Improved cognitive and motor development in a community-based intervention of psychosocial stimulation in northeast Brazil

Abstract

The aim of the study was to compare the development of children with and without a programme of psychosocial stimulation in 'control' and 'intervention' sites in a poorly resourced area of northeast Brazil. The sample (n = 156, born 1998) was from a larger cohort. The cohort was tested at 12 months (baseline) with the Bayley Scales of Infant Development. All children in the intervention site with a mental development index (MDI) and/or psychomotor development index (PDI) < or = 100 were enrolled. Each time such a child was enrolled, the next child tested in that site of the same sex and with an index of 101 to 115 was also enrolled, and the next two children matched for sex and scores of < or = 100 and 101 to 115 in the control sites were recruited in parallel. The intervention comprised 14 contacts between 13 and 17 months of age. All children were tested again at age 18 months. The intervention and control groups were similar at baseline for a range of socioeconomic, demographic, environmental, and biological variables, and their MDI and PDI were also similar. At 18 months, the mean differences between the intervention and control groups were + 9.4 points for MDI and + 8.2 points for PDI (p < 0.001 in each case). For children with an initial score of < or = 100, the mean difference between the intervened and control groups was + 11.2 points for MDI (p < 0.001), and + 10.8 points for PDI (p = 0.001). The intervention was thus associated with significant improvements in cognitive and motor development.

Intellectual Disability in a Birth Cohort: Prevalence, Etiology, and Determinants at the Age of 4 Years

“…In addition, the importance of these interventions, independently of ID etiology, has also been observed [29]. In Brazil, a similar intervention has been successfully documented in a poverty area where mothers were taught to play and stimulate their children [30]. Consequently, it would be expected that a considerable portion of cases could have been potentially reduced if appropriate interventions had been delivered.…”

Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo

“…Our results suggest that HIV affects the neurodevelopment of children through both a direct pathway (ie, the presence of HIV in the CNS) and its effect on the child’s living conditions. The high rate of developmental delay in HIV-infected and HIV-affected children as compared with control children underscores the need for screening for and prevention of neurodevelopmental delay at an early age and calls for access to early interventions and nutritional and care programs for these vulnerable children 24–27…”

Development and Evaluation of the Korean Health Literacy Instrument

“…A few had small effect sizes, but typically effects were medium to large. Home-visiting programs benefited development in children recovering from severe malnutrition (Grantham-McGregor, Schofield, & Powell, 1987; Nahar et al, 2012); undernourished children (Grantham-McGregor, Powell, Walker, & Himes, 1991; Hamadani et al, 2006; Powell, 2004), children with iron deficiency anemia (Lozoff et al, 2010); low birth weight infants (Walker, Chang, Powell, & Grantham-McGregor, 2004), and disadvantaged children in poor communities (Powell & Grantham-McGregor, 1989; Eickmann et al, 2003; Powell, 2004; Vazir et al, 2013). The evaluations of home-visit interventions provide strong evidence that they can be successfully implemented by women who have completed only primary education or partially completed secondary education.…”

“…To address this problem, some home-visit interventions have been combined with group sessions. An intervention evaluated in Brazil combined group sessions to demonstrate and practice play activities and interaction with home visits to reinforce the workshops through play sessions with the mother and child (Eickmann et al, 2003). Individual play sessions with mother and child can also be conducted at visits to a community clinic (Nahar et al, 2012).…”