OBJECTIVE: To assess the opportunities present in the home environment for motor development of infants. METHODS: This was a cross-sectional population-based epidemiological study on 239 infants aged three to 18 months who were living in the municipality of Juiz de Fora, Southeastern Brazil, in 2010. The participants were selected by means of stratifi ed random sampling, in clustered multiple stages. To assess the quality and quantity of motor stimulus in the home environment, the "Affordances in the Home Environment for Motor Development-Infant Scale" instrument was used. Bivariate analysis was performed, with application of the chi-square test followed by multinomial logistic regression, in order to investigate associations between the opportunities present in the home and biological, behavioral, demographic and socioeconomic factors. RESULTS: The opportunities for environmental stimulation were relatively low. In the bivariate analysis, for the age group from three to nine months, associations with the following factors were found: birth order (p = 0.06), socioeconomic classifi cation (p = 0.08), monthly income (p = 0.06) and per capita income (p = 0.03). In the regression model, the socioeconomic classifi cation prevailed (OR = 7.46; p = 0.03). For the age group from 10 to 18 months, bivariate analysis showed that the following factors were associated: mother's marital status (p < 0.01), father living with the child (p = 0.08), head of the family (p = 0.04), number of people in the household (p = 0.05), mother's schooling level (p < 0.01), father's schooling level (p < 0.01), socioeconomic classifi cation (p < 0.01) and per capita income (p = 0.03). In the regression model, the mother's marital status (OR = 4.83; p = 0.02), mother's schooling level (OR = 0.29; p = 0.03) and father's schooling level (OR = 0.33; p = 0.04) remained associated with the opportunities for environmental stimulation. CONCLUSIONS: Stable partnership between the parents, higher maternal and paternal schooling levels and higher economic level were the factors associated with better opportunities for motor stimulation in the home.
| Background: Socioeconomic status (SES) and stimulation provided in the home environment are influential factors in aspects of child well-being including motor development. Little is known regarding the influence of SES on specific aspects of the home environment. Objective: To evaluate the availability of affordances in the home to promote infant motor development and family SES. Method: The sample consisted of 300 families with infants aged 3 to 18 months. SES was assessed according to family socioeconomic class, income and parental level of education. To evaluate motor affordances found at home, the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) was used. The AHEMD-IS was designed to assess dimensions of the home environment including Physical Space (outside and inside space), Daily Activities and Play Materials (fine-motor and gross-motor toys). Results: SES indicators significantly influenced the availability of Physical Space and Play Materials. The Physical Space dimension was influenced by family economic class and income. The Play Materials dimension was influenced by all SES indicators. Daily Activities were not influenced by any of the SES indicators. Daily activities and play material were influenced by the infant's age. Conclusions: This study suggests that SES indicators are influential with regard to the provision of motor affordances in the home environment for infants. However, daily activities, which represent an aspect of the environment that is highly dependent on parental generation of situations that are conducive to motor skill development, are independent of family SES.
Resumo:Existe um consenso na literatura científica sobre a forte influência dos estímulos ambientais no desenvolvimento motor das crianças. O presente trabalho tem como objetivo analisar as oportunidades para o desenvolvimento motor em ambientes domésticos de diferentes ní-veis socioeconômicos no Estado do Ceará, Brasil. Os dados apresentados no estudo foram colhidos a partir das respostas ao questionário Affordances in the Home Enviroment for Motor Development -AHEMD -18-42 meses quando se entrevistaram 128 tutores responsáveis por crianças com idade entre 18 e 42 meses. Os resultados do estudo são bastante preocupantes, pois mostram uma prevalência da inadequação das estruturas arquitetônicas das residências favorecedoras do desenvolvimento motor e a inexistência de materiais suficientes ao desenvolvimento da motricidade grossa e fina de crianças. Nota-se a necessidade, segundo os dados apresentados, de que seja avaliado o desenvolvimento motor das crianças para verificar se há uma associação entre as affordances e o desenvolvimento motor, e que haja uma aproximação das áreas de engenharia civil, arquitetura e educação física na busca de soluções para este problema. O estudo sugere, ainda, o surgimento de uma nova área de atuação para os profissionais que lidam com o movimento humano no sentido de prestarem consultorias para aquisição de brinquedos que auxiliem no desenvolvimento da motricidade grossa e fina. Palavras
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.
A contemporary view of motor development considers environmental influences as critical factors in optimal growth and behavior, with the home being the primary agent. The intent of this communication is to introduce the Affordances in the Home Environment for Motor Development Self-Report (AHEMD-SR) to early childhood practitioners. The AHEMD-SR is a reliable and valid parental self-report assessment instrument that addresses the quality and quantity of factors (affordances and events) in the home that are conducive to enhancing motor development in children ages 18-42 months. The instrument could provide useful information in a wide variety of settings, including applications to intervention and remediation.
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.
Preterm birth remains a major contributor to infant mortality and morbidity including neurodevelopmental delay and childhood disability. Mothers experiencing a preterm birth are at risk for maternal mental health issues, inclusive of depression and posttraumatic stress disorder (PTSD), which may affect mother-infant attachment and infant development. Depression and PTSD, frequently comorbid, following preterm birth and relationships between these symptoms, maternal-infant attachment, and infant development are reviewed. Assessments and interventions potentially capable of benefitting mother and infant are noted. The need for healthcare professionals to intervene prenatally and at postpartum is significant as maternal distress remains one of the most consistent factors related to infant development. Although depression has received much attention in the literature as a risk factor for preterm birth, impaired attachment, and delayed infant development, some of the consequences of PTSD have only recently gained research attention. A few studies support the role of PTSD in impaired maternal-infant attachment; yet, it is unclear whether preterm infants of mothers experiencing symptoms of PTSD following birth are at a higher risk for motor development problems. Because early mother-infant interactions are influenced by prematurity as well as maternal mental health, consideration for home interventions that stimulate infant development and encourage mother-infant relationships concurrently are important. Directed interventions may be beneficial for infant development and aid in strengthening the mother-infant relationship, potentially reducing depression and PTSD symptoms in the mother.
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