affordances in the home environment on children's personal-social, problem-solving, and communication skills. Child Care Health Dev 2020; 46:429-435. [PMID: 32026508 DOI: 10.1111/cch.12756] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/21/2020] [Accepted: 01/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Among the various factors forming the environment, most developmentalists are in agreement that the home is the primary agent for change in child growth and development. The present study investigated the effect of affordances in the home on personal-social, problem-solving, and communication skills of children between 18 and 42 months of age. This investigation extends work focusing on "motor" affordances as an environmental feature. METHODS Using cross-sectional design, 251 families (124 boys and 127 girls) were evaluated using the Persian translation of Affordances in the Home Environment for Motor Development and the Ages and Stages Inventories to determine the three skill competencies. RESULTS Results showed that the level of home affordances significantly impacted all three skill areas. And the total variance of predictive values in the final model had a moderate and significant ratio. Other factors such as attendance and non-attendance of children in kindergarten, family income, and education of parents were also contributing factors. CONCLUSIONS In general, these findings indicate that the home environment plays an important role in the development of personal-social, problem-solving, and communication skills.
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Affiliation(s)
- Saeed Valadi
- Young Researchers and Elites Club, Islamic Azad University, Sciences and Research Branch, Tehran, Iran
| | - Carl Gabbard
- Child Motor Development Laboratory, Texas A&M University, College Station, Texas
| | - Faramarz Hooshyari
- Department of Sport Sciences and Physical Education, Faculty of Humanities, Islamic Azad University, Science and Research Branch, Tehran, Iran
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Brandão MDB, Frota LMDCP, Miranda JL, Cavalcante Brasil RM, Mancini MC. Family-Centered Early Intervention Program for Brazilian Infants with Congenital Zika Virus Syndrome: A Pilot Study. Phys Occup Ther Pediatr 2019; 39:642-654. [PMID: 31144558 DOI: 10.1080/01942638.2019.1600100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Aims: To evaluate the effects of a 16-week program based on Goals-Activity-Motor Enrichment (GAME) principles on infants with congenital Zika virus syndrome (CZS)'s mother report of functional goal achievement, motor and cognitive abilities, home enrichment, and parents' perceptions regarding the service provided. Methods: Quasi-experimental study with infants (n = 32) with CZS and their mothers. Twenty-two infants composed the GAME-based group and 10 were included in the control group. The primary outcome measure was the Canadian Occupational Performance Measure. Secondary outcome measures were the Bayley Scales of Infant and Toddler Development, the Affordances in the Home Environment for Motor Development-Infant Scale, and the Measure of Processes of Care. All measures were performed by blinded assessors. Results: Mothers of infants in the GAME-based group reported significant improvements in their infants' performance on functional priorities (p = 0.0001) and satisfaction with their infants' performance (p = 0.0001), the extent in which services promoted enabling and partnership (p = 0.021), provided general information (p = 0.039), specific information (p = 0.0001), and an enriched home environment (p = 0.0001). Infants in both groups did not improve in motor or cognitive abilities. Conclusions: A family-centered early intervention program based on GAME principles improved mothers' individualized outcomes and enriched infants with CZS's environment. Future studies should elucidate long-term benefits of interventions for this population.
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Affiliation(s)
- Marina de Brito Brandão
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil
| | - Lêda Maria da Costa Pinheiro Frota
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil.,Núcleo de Tratamento e Estimulação Precoce (NUTEP) , Fortaleza , Brazil
| | - José Lucivan Miranda
- Núcleo de Tratamento e Estimulação Precoce (NUTEP) , Fortaleza , Brazil.,Department of Maternal and Child Health, Universidade Federal do Ceará (UFC) , Fortaleza , Brazil
| | | | - Marisa Cotta Mancini
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil
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