An investigation of the effect of implementation of evidence-based care package on the gross motor development of the foster care infants

Document Type : Original Quantitative and Qualitative Research Paper

Authors

1 Instructor of Nursing, Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 MS in Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 Phd candidate in Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: The first year of life is the most important period of an extra uterine brain development requires environmental stimulation for developmental capabilities expression. Mean while, due to the repeated environmental disparity, nursery children are at great risk of developmental delay.
Aim: To determine the effect of an evidence-based care package on infant gross motor development.
Methods: In this randomized clinical trial, conducted at Ali Asghar (AS) nursery of Mashhad, an evidence-based care package was utilized. Fifty babies with the age of 12-1 months eligible according to inclusion criterion were randomly divided into the intervention (25 infant) and control (25 infant) groups. Then, the care package was administered for children in the intervention group, three times a week for 8 consecutive weeks (24 sessions, each two hours). Gross motor developmental age of the children was assessed by the Denver-II, before the intervention, 6 and 8 weeks after the intervention.  The results were analyzed with SPSS 11.5 software using independent t-test, Mann-Whitney U and repeated measures ANOVA.
Results: The mean age of the sample was 20.64 ± 14.62 years and 32% of total were female and 68% male. The average of the gross motor age were 21.4±7.9 and 15.8±13.0 years in the intervention and control groups (P>0.05), respectively. After 6 weeks implementation of the care package, the difference of the mean of the gross motor age between the intervention (26.5±10.8) and control groups (21.4±11.4) was not statistically significant (P=0.115). Two weeks later (8th weeks), the difference of the mean of the gross motor age in the intervention group (29.4±10.5) and control group (22.9±10.3) was statistically significant (P=0.033). 
Conclusion: Six weeks intervention by this evidence-based care package is not effective on the infant's gross motor development. This effect was determined after 8 weeks of an intervention. This package can be used to improve gross motor skills in infants at risk of developmental delay such as infant sliving inorphanages.

Keywords

Main Subjects


1.   Rezaeian A. Ppediatric Nursing Textbook of Mashhad University. Mashad: Mashhad Medical University; 1390.(Persian)
2.   Nahar B, Hossain M, Hamadani J, Ahmad T, all a. Effects of Food Supplementation and Psychosocial Stimulation on Growth and Development of Severely Malnourished Children. 2012;66(6):701-9.
3.   Nagar S, Sharma S. Influence of Intervention on Temperament and Developmental Outcomes of Infants. J Hum Ecol. 2009;28(2):6.
4.   Weber TR, Reyes HM, Karrer FM. Long-term Results with the Kasai Operation for Biliary Atresia - Discussion. Arch Surg-Chicago. 1996 May;131(5):496-. PubMed PMID: WOS:A1996UK35400010. English.
5.   Kimura-Ohba S, Sawada A, Shiotani Y, Matsuzawa S, Awaya T, Ikeda H, et al. Variations in Early Gross Motor Milestones and in the Age of Walking in Japanese Children. Pediatr Int. 2011 Dec;53(6):950-5. PubMed PMID: 21752149.
6.   American Academy of Pediatrics. Committee on Early Childhood and Adoption and Dependent Care. Developmental Issues for Young Children in Foster Care. Pediatrics. 2000 Nov;106(5):1145-50. PubMed PMID: 11061791. Epub 2000/11/04. eng.
7.   Bruskas D. Children in Foster Care: A Vulnerable Population  at Risk. J Child Adolesc Psychiatr Nurs.7-70:(2)21;2008.
8.   Farsi A, Abdoli B, Kaviani M, Kaviani A. Influence of Perceptual Experience - Gross and Fine Motor Movements and Motor Development of Infants 5-8 months of Use. Motor Learning and Movement – Sports. 1389;5:71-84. (Persian)
9    Rasoli M, Lankarani NB, Rahgoy A. The Effect of Play Therapy on Children's Social Development (4-6 years) With Delayed Social Development in Nursery Ameneh. Institute for Humanities and Culture. 1376:205-12.
10. Mustard J. Experience-based brain development: Scientific Underpinnings of the Importance of Early Child Development in a Global World. Paediatr Child Health. 2006 Nov;11(9):571-2. PubMed PMID: 19030325. Pubmed Central PMCID: 2528649.
11. Grossman AW, Churchill JD, McKinney BC, Kodish IM, Otte SL, Greenough WT. Experience Effects on Brain Development: Possible Contributions to Psychopathology. J Child Psychol Psychiatry. 2003 Jan;44(1):33-63. PubMed PMID: 12553412.
12. Bengoetxea H, Ortuzar N, Bulnes S, Rico-Barrio I, Lafuente JV, Argandona EG. Enriched and Deprived Sensory Experience Induces Structural Changes and Rewires Connectivity During the Postnatal Development of the Brain. Neural Plast. 2012;2012:305693. PubMed PMID: 22848849. Pubmed Central PMCID: 3400395.
13. Dawson G, Ashman SB, Carver LJ. The Role of Early Experience in Shaping Behavioral and Brain Development and Its Implications for Social Policy. Dev Psychopathol. 2000 Autumn;12(4):695-712. PubMed PMID: 11202040.
14. Whittle S, Dennison M, Vijayakumar N, Simmons JG, Yucel M, Lubman DI, et al. Childhood Maltreatment and Psychopathology Affect Brain Development During Adolescence. J Am Acad Child Adolesc Psychiatry. 2013 Sep;52(9):940-52 e1. PubMed PMID: 23972696.
15. Dareh F, Bayat GF. A Developmental Status of Children 4-60 Month With a History of Hospitalization in the Neonatal Intensive Care Based on the Questionnaire ASQ in Amir kabir  Hospital. Ardabil university of Medical Sciences. 1390;11(2):143-50. (Persian)
16. Dalvandmsoddini H, Dehghan L, Sh AR, Joghataei MT, Sazmand AH, Feizi A. Standardized of Peabody Developmental Scale (PDMS) in First Grade Elementary School Children in Tehran. Rafsanjan university of Medical Sciences. 1387;7(2):137-44. (Persian)
17. Eickmann SH, Lima ACV, Guerra MQ, Lima MC, Lira PIC, Huttly SRA, et al. Improved Cognitive and Motor Development in a Community-Based Intervention of Psychosocial Stimulation in Northeast Brazil. Dev Med Child Neurol. 2003 Aug;45(8):536-41. PubMed PMID: WOS: 000184341700005. English.
18. Abbott AL, Bartlett DJ. Infant Motor Development and Equipment Use in the Home. Child Care Hlth Dev. 2001 May;27(3):295-306. PubMed PMID: WOS:000168692400007. English.
19. van Batenburg-Eddes T, de Groot L, Huizink AC, Steegers EA, Hofman A, Jaddoe VW, et al. Maternal Symptoms of Anxiety During Pregnancy Affect Infant Neuromotor Development: the Generation R study. Dev Neuropsychol. 2009;34(4):476-93. PubMed PMID: 20183712.
20. Kosarian M, Vahidshahi K, Shafaat A, Abaskhanian A, Azizi S, Shahrokh S, et al. Screening for developmental disorders in children sari child care in 1385. Mazandaran university of Medical Sciences. 1386;59(17):69-75. (Persian)
21. Shahshahani S, Vameghi R, Azari N, Sagedi F, Kazemnezhad A. A Reliability and Validity of Two of Denverscreening Test Forscreening of Growth and Development Disorders in Children Zero to Six Years in Tehran's. Quarterly Monitoring. 1390;10(4):469-75. (Persian)
22. Rezaeian A, Niknejad A, Ashrafzadeh F. An Evidence Based Care Package to Improve Motor Skills of Infants Living in Foster Care According to Integrative Review Approach. Evidence based care nursing. 2013;3(6):15. (Persian)
23. Perra O, Gattis M. Attention engagement in early infancy. Infant Behavior & Development 2012;35:635-44.
24. Karimi H, Nazi S, Sajedi F, Fahimi NA, Karimloo M. Comparison the Effect of Simultaneous Sensory Stimulation and Current Occuptional Therapy Approaches on Motor Development  of the Infants  with Down Syndrom.Iranian Journal of children neurlology 2010;4(3):6. (Persian)
25. Lekskulchai R, Cole J. Effect of a Developmental Program on Motor Performance in Infants Born Preterm. Aust J Physiother. 2001;47(3):169-76. PubMed PMID: WOS:000171169400010. English.
26. Monson RM, Deitz J, Kartin D. The Relationship Between Awake Positioning and Motor Performance Among Infants Who Slept Supine. Pediatr Phys Ther. 2003.
27. Ratliff-Schaub K, Hunt CE, Crowell D, Golub H, Smok-Pearsall S, Palmer P, et al. Relationship Between Infant Sleep Position and Motor Development in Preterm Infants. J Dev Behav Pediatr. 2001;22(5):7.
28. Trainor LJ, Zacharias CA. Infants Preffer Higher-Pitched Sining.Infant Behav Dev. 1998;21(4):7.
29. Chopra G, Sharma S, Nagar S. The Impact of Intervention on Motor and Mental Development of Rural Female Infants in District Kangra of Himachal Pradesh. J Hum Ecol. 2004;15(3):5.
30. Leppo ML, Davis D, Crim B. The Basics of Exercising the Mind and Body. Child Educ. 2000;76(36)
31. Latifi S, khalilpour A, Rabiee L, Amani N. The Barriers to Research Findings  Utilization Among.Clinical Nurses. Mazand Univ Med Sci. 2012;22(87):88-95. (Persian)
32. Livshits G, Cohen Z, Otremski I. Relationship between Physical Growth and Motor Development in Infancy and Early-Childhood - Multivariate-Analysis. Am J Hum Biol. 1993;5(4):481-9. PubMed PMID: WOS:A1993LT19300011. English.
33. Valvano J, Rapport MJ. Activity-Focused Motor Interventions For Infants and Young Children with Neurological Conditions. Infant Young Child. 2006 Oct-Dec;19(4):292-307. PubMed PMID: WOS:000240759700003. English.
34. Thakur A, Sharma S, Rani R. Assessment of Mental and Motor Development of Infants in Hamirpur District of Himachal Pradesh. Anthropologist,. 2004;6(2):4.