D. Metgud1, R. Ajgaonkar1, M. Fernandes2, S. Dhaded3
1KLE Institute of Physiotherapy, Pediatric Physiotherapy, Belagavi, India, 2University of Southampton, Department of Paediatrics, Southampton, United Kingdom, 3J.N.Medical College, Department of Pediatrics, Belagavi, India
Background: The Lancet series on early child development (ECD) estimates that 250 million children under 5 years of age, in low- and middle-income countries, are at risk of not achieving their development potential due to issues relating to poverty, malnutrition, infectious diseases and poor access to healthcare. These early disturbances have been evidenced to lead to poorer school readiness and literacy outcomes during middle and late childhood.
A range of interventions (such as Project CARE, Sitting together and reaching to play, and Reach out and Read) that promote child development through various parent child interaction activities have been reported to be associated with positive influences on cognitive, language, motor, and behavioral outcomes during early childhood.
A range of interventions (such as Project CARE, Sitting together and reaching to play, and Reach out and Read) that promote child development through various parent child interaction activities have been reported to be associated with positive influences on cognitive, language, motor, and behavioral outcomes during early childhood.
Purpose: At our study location, the prevalence of global neurodevelopmental disturbance is estimated to between 19.8% and 48.5% in rural children aged three years. These high rates of developmental delays during early childhood have been attributed to environmental influences relating to poverty, lower levels of formal maternal education and undernutrition. Our aim was to determine whether the implementation of culturally appropriate SIT Down and Play (SDP)intervention is able to have a positive effect on parenting behavior and neuromotor developmental outcomes among the children in rural India.
Methods: 52 eligible infants between 5.5-6.5 months reporting to well baby clinicof a tertiary care hospital in south India, were recruited after obtaining consent and randomly allocated to either interventional group or control group with 26 participants in each group. Baseline data on parenting behavior was collected using STIM-Q .Infants in both the groups received standard care. Infants in intervention group received SDP intervention using a simple age appropriate toy with a range of simple activities. The mothers were asked to demonstrate the same and feedback was given with advise to play with their child at least twice a day. At 8 and 10 months of age they again received SDP using age specific toys. At 12 months the infants were re evaluated using STIMQ and for early neuromotor outcome using Developmental Assessment Scale for Indian Infants(DASII) and Oxford Neurodevelopment Assessment(OX-NDA) by a blinded evaluator.
Results: At 12 months follow up, improvements in the mean raw OX-NDA scores for the intervention group 3.18 and control groups 2.77 were noted. The total raw scores for DASII were higher for the intervention group (157.92± 6.26) as compared to the control group(154.73 ±7.65). The parental involvement in development advance and parental verbal responsivity scores of StimQ-I showed significant improvements in both the groups. For within group analysis the PIDA scores improved from 1.34 to 6.19 and 1.84 to 4.96 in the intervention and control group respectively.
Conclusion(s): Sit down and play intervention is an effective intervention for enhancing the parent child behavior and improving the neuromotor development in young infants. Future studies with longer follow up and in preterm infants can be considered.
Implications: Considering the positive impact of SDP intervention on ECD, it can be implemented as a primary preventive care intervention in well baby clinics and in early intervention program for high risk infants.
Funding, acknowledgements: self funded project
Keywords: play, parent behaviour, neuromotor development
Topic: Paediatrics
Did this work require ethics approval? Yes
Institution: KLE Institute of Physiotherapy,Belagavi,Karnataka,India
Committee: Research and ethics committee of KLE Institute of Physiotherapy
Ethics number: 220
All authors, affiliations and abstracts have been published as submitted.
