Characterization of the neuropsychomotor development of children up to three years old: the ICF model in the context of the Family Health Support Center¹

Abstract:

Introduction:  The neuropsychomotor development (NPMD) is dynamic and complex, explained by the contextual model, which can be discussed with an expanded view of health through the International Classification of Functioning, Disability, and Health (ICF).

Objective:  To characterize the NPMD of children up to 3 years old participating in the “Children’s Milk Program” (CMP) from the ICF model in the context of the Family Health Support Center (FHSC) and to relate to individual, family, socioeconomic aspects and stimulation of the child in different environments.

Method:  In this study, 19 volunteer children, 10 (52.63%) boys and 9 girls (47.37%), aged 7-35 months old (19.42 ± 9.11), duly authorized by the person responsible participated in the study, evaluated through a semi-structured interview, and ABEP socioeconomic questionnaire, Denver Developmental Screening Test and Affordances in the Home Environment for Motor Development test. The instruments were related to ICF components for Children and Young People. The study was performed at the FHCS of a metropolitan city of Curitiba/PR, Brazil. Statistical analysis was performed using the Spearman’s rô (rs) for non-parametric correlation, Mann-Whitney in quantitative comparison and Fisher’s Exact Test in categorical data for occurrence probability.

Results:  Regarding the Denver II test, 9 (47.37%) children had questionable NPDM, and the language area was the most compromised (88.88%), 7 families (36.84% were classified in C1 by ABEP and 6 children (54.5%) up to 18 months old received adequate stimulation in the home environment and all the kids (n=8) over 19 months old, presented reasonable stimulation. The model proposed in this study responded to contextual approach of the ICF.

Conclusion:  It is necessary to use appropriate instruments to plan actions in basic care so children at risk to NPMD can be included in programs of early intervention, to enable the FHCS as a space for monitoring and promoting the NPMD. The ICF has proved to be an adequate and valid classification instrument for this context.

Keywords: International Classification of Functioning; Disability; and Health; Public Health; Child; Family Health; Primary Health Care