Neurodesenvolvimento, linguagem e funcionalidade nos primeiros anos de vida: um estudo exploratório

Abstract

Language development is a multidimensional process that occurs quickly and easily in the first years of life – although it can be affected by the interaction between genetic, biological, and environmental characteristics. Thus, the complexity of language development requires an expanded and holistic view. This research aimed to analyze the language development of children aged 1 year to 3 years, 11 months, and 29 days followed up in primary healthcare and its association with sociodemographic, clinical, and assistance aspects, neuropsychomotor development, and functioning. Hence, a scoping review was conducted on language monitoring in primary healthcare, followed by a cross-sectional, observational, analytical study with a sample of 66 children. The following instruments were used: a sample characterization survey, the development milestones form of the Survey of Wellbeing of Young Children, the Brazilian Economic Classification Criteria, the Language Development Assessment, and the International Classification of Functioning, Disability, and Health. Descriptive analysis was performed with frequency distribution of categorical variables and measures of central tendency and dispersion of continuous variables. Association analyses were performed with the Mann-Whitney, Kruskal-Wallis, Shapiro-Wilk, and Kolmogorov-Smirnov tests. Correlation analysis was performed with Spearman's correlation coefficient. Four multiple logistic regression models were constructed, which included variables whose association values were p<0.20, using the backward selection method. Categorical variables were transformed into dummy variables to adapt the models. The review verified that language development is not yet regularly monitored in primary healthcare’s health surveillance, despite the increasingly documented growth in the prevalence of delays. The empirical investigation found that language development was associated with clinical, assistance, and functional aspects. Language was strongly positively correlated with age. The multivariate analysis showed a mean 0.861 increase per year in the comprehensive language score, while those whose development was “as expected” had a 6.183 increase. Model 2 showed a mean 0.739 increase per year in the comprehensive language score, while those classified as having “no difficulty” doing a single task – performance had a 0.530 increase. Model 3 found a mean 0.399 increase per year in the expressive language score, while those whose development was “as expected” had a 5.745 increase. Model 4 found a mean 0.587 increase per year in the expressive language score but a mean 1.027 decrease in the score of those classified as having “no difficulty” in speaking – competence. It is concluded that age strongly influenced language scores and that the results point to a relationship between language development and the acquisition of developmental milestones and cognitive functions.