The assessment of motor coordination and dexterity: test development and validation perspectives

Problems in motor coordination are common in infancy and they may influence the child's school performance and self-stem. There are various tests designed to detect motor problems, but none of them was created and standardized for the Brazilian children. In the absence of appropriate instruments to diagnose and characterize motor problems, the children do not get assistance, increasing the risk for school failure. In this study we describe the initial steps of the creation of the Assessment of Motor Coordination and Dexterity (ACOORDEM), a test designed to detect developmental coordination disorder in children ages 4 to 8 years old. The methodology included a review of the most well known tests that are used to assess motor coordination in children and the creation of a item bank, with 349 entries. Items that were similar were discarded and the remaining were submitted to inclusion criteria, based on theoretical principles that guided the creation of the ACOORDEM. An initial version of the test was created, and its content validity was examined by panels of experts and clinicians, involved in the area of child development.Problemas de coordenação motora são comuns na infância e podem influenciar o desempenho escolar e a auto-estima da criança. Existem vários testes para detecção de problemas motores, mas nenhum deles foi criado e estandardizado para a criança brasileira. Na ausência de instrumentação apropriada para diagnóstico e caracterização das dificuldades motoras, muitas crianças não recebem ajuda, aumentando o risco de fracasso escolar. Nesse trabalho descrevemos as etapas iniciais de criação da Avaliação da Coordenação e Destreza Motora (ACOORDEM), teste para detecção de transtorno da coordenação motora em crianças de 4 a 8 anos de idade. A metodologia incluiu a revisão dos principais testes utilizados para avaliação da coordenação motora em crianças e criação de banco de dados com 349 itens de teste. Itens similares foram descartados e os restantes submetidos a critérios de inclusão, baseados nos princípios teóricos que nortearam a criação da ACOORDEM. Criou-se a versão inicial do teste, cuja validade de conteúdo foi avaliada por pesquisadores e profissionais que atuam na área de desenvolvimento infantil

Cross-cultural adaptation of the assessment protocols of the Modèle Ludique

The objective of this study was to conduct a cross-cultural translation of the assessment protocols of the Modèle Ludique created by Francine Ferland. The assessment tool "Evaluation of the Play Behavior" cover five areas of observation: the child's general interest; basic play interests; basic play capacities; play attitude and the capacity to express needs and feelings. The "Parents Initial Interview" assesses nine areas with questions about the child's play behavior. Both protocols were translated and adapted according to a methodology that included translation and back translation, followed by the verification of the semantic, idiomatic and conceptual equivalence. The translated version was administered to a sample of 13 children with cerebral palsy and their caretakers. The results indicated that the protocols respond to the need for assessment tools that are valid and reliable, therefore, further studies to advance into the process of validating the two protocols are recommended.O objetivo desse estudo foi realizar a adaptação transcultural dos protocolos de avaliação do Modèle Ludique desenvolvidos por Francine Ferland. O instrumento "Avaliação do Comportamento Lúdico" abrange cinco áreas de observação: interesse geral da criança; interesses lúdicos básicos; capacidades lúdicas básicas; atitude lúdica e expressão das necessidades e dos sentimentos. A "Entrevista Inicial com os Pais" abrange nove áreas, avaliadas por meio de perguntas sobre o comportamento lúdico da criança. Os dois protocolos foram traduzidos e adaptados seguindo metodologia que incluiu a tradução e a retrotradução, seguidas da avaliação da equivalência semântica, idiomática e conceitual. A versão traduzida foi aplicada em amostra de 13 crianças com paralisia cerebral e seus pais ou responsáveis. Os resultados indicam que os protocolos atendem à necessidade de instrumentos de avaliação validos e confiáveis, sendo recomendada a ampliação e aprofundamento de estudos para avançar no processo de validação dos dois protocolos

Impaired gas exchange: accuracy of defining characteristics in children with acute respiratory infection

OBJECTIVE: to analyze the accuracy of the defining characteristics of the Impaired gas exchange nursing diagnosis in children with acute respiratory infection.METHOD: open prospective cohort study conducted with 136 children monitored for a consecutive period of at least six days and not more than ten days. An instrument based on the defining characteristics of the Impaired gas exchange diagnosis and on literature addressing pulmonary assessment was used to collect data. The accuracy means of all the defining characteristics under study were computed.RESULTS: the Impaired gas exchange diagnosis was present in 42.6% of the children in the first assessment. Hypoxemia was the characteristic that presented the best measures of accuracy. Abnormal breathing presented high sensitivity, while restlessness, cyanosis, and abnormal skin color showed high specificity. All the characteristics presented negative predictive values of 70% and cyanosis stood out by its high positive predictive value.CONCLUSION: hypoxemia was the defining characteristic that presented the best predictive ability to determine Impaired gas exchange. Studies of this nature enable nurses to minimize variability in clinical situations presented by the patient and to identify more precisely the nursing diagnosis that represents the patient's true clinical condition

A ética do silêncio racial no contexto urbano: políticas públicas e desigualdade social no Recife, 1900-1940

Mais de meio século após o preconceito racial ter se tornado o principal alvo dos movimentos urbanos pelos direitos civis nos Estados Unidos e na África do Sul, e décadas depois do surgimento dos movimentos negros contemporâneos no Brasil, o conjunto de ferramentas legislativas criado no Brasil para promover o direito à cidade ainda adere à longa tradição brasileira de silêncio acerca da questão racial. Este artigo propõe iniciar uma exploração das raízes históricas desse fenômeno, remontando ao surgimento do silêncio sobre a questão racial na política urbana do Recife, Brasil, durante a primeira metade do século XX. O Recife foi eé um exemplo paradigmático do processo pelo qual uma cidade amplamente marcada por traços negros e africanos chegou a ser definida política e legalmente como um espaço pobre, subdesenvolvido e racialmente neutro, onde as desigualdades sociais originaram na exclusão capitalista, e não na escravidão e nas ideologias do racismo científico. Neste sentido, Recife lança luzes sobre a política urbana que se gerou sob a sombra do silêncio racial.More than half a century after racial prejudice became central to urban civil rights movements in the United States and South Africa, and decades after the emergence of Brazil’s contemporary Black movements, Brazil's internationally recognized body of rights-to-the-city legislation still adheres to the country's long historical tradition of racial silence. This article explores the historical roots of this phenomenon by focusing on the emergence of racial silence in Recife, Brazil during the first half of the 20th Century. Recife was and remains a paradigmatic example of the process through which a city marked by its Black and African roots came to be legally and politically defined as a poor, underdeveloped and racially neutral space, where social inequalities derived from capitalist exclusion rather than from slavery and scientific racism. As such, Recife'sexperience sheds light on the urban policies that were generated in the shadow of racial silence

Effect of preterm birth on motor development, behavior, and school performance of school-age children: a systematic review ,

OBJECTIVES:to examine and synthesize the available knowledge in the literature about the effects of preterm birth on the development of school-age children.SOURCES:This was a systematic review of studies published in the past ten years indexed in MEDLINE/Pubmed, MEDLINE/BVS; LILACS/BVS; IBECS/BVS; Cochrane/BVS, CINAHL, Web of Science, Scopus, and PsycNET in three languages (Portuguese, Spanish, and English). Observational and experimental studies that assessed motor development and/or behavior and/or academic performance and whose target-population consisted of preterm children aged 8 to 10 years were included. Article quality was assessed by the Strengthening the reporting of observational studies in epidemiology (STROBE) and Physiotherapy Evidence Database (PEDro) scales; articles that did not achieve a score of 80% or more were excluded.SUMMARY OF FINDINGS:the electronic search identified 3,153 articles, of which 33 were included based on the eligibility criteria. Only four studies found no effect of prematurity on the outcomes (two articles on behavior, one on motor performance and one on academic performance). Among the outcomes of interest, behavior was the most searched (20 articles, 61%), followed by academic performance (16 articles, 48%) and motor impairment (11 articles, 33%).CONCLUSION:premature infants are more susceptible to motor development, behavior and academic performance impairment when compared to term infants. These types of impairments, whose effects are manifested in the long term, can be prevented through early parental guidance, monitoring by specialized professionals, and interventions

Relationship between very low birth weight, environmental factors, and motor and cognitive development of children of 5 and 6 years old Relação entre muito baixo peso ao nascimento, fatores ambientais e o desenvolvimento motor e o cognitivo de crianças aos 5 e 6 anos

OBJECTIVE: To examine the relationships between birth weight, preterm birth, environmental factors and the motor and cognitive development of 5 to 6 year-old children. METHODS: A case control study in which the motor and cognitive performance, as well as the home environment of children aged 5-6 years, born pre-term and weighing <1.500 grams, were compared to peers born full-term and with normal weight. The following testes were used: Movement Assessment Battery for Children (MABC), the Developmental Coordination Disorder Questionnaire (DCDQ), the vocabulary and cube tests of the Weschsler Intelligence Test for Children-III (WISC), the Swanson, Nolan and Pelham IV Scale (SNAP IV) and the Home Observation for Measurement of the Environment (HOME). RESULTS: 50.54% of the very low birth weight (VLBW) children died and 15.2% of them demonstrated severe impairments. The scores (±SD) of the VLBW and normal birth weight (NBW) groups were: HOME 33.83±7.81(VLBW), 39.61±8.75(NBW); MABC 8.17±7,10(VLBW), 3.06±3.80(NBW); DCDQ 54.0±11.3(VLBW), 63.0±7.5(NBW); WISC Cubes 8.35±2.15(VLBW), 10.57±2.25(NBW); WISC Vocabulary 9.61±2.62(VLBW), 13.48±2.45(NBW); SNAP IV 4.04±4.95(VLBW), 1.57±3.27(NBW). Significant differences between the groups were found, with higher scores on all measures for the NBW group. The results of the motor and cognitive tests demonstrated correlations with birth weight (p<0.01) and HOME scores (p<0.05). CONCLUSIONS:The findings reaffirmed the evidences that children born pre-term and with VLBW were more vulnerable to have motor and cognitive impairments, compared to those born full-term. Environmental factors appeared to interfere with development of these children.<br>OBJETIVO: Examinar as relações entre baixo peso ao nascimento, prematuridade, fatores ambientais e os desenvolvimentos motor e cognitivo de crianças aos 5 e 6 anos de idade. MÉTODOS: Estudo caso-controle no qual os desempenhos motor e cognitivo e o ambiente domiciliar de crianças com idade de 5-6 anos, nascidas pré-termo e com peso < 1.500 gramas, foram comparados com os de pares nascidos a termo e com peso adequado (PA). Foram utilizados os testes Movement Assessment Battery for Children (MABC), Developmental Coordination Disorder Questionnaire (DCDQ), as provas de vocabulário e de cubos do Weschsler Intelligence Test for Children-III (WISC), o Swanson, Nolan and Pelham IV Scale (SNAP IV) e o Observation for Measurement of the Environment (HOME). RESULTADOS: 50,54% das crianças nascidas com muito baixo peso (MBP) foram a óbito, e 15,2% deste grupo desenvolveram sequelas severas. Os escores para os grupos de MBP e de PA foram: HOME 33,83±7,81(MBP), 39,61±8,75(PA); MABC 8,17±7,10(MBP), 3,06±3,80(PA); DCDQ 54,0±11,3(MBP), 63,0±7,5(PA); WISC Cubos 8,35±2,15(MBP), 10,57±2,25(PA); WISC Vocabulário 9,61±2,62(MBP), 13,48±2,45(PA); SNAP IV 4,04±4,95(MBP), 1,57±3,27(PA). Foram encontradas diferenças significativas entre os grupos, com melhor desempenho em todos os testes no grupo de PA. Os resultados dos testes motores e cognitivos tiveram correlação com o peso ao nascer (p<0,01) e com o HOME (p<0,05). CONCLUSÕES: Os resultados reforçaram as evidências de que crianças nascidas prematuras e de MBP são mais propensas a apresentar dificuldades motoras e cognitivas que seus pares nascidos a termo e de PA. Fatores ambientais parecem interferir no desenvolvimento dessas crianças

Análise comparativa da coordenação motora de crianças nascidas a termo e pré-termo, aos 7 anos de idade

OBJETIVO: comparar o desenvolvimento motor, na idade escolar, de crianças nascidas a termo e pré-termo. MÉTODOS: participaram do estudo dois grupos de crianças, com sete anos de idade: a) grupo pré-termo com 35 crianças, de famílias de baixa renda, nascidas com idade gestacional <34 semanas e/ou peso ao nascimento <1500 g, e b) grupo controle com 35 crianças nascidas a termo, com idade, sexo e nível socioeconômico equivalente ao grupo pré-termo. Todas as crianças foram avaliadas com o teste Movement Assessment Battery for Children (M-ABC). RESULTADOS: o teste de Wilcoxon indicou diferença significativa entre os grupos no escore total (Z=-4,866, p<0,001) e nas subáreas do M-ABC, com pior desempenho no grupo pré-termo. CONCLUSÃO: 57% das crianças do grupo pré-termo apresentaram sinais de transtorno da coordenação, o que ressalta a importância do acompanhamento do desenvolvimento até a idade escolar