Steinberg M.1,2, Benjamin N.1, Roos R.1, Joubert G.3
1University of the Witwatersrand, Faculty of Health Sciences, Department of Physiotherapy, Johannesburg, South Africa, 2Kimberley Hospital Complex, Department of Physiotherapy, Kimberley, South Africa, 3University of the Free State, Department of Biostatistics, Bloemfontein, South Africa
Background: The early childhood years are the foundational years for development. Many factors during this time influence childhood development positively or negatively. Negative factors include poverty, maternal depression, a low maternal educational level, poor health and a poor nutritional state of the child. Early assessment of development is essential to detect impairments that require physiotherapy intervention.The Platfontein community is a very poor San Bushmen community in the Northern Cape of South Africa consisting of the !Xun and Khwe tribes. The motor development of children in this community is currently unknown.
Purpose: The study determined the motor development, nutritional status and the demographic profile of children attending two respective crèches in the Platfontein community.
Methods: A cross sectional study was done using a sample of convenience inviting all children attending these crèches to participate. Motor development was assessed using the Movement Assessment Battery for Children-2 (M-ABC2®). The presence of malnutrition was determined according to the WHO growth charts; a weight-for-height under the two standard deviations of the median was defined as malnourished. The demographic profile was determined using a demographic questionnaire. The Statistical Analysis Software programme was used. Inferential statistics were done to determine p-values. A p-value ≤ 0.05 was deemed statistically significant.
Results: The potential sample consisted of 70 children. Six children did not meet the inclusion criteria. The final sample consisted of 64 participants, 27 (42.2%) from one creche and 37 (57.8%) from the other. In total there were 28 (43.8%) females and 36 (56.3%) males. The mean age was 4 years and 10 months
(SD ±8.3 months). Most participants (n=52; 81.3%) were raised by a primary caregiver who was not married (n=41; 64.1%) and/or unemployed (n=48; 75%). The highest level of education of the primary care givers was a grade 7 pass (n=24; 37.5%) but 22 (34.4%) primary caregivers had no formal education. Six (9.4%) participants had a history of tuberculosis (TB). The majority of participants (n=57; 90.5%) were not considered malnourished. Fifty four complete M-ABC2® scores were available for analysis. Twenty nine (53.7%) participants did not have a risk for motor impairment, 13 (24.1%) were at risk for motor impairment and 12 (22.2%) had a definite motor impairment. The manual dexterity subcategory was of most concern: 37 (68.5%) scored at or below the 5th percentile. The balance subcategory (n= 4; 7.4% scored at or below the 5th percentile) and the aim and catch subcategory (n=2; 3.7% scored at or below the 5th percentile) were less of a concern. TB history (p=0.49) or malnutrition (p=0.19) had no relationship with M-ABC2® results. No significant difference (p=0.59) was noted between the M-ABC2® scores of the children attending the two respective crèches.
Conclusion(s): A motor developmental delay, specifically a delay in manual dexterity, was found in children attending the crèches in the Platfontein community. Compared to national and international studies this cohort achieved lower M-ABC2® scores.
Implications: Multidisciplinary long term intervention programmes are needed in this community to address the aspects of concern of the childrens motor development.
Funding acknowledgements: Self funded.
Topic: Paediatrics
Ethics approval: University of the Witwatersrand Human Research Ethics Committee
All authors, affiliations and abstracts have been published as submitted.
