Qualidade dos berçários e aspectos biopsicossociais e familiares no desenvolvimento neuropsicomotor de crianças em Belém

Abstract

This dissertation aimed to investigate the association between the quality of municipal public nurseries and biopsychosocial and family aspects on children's neuropsychomotor development in Belém. There were carried out three cross-sectional and descriptive studies. The first study investigated the twelve municipal public nurseries quality in Belém through the Infant/Toddler Environment Rating Scale, Revised Edition (ITERS-R), identifying nurseries with higher and lower quality averages and the main differences between them. The second study set the neuropsychomotor development profile of 54 children that belonged to the four nursery classes with higher and lower quality averages, through the Denver II Development Screening Test (DDST II), where it was analyzed the biopsychosocial and familial associated aspects. Finally, the third study tried to relate quality aspects of the ecological environment the Child Education Units to the children's development. The first study results indicated quality averages by scale ITERS-R between nursery classes ranging from 2.62 (inadequated) to 4.42 (minimally adequated) and with quality average per class group of 3.68. The subscales with lower quality averages between the classes were Personal Care Routines and Space and Furniture and Activities, considered as inadequated and minimally adequated, respectively. The subscale with the higher means was Structure of the program, evaluated as good quality. Items that obtained the lowest quality scores among the classes were Provisions for personal needs of the team with an mean of 1, in addition to Furniture for routines care and plays and Health practices, both with means of 1.25 each. Items that obtained the highest quality scores among the groups were Interaction and cooperation between the team with mean of 5.83 and Team stability with mean of 6. The second study results indicated that 62.96% of the children were classified by DDST II with suspicion of developmental delay, especially in the Language domain. Birth weight, prenatal accomplishment, childbirth complications, child primary caregiver, place of the child's home and also Child Education Unit locations were variables presented a statistically significant relation to DDST II outcomes. The third study results showed that the mean of indicators of nursery quality by the ITERS-R scale, as well as several items from six of the seven subscales contained therein, there were significantly associated with DDST II scores, especially in fine motor area. The three studies results reinforced the influence of both biopsychosocial and family characteristics, as well as the ecological factors that characterize the quality of Nursery schools, in the child developmentprocess. For this reason, it is necessary to encourage the complementarity of the care and education offered by the family and the public nurseries in order to obtain more adequate neuropsychomotor development scores in the early childhood years and in the following years.