Associations of biological factors and affordances in the home with infant motor development

Factors influencing on gross motor skills in infants: Implications for walking development

BACKGROUND

This longitudinal study aimed to explore the impact of containers on gross motor percentile from 8 to 13 months corrected age during the walking development in moderate to late preterm infants.

METHODS

Sixty preterm infants were enrolled in this study, and their monthly assessment the gross motor percentile using the Alberta Infant Motor Scale. Monthly parent interviews focused on collecting information about container characteristics.

RESULTS

Infants exhibited fluctuating percentiles in gross motor development, averaging 37.81 (SD = 21.9; SEM = 1.4). The gross motor skills percentiles varied between 2 and 86 points across the six assessments. Factors significantly associated with gross motor development percentiles were a large container size (Coef. = 15.29; p < 0.001*) and a container with a soft floor surface (Coef. = 3.64; p = 0.042*).

CONCLUSION

Healthy preterm infants exhibited minimal instability in gross motor development and attained walking independently by 13 months. Placing preterm infants in a baby container during their first year should prioritize a wide space and a soft floor surface to enhance gross motor development.

Predicting Age of Independent Walking in Preterm Infants: A Longitudinal Study Using Neonatal Characteristics and Motor Development Variables

OBJECTIVE

To formulate an equation estimating months to independent walking in moderate to late preterm infants based on neonatal characteristics and gross motor development from 7 months to independent walking.

METHODS

Sixty infants born between 32 to 36 weeks were assessed using Alberta Infant Motor Scale (AIMS) for gross motor development. Neonatal characteristics were recorded at 7 months, and caregiver-reported independent walking onset. Pearson correlation analyzed age, AIMS scores, and neonatal factors. Multiple regression developed the prediction equation.

RESULTS

The equation for independent walking onset, which included gestational age (GA) at birth, total AIMS score at 10 months of age (10th AIMS), and birth head circumference (BHC), exhibited a strong correlation (r=0.707) and had a predictive power of 50.0%. The equation is as follows: age onset of independent walking (months)=33.157, -0.296 (GA), -0.132 (10th AIMS), -0.196 (BHC), with an estimation error of 0.631 months.

CONCLUSION

Neonatal characteristics, such as GA, 10th AIMS, and BHC, are key determinants in estimating the onset of independent walking in moderate to late preterm infants.

Late preterm and very preterm infants differ in the acquisition time and quantity of reaches with grasping at reaching onset: an exploratory study

Introduction

The onset of manual reaching allows the expansion of the infant's interaction with the environment. When born preterm, infants become vulnerable to problems in the development of reaching. However, it is still unknown whether there are differences in reaching according to the degree of prematurity.

Objective

This study aimed to explore the differences in reaching acquisition and behavior between late preterm and very preterm infants, as well as whether age and clinical variables influence the results.

Method

This is an exploratory, comparative, observational study. In total, 24 infants were included soon after reaching onset; 12 infants were born late preterm (35.55 ± 0.67 gestational weeks) and 12 very preterm (30.60 ± 0.05 gestational weeks). Infants were placed in a baby seat, and a toy was placed at a reachable distance for 2 min. Reaching behavior was the primary variable; birth weight and length of hospital stay were secondary variables.

Results

The age of reaching onset was higher in the very preterm group. The proportion of reaches with grasping was higher in the late preterm group. These differences were affected by the lower birth weight and longer length of hospital stay in the very preterm group. The proportions of proximal and distal adjustments did not differ between groups.

Conclusion

Very preterm infants presented disadvantages in the acquisition time and the number of reaches with grasping, but not in the proportions of proximal and distal adjustments of reaching, relative to late preterm infants. Group differences were influenced by clinical variables.

Home environment factors associated with early childhood development in rural areas of Bangladesh: evidence from a national survey

Background

Knowing the relationship between the factors related to home environment and early childhood development (ECD) in Bangladeshi children aged 3 to 4  years would help to find out appropriate interventions for the children with lower ECD outcomes. Therefore, we aimed to understand the relationship between the home environment factors and ECD in rural Bangladeshi children aged 3 to 4  years.

Methods

We used data from the Multiple Indicator Cluster Survey (MICS) 2019, and included 7,326 rural children aged 3 to 4  years. The ECD index (ECDI) included four domains: literacy-numeracy, learning, physical and socio-emotional development. If a child met at least three of these four domains, the child was indicated as developmentally "on track".

Results

The findings show that 27.4% of rural children missed to reach developmentally on-track while 72.2% of children did not attain the literacy-numeracy domain of ECD. The home environment factors including parental participation in children's activities, was found to be associated with ECD. For instance, reading books to child had 26% (aOR = 1.26, 95% CI = 1.08-1.48), and telling stories to child had 29% (aOR = 1.29, 95% CI = 1.09-1.53) more developmentally on-track in overall ECDI. Similar associations between home environment factors and specific ECD domains were also obtained. We also identified that children aged 4  years, girls, and children of mothers with higher socio-economic status (SES) were higher developmentally on-track than their counterparts.

Conclusion

Home environment factors like reading books and telling stories to children were found to be significantly associated with ECD in rural areas of Bangladesh. Our study's findings would assist in implementing the essential public health intervention to enhance the ECD program especially in the rural Bangladeshi context.

Different intrauterine environments and children motor development in the first 6 months of life: a prospective longitudinal cohort

This prospective cohort longitudinal study examines the risk factors associated with different intrauterine environments and the influence of different intrauterine environments on children's motor development at 3- and 6-months of life. Participants were 346 mother/newborn dyads enrolled in the first 24 to 48 h after delivery in public hospitals. Four groups with no concurrent condition composed the sample: mothers with a clinical diagnosis of diabetes, mothers with newborns small for gestational age due to idiopathic intrauterine growth restriction (IUGR), mothers who smoked tobacco during gestation, and a control group composed of mothers without clinical condition. Children were assessed at three- and six-months regarding motor development, weight, length, head circumference, and parents completed a socioeconomic questionnaire. The IUGR children had lower supine, sitting, and overall gross motor scores at 6 months than the other children's groups. Anthropometric and sociodemographic characteristics negatively influenced gross motor development. IUGR and anthropometric and sociodemographic characteristics negatively impact motor development. Intrauterine environment impact child neurodevelopment.

Information Available to Parents Seeking Education about Infant Play, Milestones, and Development from Popular Sources

Parents commonly seek information about infant development and play, yet it is unclear what information parents find when looking in popular sources. Play, Milestone, and Development Searches in Google identified 313 sources for content analysis by trained researchers using a standardized coding scheme. Sources included websites, books, and apps created by professional organizations, commercial entities, individuals, the popular press, and government organizations/agencies. The results showed that for popular sources: (1) author information (i.e., qualifications, credentials, education/experience) is not consistently provided, nor is information about the developmental process, parents' role in development, or determining an infant's readiness to play; (2) milestones comprise a majority of the content overall; (3) search terminology impacts the information parents receive; (4) sources from the Milestone and Development Searches emphasized a passive approach of observing developmental milestones rather than suggesting activities to actively facilitate learning and milestone development. These findings highlight the need to discuss parents' online information-gathering process and findings. They also highlight the need for innovative universal parent-education programs that focus on activities to facilitate early development. This type of education has potential to benefit all families, with particular benefits for families with children who have unidentified or untreated developmental delays.

Biopsychosocial Factors Related to Postural Sway During Sit-to-Stand Movement in Children and Adolescents With Down Syndrome: A Cross-Sectional Study

We investigated factors related to postural sway during sit-to-stand movement in children and adolescents with Down syndrome (DS). Our assessment of participants followed the biopsychosocial model. Body function and structure were represented by muscle strength and postural sway during sit-to-stand movement, which were assessed by manual muscle testing and kinetics analysis, respectively. The Gross Motor Function Measure and Pediatric Balance Scale depicted the activity component. In addition, we included these relevant contextual factors: age, Home Observation for Measurement of the Environment, family income, and maternal schooling. A correlation analysis verified a suspected association between biopsychosocial and postural sway variables. There were significant separated correlations between postural sway in the three phases of the sit-to-stand movement, and age, GMFM-88 dimension D, and muscle strength. Thus, postural control in sit-to-stand movement was related to biopsychosocial factors involving different life aspects of children and adolescents with DS, and these factors should be addressed in rehabilitation therapy intended to improve postural control among these individuals.

Mom Didn't Go to School, Dad Is Out of Work: Associations between Maternal Educational Attainment, Family Socioeconomic Status, and Infant Development

The purpose of this research is to assess the neuropsychomotor development (NPMD) of 6- to 18-month-old infants and identify factors that may pose a risk to their development. They underwent NPMD assessments, while the parents/guardians were interviewed through the other instruments. Altogether, 64 infants participated in this research. The results revealed infants with questionable NPMD: 29.7% verified with AIMS and 32.8%, with Denver II. There were significant associations between NPMD and maternal low educational attainment (P = .032); family low socioeconomic status and NPMD (P = .026), verified with AIMS and Denver II (P = .037); stimulation opportunities at home and maternal low educational attainment (P = .00026), socioeconomic status (P = .035), and NPMD, verified with AIMS (P = .02) and Denver II (P = .009). The following were identified as risk factors for NPMD: maternal low educational attainment (the lower her attainment, the more likely for the NPMD to be questionable) and family socioeconomic status (infants from disadvantaged homes tend to have questionable NPMD). Stimulation opportunities at home were also significantly associated with NPMD-that is, insufficient stimulations at home may lead to questionable NPMD.

Risk Factors for cognitive, motor and language development of preterm children in the first year of life

Abstract Objective: To perform a longitudinal investigation of risk factors in premature infants’ cognitive, motor, and language development. Methods: Thirty-three preterm infants were assessed at 4, 8, and 12 months of corrected age, using the Bayley-III Scales. Parents completed questionnaires regarding development opportunities at home, parenting practices and knowledge. Results: Significant associations were found (1) at 4-months between cognitive scores and family income, variety of stimuli, availability of toys, parenting practices and knowledge; language and parenting practices; and motor skills and parenting practices; (2) at 8-months between cognitive score and length of stay in the Neonatal Intensive Care Unit (NICU), gestational age, birth weight, toys, and parenting knowledge; language and toys; and motor skills and toys and parenting knowledge; (3) at 12-months between cognitive scores and length of stay in the NICU, family income, breastfeeding, toys, and parenting knowledge; language and income and toys; and motor scores and length of stay in the NICU, gestational age, income, stimuli, toys, and parenting knowledge. Regression analyses indicated that: for (1) cognitive development, stimulus variety explained 72% of the model variance at 4 months of age; time at the NICU explained 67 and 43% at 8 and 12 months of age, respectively, and breastfeeding time explained 41% of the model variance at 12 months; (2) for language development, family income explained 42% of the model variance at 12 months; and for motor development (3), time at the NICU explained 80% of the model variance at 12 months. Conclusions: The development over the first year of life is not explained by the severity of birth conditions and associated morbidities only, but also by parenting practices.

Affordances in the home environment of children at risk of developmental delay

OBJECTIVE

The aim of this study was to verify the adequacy of affordances in the home environment of children at risk of developmental delay and to identify factors associated with their frequency.

METHODS

The cross-sectional study included 97 families who responded to the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) for 3-18 months (n=63), or AHEMD - Self-Report (AHEMD-SR) for 18-42 months (n=34). The Mann-Whitney U test was used to identify the differences between the frequencies of affordances between the groups. Multiple linear regression was used to verify the association between the child's sex, mother's marital status, education, socioeconomic level, child and mother's ages, house residents' number, per capita income, and AHEMD scores (α=0.05).

RESULTS

The home affordances' frequency in the AHEMD-IS ranged from less than adequate to excellent, while in the AHEMD-SR, the highest predominance was medium. The offer of stimuli in the AHEMD-IS was significantly higher. Higher socioeconomic level and house residents' number were associated with greater affordances.

CONCLUSIONS

The higher the socioeconomic level and house residents' number, the greater the affordances in the homes of children at risk of delay. It is necessary to provide families with some alternatives to make their home environments richer in affordances that favor child development.

Práticas e conhecimentos parentais: um estudo associativo sobre as aquisições motoras infantis

RESUMO O estudo objetivou investigar as associações entre práticas e conhecimentos dos cuidadores e o desempenho motor de crianças de zero a 2 anos de idade. Participaram 53 crianças avaliadas com a Peabody Developmental Motor Scale-2. Seus familiares responderam a dois questionários de cuidados parentais, a Daily Activities of Infant Scale e Knowledge of Infant Development Inventory, e um questionário de nível socioeconômico. Identificaram-se correlações significativas entre desempenho motor e comprimento (p=0,001) e peso atual da criança (p=0,005). Em relação às práticas parentais, correlações significativas foram observadas entre o desempenho motor e posturas durante a alimentação (p≤0,001), banho (p≤0,001), trocas de roupa (p=0,024), sono (p=0,035) e no colo (p=0,001), bem como em brincadeiras tranquilas (p=0,003), ativas (p=0,024) e oportunidades de passeio (p=0,004) da criança. A análise de regressão evidenciou que o modelo com posturas na alimentação, trocas de roupas e brincadeiras explicou 79% da variância no desempenho motor (p<0,001). As oportunidades de trocas posturais durante a alimentação, a higiene do bebê e brincadeiras ativas, influenciaram aquisições de habilidades motoras mais sofisticadas nos primeiros anos de vida.

Motor development in the first year of life predicts impairments in cognition and language at 3 years old in a Brazilian preterm cohort of low-income families

Purpose

Early identification of impairments is crucial to providing better care for preterm children, especially those from low-income families. The early motor assessment is the first step in monitoring their neurodevelopment. This study investigates if motor development in the first year of life predicts impairments in cognition and language at 3-year-old in a Brazilian preterm cohort.

Materials and methods

Data were collected in a follow-up clinic for high-risk infants. The Bayley Scales were used to assess children at 4, 8, 12, and 36 months of age, considering composite scores. Cognitive and language impairments were considered if scores were ≤85. Children (N = 70) were assessed at 4 and 36 months, 79 were assessed at 8 and 36 months, and 80 were assessed at 12 and 36 months. Logistic regressions were used to analyze the predictability of cognitive and language impairments, and receiver-operating characteristics (ROC) curves were used to analyze the sensibility and specificity of motor assessment and cognitive and language impairments.

Results

Poor motor scores at 8 and 12 months increased the chances of cognitive and language impairment at 3-year-old. The chance of cognitive impairment at 3-year-old increases by 6–7% for each point that the motor composite score decreases, and the chance of language impairment at 3-year-old increases by 4–5% for each point that the motor composite score decreases. No-significant results were found at 4-months. Adequate sensibility and specificity were found for language impairments considering 12 months scores and for cognitive impairments as soon as 8 months scores.

Conclusion

Monitoring preterm motor development in the first year of life helps to identify preterm children at risk for impairment in other developmental domains. Since preterm children from low-income families tend to demonstrate poorer neurodevelopment outcomes, these children need early assessment and referral to intervention to prevent school failures and support from public policies.

Avaliação do desenvolvimento neuropsicomotor de lactentes expostos ao HIV a partir do modelo da CIF

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.

Assessment of the neuropsychomotor development of HIV-exposed infants using the ICF model

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.

Maternal Emotional Intelligence and the Provision of Child Motor Affordances

Background: Mothers are not only the axis of an ecological subsystem for their children but are also capable of creating a significant emotional and psychological environment through constant and direct interaction. This leads to interactions and emotional connections with the children, supportive behaviors, and a long-term commitment to their upbringing and development. Aims: This study examined the relationship between maternal emotional intelligence (EI) and demographics on the availability of motor affordances in the home environment that are conducive to their child’s motor development. Methods: Mothers (N = 451) and homes of children aged 18–42 months were assessed using the Persian version of Affordances in the Home Environment for Motor Development-Self-Report (AHEMD-SR) and the Bar-On Emotional Intelligence Questionnaire. In addition, mothers’ physical activity (PA) experience and demographic data were collected. Results: Analyses indicated significant correlations between mothers’ education, level of PA, and income with EI and motor affordances. Conclusions: EI, PA experience, and select mother demographics were important to the availability of motor affordances in the home. One could also speculate, based on previous research, that such provision may affect the future motor development of the child. Future research should include a younger and more diverse population.

Developmental Functioning Outcomes in Infants With Cystic Fibrosis: A 24- to 36-Month Follow-Up Study

OBJECTIVE

This study aimed to examine early motor repertoire using Prechtl General Movement Assessment (GMA) and later developmental functioning of infants with cystic fibrosis (CF).

METHODS

Early motor repetoire was evaluated using Prechtl GMA, and developmental functioning was assessed using Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) in infants with CF and their peers who were neurotypical, as the control group.

RESULTS

Twelve infants with CF clinically stable and 12 infants who were neurotypical, with respective median post-term ages of 14 and 13 weeks, were assessed using GMA. At 24 to 36 months, the Bayley-III was applied to the CF group (median post-term age = 27.5 months) and the control group (median post-term age = 27.0 months). Fidgety movements were absent in 5 infants with CF, whereas all infants who were neurotypical had normal fidgety movements. The Motor Optimality Score was significantly lower in the CF group (median = 18.5) compared with the control group (median = 26). The CF group had significantly lower composite scores in the Bayley-III cognition, language, and motor domains compared with the control group.

CONCLUSION

Cognitive, language, and motor development was delayed in infants with CF. Developmental functioning of infants with CF should be assessed as early as possible and monitored, and age-specific early intervention programs should be considered when necessary.

IMPACT

Infants with CF may have motor, cognitive, and language developmental delays compared with peers who are neurotypical during early childhood, and hospitalization was negatively correlated with motor development at 24 to 36 months of age. This study highlights the importance of early assessment of developmental functioning and age-specific, early intervention programs when necessary in infants with CF.

LAY SUMMARY

It is important to assess developmental functioning as early as possible in infants with CF and to consider age-specific early intervention programs when necessary.

Intra-Individual Variability in Gross Motor Development in Healthy Full-Term Infants Aged 0-13 Months and Associated Factors during Child Rearing

The gross motor development of a typically developing infant is a dynamic process, the intra-individual variability of which can be investigated through longitudinal assessments. Changes in gross motor development vary, according to the interaction of multiple sub-systems within the child, environment, task setting, and experience or practice of movement. At present, studies on environmental factors that influence gross motor development in full-term infants over time are limited. The main aim of this study was to investigate environmental factors affecting intra-individual variability from birth to 13 months. The gross motor development of 41 full-term infants was longitudinally assessed every month from the age of 15 days using the Alberta Infant Motor Scale. Parents were interviewed monthly about environmental factors during childcare. Infants showed fluctuations in the percentile of gross motor development, and no systematic pattern was detected. The total mean range of gross motor percentile was 65.95 (SD = 15.74; SEM = 2.28). The percentiles of gross motor skills over the 14 assessments ranged from 36 to 93 percentile points. Factors that were significantly associated with the gross motor development percentile were the use of a baby walker (Coef. = -8.83, p ≤ 0.0001) and a baby hammock (Coef. = 7.33, p = 0.04). The use of baby hammocks could increase the gross motor percentile by 7.33 points. Although the usage of a baby walker is common practice in childcare, it may cause a decrease in the gross motor percentile by 8.83 points according to this study. In conclusion, healthy full-term infants exhibited a natural variability in gross motor development. Placing infants in a baby walker during the first year of age should be approached with caution due to the risk of delayed gross motor development.

Mother-child bonding, environment, and motor development of babies at risk accompanied by a follow-up

Abstract Objectives: to identify factors resulting from the correlation between mother-child bonding, environment, and infant motor development (MD). Methods: a cross-sectional study was conducted with 130 mothers/guardians and their infants at risk from 3 to 12 months of age, accompanied in an outpatient clinic follow-up at a public maternity. The data were collected using a form with socioeconomic data, mother/child routine at the hospital and home environments, and three other instruments validated in Brazil: Protocolo de Avaliação do Vínculo Mãe-Filho (Mother-Child Bonding Evaluation Protocol), Affordances in the Home Environment for Motor Development – Infant Scale, and Escala Motora Infantil de Alberta (Alberta Infant Motor Scale). Pearson's chi-square test, Fisher's exact test, and a significance level of 5% was used for the correlation. Results: the data showed a predominance of preterm babies (74.5%), low-income families (86.2%), and domestic opportunities below the adequate (93.8%) for good motor development. Regarding the mother-child bonding, 60% of the mothers showed a strong bonding with their children. A total of 62.3% of the children had typical motor development. Concerning the interaction between variables, statistical significance (p˂0.05) was observed in the correlation between bonding and typical motor development. Conclusion: despite the presence of risk factors, motor development was normal in most of the babies in this study, suggesting that the mother-child bonding favored motor development even with environmental and biological adversities.

Practice and proficiency: Factors that facilitate infant walking skill

Infant walking skill improves with practice-crudely estimated by elapsed time since walk onset. However, despite the robust relation between elapsed time (months walking) and skill, practice is likely constrained and facilitated by infants' home environments, sociodemographic influences, and spontaneous activity. Individual pathways are tremendously diverse in the timing of walk onset and the trajectory of improvement, and presumably, in the amount and type of practice. So, what factors affect the development of walking skill? We examined the role of months walking, walk onset age, spontaneous locomotor activity, body dimensions, and environmental factors on the development of walking skill in two sociodemographically distinct samples (ns = 38 and 44) of 13-, 15-, and 19-month-old infants. Months walking best predicted how well infants walked, but environmental factors and spontaneous activity explained additional variance in walking skill. Specifically, less crowded homes, a larger percentage of time in spontaneous walking, and a smaller percentage of short walking bouts predicted more mature walking. Walk onset age differed by sample but did not affect walking skill. Findings indicate that elapsed time since walk onset remains a robust predictor of walking skill, but environmental factors and spontaneous activity also contribute to infants' practice, thereby affecting walking skill.

Relationship between the Affordances for Motor Behavior of Schoolchildren (AMBS) and Motor Competence Assessment (MCA) in Brazilian Children

During growth, children are influenced by an extensive network, in which more favorable contexts provide better affordance landscapes, and consequently have a better potential to foster child development. We aimed to examine the affordances provided to children using the Affordances for Motor Behavior of Schoolchildren (AMBS) tool, estimating its association with children’s motor competence, as assessed by the Motor Competence Assessment (MCA) battery. Seventy-two Brazilian children were evaluated using the MCA instrument. Their parents/guardians completed the AMBS. The correlations between the two instruments (sub-scales and total scores) were investigated. ANOVAs were used to compare the motor competence performance of children with Low, Average, and High AMBS scores. Positive associations were found between AMBS and MCA, although weak to moderate in nature. In addition, children whose environments were richer in motor affordances (higher AMBS scores) showed significantly higher levels on the MCA. This study provides evidence that AMBS is a valid tool for assessing motor affordances for schoolchildren, and that those affordances are related to children’s motor competence.

Exploring parents' provision of factors related to the establishment of physical activity between normal weight and overweight infants

PURPOSE

Infancy is a critical time for the prevention of obesity and establishment of healthy behaviors such as physical activity that help to control weight. A limited amount of research has examined if factors related to infant physical activity vary by infant weight status. Therefore, the purpose of this mixed methods triangulation study was to examine differences in motor development, the home environment, and infant-parent play behaviors as well as to explore how parents promote active play opportunities with normal weight infants (NWIs) and overweight infants (OWIs).

DESIGN AND METHODS

We used a mixed methods triangulated approach to combine quantitative and qualitative data strands to examine variables associated with active play in normal weight (n = 16) and overweight (n = 11) infants. Data were analyzed using a two-tailed Mann-Whitney U nonparametric test and a summative content analysis approach.

RESULTS

Although there were no differences in infants' motor development and parent play behaviors based on infant weight, several other differences were found. OWIs had less access to materials that stimulate locomotor movement. Further, parents of OWIs more often reported utilizing cognitive play strategies in comparison to parents of NWIs who more often reported using physical play strategies. Parents felt they were the greatest influence on their child's activity regardless of infant size. Importantly, all parents desired more specific guidelines on how to encourage active play and preferred this information was delivered by their healthcare provider.

PRACTICE IMPLICATIONS

To meet parents' desires and potentially improve infants' developmental outcomes through the establishment of healthy physical activity behaviors, pediatric nurses could provide more specific guidance on providing active opportunities for infants.

Modeling a gross motor curve of typically developing Dutch infants from 3.5 to 15.5 months based on the Alberta Infant Motor Scale

BACKGROUND

Interindividual variability in gross motor development of infants is substantial and challenges the interpretation of motor assessments. Longitudinal research can provide insight into variability in individual gross motor trajectories.

PURPOSE

To model a gross motor growth curve of healthy term-born infants from 3.5 to 15.5 months with the Alberta Infant Motor Scale (AIMS) and to explore groups of infants with different patterns of development.

METHODS

A prospective longitudinal study including six assessments with the AIMS. A Linear Mixed Model analysis (LMM) was applied to model motor growth, controlled for covariates. Cluster analysis was used to explore groups with different pathways. Growth curves for the subgroups were modelled and differences in the covariates between the groups were described and tested.

RESULTS

In total, data of 103 infants was included in the LMM which showed that a cubic function (F(1,571) = 89.68, p < 0.001) fitted the data best. None of the covariates remained in the model. Cluster analysis delineated three clinically relevant groups: 1) Early developers (32%), 2) Gradual developers (46%), and 3) Late bloomers (22%). Significant differences in covariates between the groups were found for birth order, maternal education and maternal employment.

CONCLUSION

The current study contributes to knowledge about gross motor trajectories of healthy term born infants. Cluster analysis identified three groups with different gross motor trajectories. The motor growth curve provides a starting point for future research on motor trajectories of infants at risk and can contribute to accurate screening.

Physical Activity and the Home Environment of Pre-School-Aged Children in Urban Bangladesh

Physical activity (PA) is a key determinant of health and development, yet few studies have examined PA levels and risk factors for low PA among young children in low- and middle-income countries. This study aimed to describe the PA and sedentary (SED) behavior levels of preschool-aged children in Dhaka, Bangladesh, and to estimate the associations between potential risk factors in the home built environment and moderate to vigorous PA (MVPA). In a sample of preschool-aged children (n = 65) in Dhaka, PA and SED behavior were measured for 7 days using ActiGraph GT3X-BT accelerometers. Characteristics of the home built environment, socioeconomic factors, and anthropometry were also measured. Linear mixed-effects models were used to estimate multivariable-adjusted associations between characteristics of the home environment and MVPA. Preschool-aged children spent a mean (±standard deviation) 421 ± 48 and 82 ± 23 min per day sedentary and in MVPA, respectively. There were no statistically significant associations between factors in the home built environment (indoor area, presence of an open stairwell, and presence of gross motor activity facilitating items) and MVPA. These findings suggest that the studied characteristics of the home built environment may not significantly influence the MVPA observed among preschool-aged children in Dhaka. Future research should focus on other structural and behavioral factors that facilitate PA among young children in dense urban settings.

Sazonalidade e fatores de risco associados ao desenvolvimento motor de lactentes nascidos a termo

Resumo Introdução Diferentes fatores afetam o desenvolvimento motor no primeiro ano de vida, tendo sido pouco estudada a interferência da variação sazonal. Objetivo Investigar a influência da sazonalidade e de fatores de risco e proteção para o desenvolvimento motor de lactentes nascidos a termo, aos 7 e 10 meses de idade. Método Foram incluídos no estudo lactentes a termo (N=174) que vivenciaram os marcos de desenvolvimento referentes ao 2º e 3º trimestres no período de verão ou de inverno. Prontuários, entrevistas, e a Alberta Infant Motor Scale foram utilizados. Resultados A aquisição do sentar-se e engatinhar foi mais tardia nos grupos pós-inverno (p < 0,001). Quanto aos grupos de risco e sem risco para o desenvolvimento motor, observou-se, aos 7 meses, menor prevalência de planejamento da gravidez (p=0,015), menor tempo de aleitamento materno exclusivo (p=0,004) e de amamentação (p=0,012) no grupo com risco. Aos 10 meses, os lactentes do grupo de risco se caracterizaram pela menor idade gestacional (p=0,040), por serem filhos de mães mais velhas (p=0,020), maior número de irmãos (p=0,002), níveis mais elevados de pobreza (p=0,002) e maiores restrições de movimento (p=0,000). A regressão logística evidenciou que, aos 7 meses, o aleitamento materno foi a variável associada ao desenvolvimento motor, enquanto aos 10 meses, o número de filhos, a pobreza e a restrição de movimento do lactente explicaram a variação no desenvolvimento motor. Conclusão O clima frio não se mostrou um determinante isolado para o risco de atraso motor, variáveis ambientais foram mais influentes no modelo.

Inspection of infant motor development: importance of the insertion of a physical therapist in childcare

Abstract Introduction: The Childcare Program aims at the health promotion, prevention and early diagnosis of diseases and recovery from diseases in childhood through programmed monitoring of the child's growth and development. A physical therapist can contribute to the early identification of neuropsychomotor developmental disorders. Objective: To characterize the motor development (DM) of infants during childcare consultations and to discuss the importance of a professional physical therapist in primary health care teams. Methods: The sample comprised 91 infants aged 0-6 months attended in childcare consultations. Infants with musculoskeletal disorders, neuropathology, and those who cried bitterly, thereby preventing the evaluation were excluded. DM was evaluated using the Alberta Infant Motor Scale. Results: Of the infants aged 0-3 months, 11.76% had atypical DM, 23.62% were at risk for motor delay, and 64.07% had typical DM. Among the infants aged 4-6 months (25.3%), less than half of the children (39.13%) had typical DM. Among the infants aged 4-6 months who did not have typical DM, 40% belonged to the group of premature infants. Conclusion: As the child grows, the motor experiences should be more challenging for DM to constantly evolve. The insertion of a physical therapist in childcare, together with the Family Health Strategy team, can expand care and guarantee the assessment, monitoring, and promotion of early stimulation of childhood DM, in addition to the recognition of its importance in primary care.

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.

Avaliação dos Movimentos Gerais de Prechtl (GMA) na detecção precoce de risco ao desenvolvimento

RESUMO Verificar a relação entre a avaliação dos movimentos gerais (General Movements Assessment - GMA) com as variáveis obstétricas (aleitamento materno, intercorrência na gestação, medicação na gestação, álcool na gestação, fumo na gestação, intercorrência ao nascer, necessidade de internação em UTI neonatal e necessidade de ventilação mecânica), a presença de risco psíquico e o desfecho no desenvolvimento da linguagem, cognitivo e motor aos 18 e 24 meses. A amostra foi composta por 42 bebês, que foram filmados até a faixa etária de quatro meses, em movimentação espontânea por 15 minutos. Os movimentos gerais foram avaliados por vídeos usando a avaliação qualitativa de Prechtl e classificados como normais ou anormais dependendo da presença de fluência, complexidade e variabilidade. Os dados foram analisados estatisticamente em sua relação com variáveis obstétricas e com a presença de risco psíquico, avaliada por meio dos Sinais PREAUT, dos indicadores clínicos de risco ao desenvolvimento e do M-CHAT. Verificou-se que não houve associação entre o método GMA e as variáveis analisadas. Acredita-se que, pelo fato de a amostra ter sido composta, em sua maioria, por bebês nascidos a termo ou prematuros tardios sem intercorrências e de a avaliação ter sido de forma transversal, em um único momento, não foi possível analisar se os movimentos avaliados como anormais foram ou não transitórios. A alteração dos movimentos por meio do método Prechtl não apresentou associação com as variáveis analisadas na amostra de bebês prematuros tardios e nascidos a termo.

Risk factors for motor coordination problems in preschool-age children

BACKGROUND

Motor coordination problems (MCP) in children can sometimes be diagnosed as developmental coordination disorder. Early intervention for developmental coordination disorder is necessary because it often continues into adolescence, causing mental and physical complications. Few studies have investigated the prevalence of childhood MCP in the Japanese population, examining the risk factors for MCP. We therefore investigated the prenatal factors associated with MCP in preschool-age children.

METHODS

This study was based on a prospective cohort study, the Hokkaido Study on Environment and Children's Health. Mothers of 4,851 children who reached the age of 5 years within the study-period received questionnaires, including the Japanese version of the Developmental Coordination Disorder Questionnaire (DCDQ-J). We examined the risk factors associated with MCP using logistic regression analysis.

RESULTS

Of 3,402 returned DCDQ-J questionnaires, 3,369 were answered completely. From the 3,369 children, we categorized having MCP by using two cut-off scores: that of the DCDQ'07 and the cut-off at the 5th percentile of a total DCDQ-J score. Comparing children with and without MCP, we found significant differences in the education level of the mothers, annual household income during pregnancy, maternal alcohol consumption and smoking during pregnancy, and sex and age of the children at the time of completing the DCDQ-J by both categorizations. Adjusted logistic regression analysis revealed that maternal smoking during the first trimester of pregnancy and male sex were significantly associated with MCP.

CONCLUSIONS

Our results suggest that maternal smoking during pregnancy is the main factor associated with MCP in preschool-age children.

Effects of affordances in the home environment on children's personal-social, problem-solving, and communication skills

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.

Prevalence and risk factors of gross motor delay in pre-schoolers

AIM

Gross motor skills are important for children's health and development. Delays in these skills are a concern for healthy developmental trajectories and therefore early identification of delay is important. This study screened for gross motor delay in children from low-income communities and investigated potential risk factors associated with gross motor delay.

METHODS

This cross-sectional study involved 701 pre-schoolers (M_age = 54.1 ± 8.6 months, 52.8% boys) from childcare services in low-income and remote communities in Australia. Gross motor delay was assessed using the Ages and Stages Questionnaire - third edition. Potential risk factors included: sex, age, birthweight, prematurity status, weight status, childcare service, postcode, parent's education, parent's marital status, parent's employment and family income.

RESULTS

Results showed 4.4% of the children were delayed in gross motor skills and 8.8% were at risk of delay. Logistic regression showed being a boy (odds ratio (OR) 1.78, 95% confidence interval (CI) 1.12-2.84), underweight (OR 2.72, 95% CI 1.18-6.30) or overweight (OR 1.83, 95% CI 1.00-3.33), and parental unemployment (OR 1.79, 95% CI 1.01-3.16) were factors associated with a higher odds of children being delayed or at risk of gross motor delay. A higher family income (OR 0.35, 95% CI 0.13-0.93) was associated with lower odds of delay.

CONCLUSION

This unique study demonstrated children in low-income communities, especially boys, underweight and overweight children, have higher odds of being at risk of gross motor delay. Therefore, early screening is vital in this population in order to identify delays and potentially intervene with appropriate motor skill interventions.

Cross-Cultural Validity: Canadian Norm Values of the Alberta Infant Motor Scale Evaluated for Dutch Infants

PURPOSE

To examine whether the Canadian normative values of the Alberta Infant Motor Scale (AIMS) are appropriate for Dutch infants.

METHOD

In a cross-sectional study, 499 infants developing typically (0.5-19 months) were assessed using the AIMS home video method. The scaling method was used for calculating item locations of the Dutch sample, and Welch test to compare Canadian and Dutch raw scores.

RESULTS

THE: AIMS items (45 of 58) met the criterion for stable regression to calculate item locations of the Dutch data set and compare these with the Canadian data set. Dutch infants passed 42 of 45 items at an older age. Most monthly age groups of Dutch infants had lower mean AIMS scores.

CONCLUSION

The Canadian norms are not appropriate for the Dutch study sample. Dutch infants appear to develop in a similar sequence but at a slower rate. This has implications regarding the clinical use of the AIMS in the Netherlands.

Motor trajectories of preterm and full-term infants in the first year of life

BACKGROUND

Motor development occurs throughout periods of motor skill acquisition, adjustment and variability. The objectives of this study were to analyze and compare biological and health characteristics and motor skill acquisition trajectories in preterm and full-term infants during the first year of life.

METHODS

Two thousand, five hundred and seventy-nine infants (1,361 preterm) from 22 states were assessed using the Alberta Infant Motor Scale. Multivariate General Linear Model, t-tests, ANOVA, and Tukey tests were used.

RESULTS

An age × group significant interaction was found for motor scores. On follow-up tests full-term infants had higher scores in prone, supine, sitting and standing postures that require trunk control from 9 to 10 months of age; although this advantage was observed for sitting from the second month of life.

CONCLUSION

During the first trimester of life, preterm infants have higher scores in the supine and standing postures. Regarding motor trajectories, from newborn to 12 months, the period of higher motor acquisition was similar between full-term and preterm infants for prone (3-10 months), supine (1-6 months), and standing (6-12 months). For the sitting posture, however, full-term infants had a period of intensive motor learning of acquisition from the first to 7 months of life, whereas for preterm infants a shorter period was observed (3-7 months).

CONCLUSION

Although the periods of higher motor acquisition were similar, full-term infants had higher scores in more control-demanding postures. Intervention for preterm infants needs to extend beyond the first months of life, and include guidance to parents to promote motor development strategies to achieve control in the higher postures.

Home environment of infants with risk indicators for hearing loss tends to be less stimulating

OBJECTIVE

To verify the home opportunities to the motor development offered to infants with and without risk indicators for hearing loss (RIHL).

METHODS

Observational transversal study was done with infants between 8 and 10 months, being 77 with RIHL (Study Group-SG) and 77 without RIHL (Control Group-CG) The instrument used to characterize the sample and obtain information about the home affordances was the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The results of the AHEMD-IS between the groups were compared using the Mann-Whitney and Chi-Squared tests. The significance test adopted for the study was 5%.

RESULTS

Absolute values in the frequency of homes considered "moderately adequate" and "less than adequate" were greater in the SG in the most part of the categories, except the item Toys for Fine Motricity. It was possible to observe a statistically significant difference in the Total Score of the groups (p-value = 0.01346). Even with better results when compared with the SG, the number of homes of the CG group with affordances below expected is more than half of the sample.

CONCLUSIONS

It was possible to verify that home of infants with risk indicators for hearing loss have statistically less affordances when compared to the homes of infants without the indicators. The results alert us to the need of orientation to the infant's responsible/caretakers regarding to the importance of a favorable environment with stimulation of the infant motor development.

Affordances for Motor Skill Development in Home, School, and Sport Environments: A Narrative Review

Through development, a child's varied movement contexts provide different opportunities or affordances for action that are fundamental to promoting motor competence. Although home is the primary environment for infants, as children age, school and sport environments gain importance. Studies focusing on affordances for motor behavior in children have mainly addressed the home microsystem, providing an incomplete picture of affordances across different settings, particularly later in development. Here, we undertook a narrative literature review of various affordances for children's motor development. This review revealed that prior studies of school and sports contexts have not specifically focused on those environmental properties that promote or hinder motor learning opportunities, meaning that future research should assess these relationships through manipulations of environmental features in these different microsystems.

Maternal intelligence quotient and motor development in early childhood: The mediating role of mother's education

AIM

To examine the association between maternal intelligence quotient (IQ) and early childhood motor development and whether maternal education mediates this relationship.

METHODS

Data were collected prospectively in the Ma'anshan Birth Cohort study. Maternal IQ was assessed using the Wechsler Adult Intelligence Scale-Revised by China (WAIS-RC). Information on baseline characteristics and maternal education was obtained from questionnaires and medical records. The study outcome was motor development evaluated at 18 months by the Third Edition of Ages and Stages Questionnaire. Logistic regression analyses and mediation analyses were used.

RESULTS

Of 2739 valid subjects (84% follow-up), the rate of developmental delay was 3.1% in the gross motor domain and 6.2% in the fine motor domain. The mean value for maternal IQ was 96.2 (standard deviation 10.6). About 40.3% of the mothers had secondary education or less, while 59.7% had a college education. Mothers with higher IQ had a significantly higher educational level and had children with better motor development. Maternal education significantly mediated the association between maternal IQ and fine motor development. There was a direct effect of maternal IQ on gross motor development, but the mediation effect of maternal education was not found.

CONCLUSIONS

Maternal IQ was associated with motor development. Maternal education played an important role in reducing the disparities in fine motor development among children of different maternal IQs.

Modified ride-on cars and mastery motivation in young children with disabilities: Effects of environmental modifications

BACKGROUND

Independent mobility is important for children's psychological development. Modified ride-on cars are innovative, alternative options to enhance independent mobility, socialization, and motivation in young children with disabilities.

AIM

We compared the effects of combining ride-on car use and a social interaction training program on mastery motivation and home affordances with a home education program in young children with disabilities.

METHODS AND PROCEDURES

Twenty-nine children with disabilities aged 1-3 years were recruited. The treatment group (n = 15) received two 2-h sessions/week for 9 weeks of ride-on car training in a hospital environment in Taiwan. The control group (n = 14) underwent similar home education programs. No treatment except regular therapy was administered during the 9-week follow-up period. Assessments included the Revised Dimensions of Mastery Questionnaire-Chinese version and the Affordance in the Home Environment for Motor Development-Toddler version-Chinese version.

OUTCOMES AND RESULTS

The treatment group (compared to controls) had significantly greater improvements in object persistence during the intervention. Both groups showed significant improvements in mastery pleasure and home affordances during the intervention.

CONCLUSIONS AND IMPLICATIONS

This novel study showed the potential use of modified ride-on cars to enhance mastery motivation in a hospital environment.

Motor development in school-age children is associated with the home environment including socioeconomic status

The aim of the present study was to examine how the home environment, including socioeconomic status (SES), affects motor development in school-age children. Seven hundred seven children (332 boys and 375 girls) aged between 6 and 10 years participated in the study. Motor Development was determined using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition. Parents answered the Middle Childhood Home Observation Measurement of the Environment (HOME) Inventory, and Brazilian Association of Market Research Institutes Questionnaire (for SES). Children from "Adequate" homes (HOME score), compared with "Less Adequate," displayed better motor behavior. Mediation and moderation analysis revealed that motor development increased as SES increased. The proportion of variance in motor development explained by SES increased from 9% to 13% when the home was added as a mediation variable. We also found that the effect of SES on motor development was moderated by age. For older children, the effect was lower than for younger children. The best model used SES as the predictor, HOME as the mediator, and AGE as the moderator variable and explained 17% of the variance in motor development. In summary, these findings suggest that, like previous reports with young children, the HOME environment and SES may play an important role in motor development of school-age children. Our findings encourage the assessment of the home and interventions that take into account the home environment to improve motor development in school-age children.

Motor development’s curves of premature infants on the first year of life according to Alberta Infant Motor Scale

Abstract Introduction: The motor trajectory of pre-term children is an important indicator of health during infancy, since alterations may be a signal for the need of professional intervention. Objective: To describe percentiles and motor development curves for Brazilian preterm infants in the first year of life, determining the reference values for categorization of motor performance assessed by the AIMS. Methods: Participated in this cross-sectional study 976 children born pre-term, newly-born to 12 months of corrected age. The Alberta Infant Motor Scale (AIMS) was used to assess participants’ motor development. The scores of the Brazilian norms were used as comparison criteria. Results: Children born pre-term showed lower scores compared to children born full-term indicating the need for a specific percentile curve for that population. The scores differentiated at P1 to P99 percentiles allowing for the categorization of children with typical development, at risk and with atypical development. At 0, 4, 8, 9, 10, 11 and 12 months an overlapping of extreme percentiles (P1, P5 and P10; P90, P95 and P99) was observed, but not in the other percentiles. Conclusion: The percentiles described indicate that preterm children presented lower motor performance than full-term children and AIMS has discriminant power for the clinical evaluation of these children. The developmental curves showed lower capacity for behavioral differentiation in the extreme percentiles.

Influência do ambiente domiciliar no desenvolvimento motor de lactentes com síndrome de Down

RESUMO Crianças com síndrome de Down apresentam atrasos no desenvolvimento neuropsicomotor relacionados a tônus muscular, controle postural e equilíbrio. O desenvolvimento motor sofre interferência multifatorial, que envolve características biológicas, psicológicas, sociais e ambientais. Assim, o ambiente em que o lactente está incluído pode atuar como facilitador do desenvolvimento neuropsicomotor. O objetivo deste estudo foi avaliar a influência do ambiente domiciliar no desenvolvimento motor de lactentes com síndrome de Down. Participaram do estudo 16 lactentes com a síndrome, divididos em grupo I (3 a 11 meses) e grupo II (12 a 18 meses), avaliados pela Alberta Infant Motor Scale (AIMS) e pelo questionário Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS). A análise de dados foi feita por meio do teste de Kruskal-Wallis, coeficiente de correlação de Spearman e teste de razão de verossimilhança. Os resultados evidenciaram uma correlação positiva significativa entre o escore bruto da AIMS e a variedade de estímulos (p=0,01, r=0,78) e com o escore total do questionário AHEMD-IS (p=0,02, r=0,74) no grupo II. Verificou-se, ainda, correlação entre a renda familiar e as oportunidades com brinquedos de função motora grossa (p=0,05, r=0,49), porém com correlação fraca. Conclui-se que o ambiente domiciliar tem importante papel no desenvolvimento motor de crianças com síndrome de Down entre 12 e 18 meses, por proporcionar oportunidades de vivências e experimentações. Assim, pode-se afirmar que ambientes mais adequados proporcionam melhor desempenho motor.

Affordances in the home environment for motor development: Validity and reliability for the use in daycare setting

The range of stimuli provided by physical space, toys and care practices contributes to the motor, cognitive and social development of children. However, assessing the quality of child education environments is a challenge, and can be considered a health promotion initiative. This study investigated the validity of the criterion, content, construct and reliability of the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), version 3-18 months, for the use in daycare settings. Content validation was conducted with the participation of seven motor development and health care experts; and, face validity by 20 specialists in health and education. The results indicate the suitability of the adapted AHEMD-IS, evidencing its validity for the daycare setting a potential tool to assess the opportunities that the collective context offers to child development.

VIGILÂNCIA DO DESENVOLVIMENTO INFANTIL: ANÁLISE DA SITUAÇÃO BRASILEIRA

RESUMO Objetivo: Descrever o caso do Brasil sob o aspecto de antecedentes históricos e realizar revisão sistemática de estudos publicados sobre registro da vigilância do desenvolvimento infantil mediante aplicação do Cartão ou Caderneta de Saúde da Criança. Fontes de dados: Fez-se busca da literatura em abril de 2016 nas bases eletrônicas: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO) e Medical Literature Analysis and Retrieval System Online (Medline), sem restrição do idioma nem período de publicação, e em referências bibliográficas dos artigos selecionados. Descritores utilizados: desenvolvimento infantil e cartão da criança e desenvolvimento infantil e caderneta de saúde da criança. Critério de inclusão: artigos originais que mensuravam, no Brasil, o uso do instrumento de acompanhamento do desenvolvimento infantil. Critério de exclusão: outra forma de publicação que não fosse artigo original. Os artigos foram selecionados pelos títulos, seguido dos resumos e de sua leitura na íntegra. Síntese dos dados: A recomendação em apoiar a vigilância do desenvolvimento infantil ocorre desde 1984. Em 1995, incluíram-se marcos do desenvolvimento no Cartão da Criança, tornando-se tais marcos, em 2004, ato normativo para registro da vigilância por meio desse instrumento. Na revisão sistemática foram selecionados seis artigos, nos quais verificou-se a prevalência de notificação da vigilância do desenvolvimento infantil de 4,6 a 30,4%. Essa variação deve-se a critérios e tamanhos amostrais diversos e a diferentes metodologias de análise sobre a adequação do preenchimento do cartão. Conclusões: Apesar de a formalização pelo Ministério da Saúde do Brasil da vigilância do desenvolvimento infantil ter ocorrido há 32 anos, quando avaliada pelo registro no Cartão ou Caderneta de Saúde da Criança, sua realização ainda é deficitária e irregular.

Brazilian infant motor and cognitive development: Longitudinal influence of risk factors

BACKGROUND

Infant developmental delays have been associated with several risk factors, such as familial environmental, individual and demographic characteristics. The goal of this study was to longitudinally investigate the effects of maternal knowledge and practices, home environment and biological factors on infant motor and cognitive outcomes.

METHODS

This was a prospective cohort study with a sample of 49 infants from Southern Brazil. The infants were assessed three times over 4 months using the Alberta Infant Motor Scale and the Bayley Scale of Infant Development (Mental Development Scale). Parents completed the Daily Activities Scale of Infants, the Affordances in The Home Environment for Motor Development - Infant Scale, the Knowledge of Infant Development Inventory and a demographic questionnaire. Generalized estimating equation with Bonferroni method as the follow-up test and Spearman correlation and multivariate linear backward regression were used.

RESULTS

Cognitive and motor scores were strongly associated longitudinally and increased over time. Associations between the home affordances, parental practices and knowledge, and motor and cognitive development over time were observed. This relationship explained more variability in motor and cognitive scores compared with biological factors.

CONCLUSIONS

Variability in motor and cognitive development is better explained by environment and parental knowledge and practice. The investigation of factors associated with infant development allows the identification of infants at risk and the implementation of educational programs and parental training to minimize the effects of developmental delay.

Factors associated With the development of motor proficiency in school children of Kolkata: A cross-sectional study to assess the role of chronic nutritional and socio-economic status

BACKGROUND

Development of coordinated movements is determined among others by individual growth and environmental factors, but the dynamic relationship between motor proficiency and potential contributing factors such as chronic nutritional status and socio-economic status (SES) is not known in school children of Kolkata.

AIM

To characterize the motor proficiency in school children of Kolkata and to investigate association of chronic nutritional and SES on motor proficiency.

METHODS

Motor proficiency in 843 school children of Kolkata aged 5-12 years was assessed by the Bruininks-Oseretsky Test of Motor-Proficiency-Second Edition-Short Form (BOT-2 SF). Chronic nutritional status was determined from height-for-age Z-scores (HAZ) using WHO reference and SES was measured using the updated Kuppuswamy's scale.

RESULTS

Children's motor proficiency was poor compared with the reference values. Children classified as severely undernourished and children of lower SES were found to be "below average" and "well-below average" in motor proficiency categories compared with normal nourished groups and children of upper SES. Children's BOT-2 SF standardized scores decreased incrementally with the severity of chronic undernutrition and lower grades of SES.

CONCLUSION

Chronic undernutrition and lower SES are associated with poorer motor proficiency in children. Understanding the complex interrelationships that shape childen's motor skills can help inform the development of health promotion programs and tailored interventions to help children reach their full potential. © 2016 Wiley Periodicals, Inc. Dev Psychobiol 58:734-744, 2016.

Cognição e ambiente são preditores do desenvolvimento motor de bebês ao longo do tempo

RESUMO Investigou-se longitudinalmente relações entre desenvolvimento motor e cognitivo, aspectos biológicos, práticas maternas, conhecimento parental e ambiente familiar de bebês. Participaram do estudo 49 bebês (3-16 meses) avaliados com a Alberta Infant Motor Scale e a Escala Mental da Bayley Scale of Infant Development. Os pais responderam o questionário sobre fatores biológicos, Daily Activities of Infant Scale, o Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê, e o Inventário sobre Conhecimento do Desenvolvimento Infantil. Avaliações foram conduzidas nas escolas ao longo de 4 meses. Foram utilizadas Equações de Estimativa Generalizada, teste de Bonferroni e coeficiente de correlação de Spearman. Observaram-se associações significativas na (1) análise univariada entre desenvolvimento motor e cognitivo e fatores ambientais (escolaridade, renda, disponibilidade de brinquedos, espaço físico, práticas e conhecimento parental, tempo de aleitamento e frequência na escola); (2) multivariada entre o desenvolvimento motor e renda, idade do pai e espaço físico da residência. Concluiu-se que os desenvolvimentos motores e cognitivos se mostraram interdependentes e fatores ambientais se mostraram mais significativos nas associações em detrimento dos biológicos, reforçando-se a importância do lar, do cuidado dos pais e das experiências que a criança vivencia ao longo dos primeiros anos de vida.

Developmental coordination disorder: core sensori-motor deficits, neurobiology and etiology

Among developmental disorders, DCD is one of the least studied and less understood one (Bishop, 2010). This review summarizes the current understanding of developmental coordination disorder in neuropsychology with a focus mainly on high level sensorimotor impairments, its etiology and its neural bases. We summarize these core deficits in the framework of an influent motor control model (Blakemore et al., 2002). DCD has several environmental risk factors which probably interplay with genetic factors but those have not been sufficiently identified. High-level sensori-motor deficits are probably multifactorial in DCD and involve predictive coding deficits as well as weaknesses in perceptual and sensory integration. At the brain level, DCD is associated with impaired structure and functions within the motor network. Throughout the review we highlight exciting new findings as well as potential future lines of research to provide a more comprehensive understanding of this disorder.

The new affordances in the home environment for motor development - infant scale (AHEMD-IS): Versions in English and Portuguese languages

The home environment has been established as a crucial factor for motor development, especially in infants. Exploring the home environment can have significant implications for intervention, as it is common practice in physical therapy to have professionals advise patients on home activities. Since 2010, our group has been working on the development of the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), a parental self-reporting instrument designed to assess the quality and quantity of factors (affordances) in the home environment. In Brazil, the instrument has been translated as "Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê", and it has been extensively used in several studies that address infant development. These studies in Brazil and other parts of the world highly recommended the need for a normative sample and standardized scoring system. A description of the study that addressed that need, along with the English version of the questionnaire and score sheets, was recently published in the well-known and respected journal Physical Therapy. Our intent with the present short communication is to notify Brazilian investigators and clinicians of this latest update so they can download the new instrument, as well as present the Brazilian (Portuguese) version of the AHEMD-IS along with its scoring system.

Effects of Individual and School-Level Characteristics on a Child's Gross Motor Coordination Development

The aim of this study was to identify child and school-level characteristics that explained inter-individual differences in gross motor coordination (GMC). Participants (n = 390), recruited from 18 Portuguese primary schools, were aged 6 to 10 years of age. Birth weight, body fat (BF), physical activity (PA), physical fitness (PF) and GMC were assessed. School size, setting, infrastructure and physical education classes were considered as school context markers. A multilevel modeling approach was used to identify hierarchical effects (child and school levels). It was found that children-level variables (sex, PF, and BF) significantly explained 63% of the 90% variance fraction at the individual level; boys outperformed girls (p < 0.05), individuals with higher BF were less coordinated (p < 0.05), and those with higher PF were more coordinated (p < 0.05). School-variables (e.g. school size and playing surface) explained 84% of the 10% variation fraction. These findings confirm the roles of sex, PFS and BF. Interestingly they also suggest that the school environment plays a minor but significant role in GMC development. However, it is important to stress that the school context and conditions can also play an important role in a child's motor development, providing adequate and enriching motor opportunities.