A Community-based Responsive Caregiving Program Improves Neurodevelopment in Two-year Old Children in a Middle-Income Country, Grenada, West Indies
Randall WaechterRoberta EvansMichelle FernandesBecky A. BaileyStephanie HolmesToni MurrayRashida IsaacBianca PunchNikita CudjoeLauren OrlandoBarbara Landon
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Abstract:
Many young children in low- and middle-income countries (LMICs) are at risk of developmental delays. Early child development (ECD) interventions have been shown to improve outcomes, but few interventions have targeted culturally normative violence such as corporal punishment (CP). We partnered with an existing community-based ECD organization in the LMIC of Grenada to implement a parallel controlled-trial single-blind responsive caregiving intervention that educates parents about the developing brain and teaches alternatives to corporal punishment while building parental self-regulation skills and strengthening social-emotional connections between parent and child. Parents and primary caregivers with children under age two were eligible. Allocation to the intervention and waitlist control arms was unblinded and determined by recruitment into the program. Neurodevelopment was assessed by blinded testers when each child turned age two. Primary comparison consisted of neurodevelopmental scores between the intervention and waitlist control groups (Clinicaltrials.gov registration xxx NCT04697134). Secondary comparison consisted of changes in maternal mental health, home environment, and attitudes towards CP. Children in the intervention group (n = 153) had significantly higher scores than children in the control group (n = 151) on measures of cognition (p = .022), fine motor (p .0001), gross motor (p = .015), and language development (p = .013). No difference in secondary outcomes, including CP, was detected.Keywords:
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This longitudinal study investigated monthly motor development and physical activity (PA) of infants with and without Down syndrome. Gross and fine motor skills (Bayley Scales of Infant Development-III) and PA (accelerometer) were assessed in 35 infants at eight time points during infancy. A multivariate mixed model identified time points when motor scores diverged between the groups. In infants with Down syndrome, bivariate correlations between monthly PA and motor changes were calculated, and multivariate analysis of variance probed the influence of early PA on motor-skill timing. Results indicate that differences in gross and fine motor skills first emerge at 2 and 4 months, respectively. In infants with Down syndrome, gross motor and PA changes between 4 and 6 months were positively correlated. Infants more active than the mean at 2 or 3 months achieved several prone and sitting skills earlier. These results highlight the adaptability of early infancy and the importance of early intervention.
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Abstract Literature suggests that motor skills are associated with other areas of development or domains, such as language and math, especially at early ages. These results are mainly based on studies developed in medium‐to‐high sociocultural contexts. Thus, this study was conducted in a medium‐to‐low‐income area. The aim was to know the 4–5 years old children's motor development (both fine and gross motor skills), and its relation to language and mathematical development. A total of 219 Colombian Caribbean children (105 boys and 114 girls) aged 4 and 5 years participated in this study. Results revealed higher motor skills among girls, although differences by gender were not notable. Positive and significant correlations were found between motor skills and language and mathematical skills, although most of the correlations were weak or moderate. Also, it was observed that fine motor skills were less related to language or mathematical development in comparison with gross motor skills, especially among boys. These results suggest that among Colombian Caribbean children gross motor skills could have a higher influence on the development and acquisition of some language and mathematical skills in comparison with fine motor skills.
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In this study, we analyzed whether 6-month gross and fine motor skills were related to 12-month gross and fine motor skills and cognitive development, controlling for 6-month cognitive skills and neonatal status (extremely low gestational age ELGA ≤ 28 weeks vs. full-term FT ≥ 37 weeks). We also investigated, at 6 months, predictive indexes for motor and cognitive delay at 12-months. We assessed 40 infants (20 ELGA and 20 FT) at 6 and 12 months (corrected age for the ELGA infants). Six-month gross motor skills were related to 12-month gross motor, fine motor, and cognitive skills and predicted 12-month gross motor delay. Six-month cognitive skills explained an additional amount of variance of 12-month gross motor skills, whereas neonatal status explained an additional amount of variance of 12-month cognitive skills. Considering the intradomain and cross-domain cascading effects of early gross motor skills on later motor and cognitive development, these skills should be repeatedly assessed in ELGA infants in the first year of life for early identification of infants with delayed gross motor skills and implementation of customized interventions.
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Abstract Background Motor milestones in infancy are important developmental markers, not only for later motor skills but also for more widespread social, cognitive, and communication development. The aim of the current study was to investigate the relationships between fine and gross motor development in infants at 6 and 12 months of age and communication skills at 24 months of age. Methods The Ages & Stages Questionnaire (ASQ‐II) was used to measure gross motor, fine motor, and communication skills in a large population‐based sample of 1,555 infants, recruited from well‐baby clinics in five municipalities in South‐Eastern Norway. Of these, 557 children had valid values of gross and fine motor scores at 6 and 12 months and for communication score at 24 months. The relationships between motor skills at 6 and 12 months and communication skills at 24 months were analysed using a linear regression analysis. Results Gross motor skills at 6 months were positively associated with communication skills at 24 months (coefficients 0.09, p = 0.036) and fine motor skills at 12 months were positivel y associated with communication skills at 24 months (coefficient 0.23, p < 0.001). We did not find clear evidence for a relationship between gross motor skills at 12 months and communication skills at 24 months (coefficient 0.05, p = 0.126) or between fine motor skills at 6 months and communication skills at 24 months (coefficient 0.08, p = 0.098). Conclusion The present study supports previous research showing associations between early motor development and later communication development in infancy. Targeted intervention should be considered with at‐risk infants.
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A comprehensive evaluation of basic motor abilities is provided by the Test of Gross Motor Development-3 (TGMD-3), which assesses 13 basic motor skills. These skills are categorized into locomotor and ball skill subsets.An assessment of gross motor skills in diverse populations with the TGMD-3 is the goal of this study.From control and intervention groups, locomotor subset scores were collected. In addition to identifying developmental delays, the study highlights the TGMD-3's ability to detect deficits in motor skills. Depending on whether a skill meets the criteria, it is scored as either a 1 or a 0. A locomotor score of 46, a ball skill score of 54, and an overall gross motor score of 100 are the maximum scores.The control group's baseline scores increased from 34.3±0.9 to 37.3±0.7 by the sixth week (p = 0.03), while the intervention group's scores rose from 36.5±1.1 to 40.9±0.6 (p = 0.0007). Both groups also showed similar trends in gross motor coordination scores.Gross motor skill assessment is robust across different populations, making the TGMD-3 an effective tool for improving motor development and performance.
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The aim of the study was to determine the motor development of 2 to 6-year old children (53.74 months, sd 12.49) who were infected (Group 1, n = 17) with HIV and to compare their development with an affected (Group 2, n = 13) and unaffected group (Group 3, n = 12). The motor development of the group was determined by the Peabody Developmental Motor Scales (PDMS-2). Variance of analysis (ANOVA) revealed that the developmental level of the HIV-infected group varied between 45 and 51 months, compared to their mean chronological age of 57 months, and that they performed the poorest of the groups in all the variables regarding gross motor, fine motor and total motor ability. Their total motor ability differed significantly from that of the healthy group, while their gross motor skills showed larger deficits compared to their fine motor development. A forward discriminant analysis further indicated that loco-motor skills contributed most to the discrimination between the groups. It is concluded that the infected group exhibits serious motor deficiencies in contrast to healthy children of the same chronological age. These results highlight the necessity of motor intervention for HIV-infected children, focussing on gross motor skills to improve their motor development and quality of life. Keywords: HIV; AIDS; Children; Pediatrics; Development; Motor development; Intervention. South African Journal for Research in Sport, Physical Education and Recreation Vol. 30 (2) 2008: pp. 39-51
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To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time.This was a longitudinal study that included 30 infants assessed at 12 and 17 months of age with the Motor Scale of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). This scale allows the analysis of global motor performance, fine and gross motor performance, and the discrepancy between them. The Wilcoxon test and Spearman's correlation coefficient were used.Most of the participants showed global motor performance within the normal range, but below the reference mean at 12 and 17 months, with 30% classified as having "suspected delays" in at least one of the assessments. Gross motor development was poorer than fine motor development at 12 and at 17 months of age, with great discrepancy between these two subtests in the second assessment. A clear individual variability was observed in fine motor skills, with weak linear correlation between the first and the second assessment of this subtest. A lower individual variability was found in the gross motor skills and global motor performance with positive moderate correlation between assessments. Considering both performance measurements obtained at 12 and 17 months of age, four infants were identified as having a "possible delay in motor development".The study showed the need for closer attention to the motor development of children who attend day care centers during the first 17 months of life, with special attention to gross motor skills (which are considered an integral part of the child's overall development) and to children with suspected delays in two consecutive assessments.
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