Avaliação do desenvolvimento motor grosso em crianças de 0 a 18 meses de idade: criação de curvas de percentil para a população brasileira

Abstract

Professionals in the field of children´s rehabilitation in Brazil have shown a growing interest in objective documentation of the neurodevelopment in infants. However, most standardized instruments for assessing children's performance was developed in North America, Canada and Europe. Problems related to the use of imported normative tests range from inaccurate translations to inadequate socio-culturalethnic validity. To contribute to the provision of adequate resources for child assessment, the general objective of this dissertation was to describe the gross motor performance of infants from the metropolitan region of Belo Horizonte / MG, from birth to the acquisition of independent walk, in order to examine the adequacy of the standardized norms of the Alberta Infant Motor Scale for Brazilian infants. In this regard, the specific objectives were: 1) characterize the gross motor performance of Brazilian infants ages between zero and 18 months old, 2) compare the gross motor performance of Brazilian children with the normative data from the Canadian standardization sample, 3) investigate the relationship between gross motor development and social conditions, represented by the human development index (HDI) and socioeconomic classification (ABEP). To achieve these goals, 660 infants were evaluated with the AIMS, in a sample comprised by 330 females and 330 males, stratified by age groups from zero to 18 eighteen months, in proportions similar to the original Canadian group, and distributed in three blocks according to the Human Development Index (HDI) of the metropolitan region of Belo Horizonte- MG. For each age group, zero to 18 months, we calculated the average total AIMS scores and standard deviation. The data for each age were compared to the Canadian standard data by means of Student's t-test. Brazilian infants showed lower scores in the age groups 1 <2 months (p = 0.021), 4 <5 months (p = 0.000), 5 <6 months (p = 0.001) and 10 <11 months (p = 0.009) and highest score at the age 0 <1 month (p = 0.045). Comparison of percentile curves (5th, 10th, 25th, 50th, 75th and 90th), investigated with binomial test, indicated statistically significant differences scattered over all the percentile curves. The greatest number of age differences were observed in the 75th percentile curve but significant differences were also found in the 5th percentile at 9 <10 and 10 <11 months of age; 10th at 4 <5, 9 <1010 <11 months; 25th at 4 <5, 5 <6, 11 <12 months; 50th at 4 <5, 5 <6 months and 90 to 10 <11 11 <0:13 <14 months. There were no statistically significant differences between female and male groups (except at age 12 <13, where girls had a higher score) between the three groups of HDI (except at 13 months <14, where the group presenting medium HDI scored higher than the high HDI group) and among the five levels of socioeconomic classification ABEP. In conclusion, the differences in the 5th and 10th percentile curves lead us to recommend the use of the percentile curves presented in the current study for both uses of AIMS, in clinical practice and in scientific research, with Brazilian infants.