AFFORDANCES IN THE HOME ENVIRONMENT AND NEUROMOTOR DEVELOPMENT AT 42 MONTHS OF AGE IN NEONATAL INTENSIVE CARE UNIT EGRESSES´S

Ferreira M.C.P.¹, Frônio J.S.², Silva A.J.¹, Ribeiro L.C.¹

¹Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil, ²Federal University of Juiz de Fora, Faculty of Physical Therapy, Juiz de Fora, Brazil

Background: Infant development is a complex and continuous process resulting from the interaction between biological, genetic and environmental factors, and the home environment has a large and significant importance in this relationship.

Purpose: The aims of this study were to investigate the association between biological factors, obstetric, perinatal, neonatal, postnatal, family structure and environmental stimulus presents in the home with the cognitive, motor and language development of Neonatal Intensive Care Units (NICU) egresses' and to investigate how the development-environment interaction is affected by different risk factors.

Methods: This is a transversal study from the NICU discharges, with a convenience sample of 51 preschool children evaluated at 42 months of age with the Bayley Scales of Infant and Toddler Development – Third Edition (BAYLEY–III) and the questionnaire Affordances in the Home Environment for Motor Development (AHEMD). Descriptive statistical analysis was carried out and Mann-Whitney test was used to assess the association.

Results: The majority of the study participants showed development within normal limits in the BAYLEY-III scale, but cognitive performance being found slightly or significantly lowered by almost a quarter of these (23.5%). In the AHEMD total classification, was found "average level" of environmental stimuli opportunities’ in more than two thirds of participants (74.7%), and only 7.8% had "high level" of stimuli. The home environment seems to be associate with the cognitive development (p=0.076) and the "external space of home" with the language development (p=0.056). Significant associations were found between the subscales of the AHEMD "Gross motor materials" and "fine motor materials" with cognitive development (p=0.007 and p=0.047, respectively) and the language (p=0.005 and p 0.00001, respectively). Associations were found between some biological, perinatal, neonatal, postnatal risk factors and family structure with neurodevelopment and associations of these development-environment interaction.

Conclusion(s): It was concluded that the amount and variety of opportunities in their home environment are associate with the cognitive and language development at 42 months of NICU Egresses’ and that these stimuli can minimize the undesirable effects of some risk factors on cognitive development in the long term.

Implications: The results reinforce the importance of good opportunities in the home environment, because of this, health professionals should pay more attention in these aspects, giving carefully orientation and training for parents.

Funding acknowledgements: PROPESQ- UFJF

Topic: Disability & rehabilitation

Ethics approval: Project approved by the Ethics in Research Committee of the UFJF on October, 25, 2012, protocol. n°131.343/2012.

All authors, affiliations and abstracts have been published as submitted.