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Poster #167 - Play prescriptions: intervention delivered at health centers to promote child development through play in Mexico

Sat, March 23, 12:45 to 2:00pm, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Background and Objectives:
Early child development is a change process in which the child learns ever more complex levels of movement, thinking and relationships with others, and it’s produced when the child interacts with its biophysical and social environment. Low and middle-income countries' children have an increased risk of achieving a suboptimal development. Sub-stimulation and socio-emotional deprivation are high risk factors that affect negatively the neurodevelopment of children in our country and correlates with poor parental cognition.
Although there are many institutional programs for the attention of developmental disorders, they are usually based institutionally and rarely include home based, family supported management. The present study's objective was to develop and validate a didactic toolkit to be utilized by the primary caregivers of children in their households to further promote child development.
Participants and setting:
We conducted a prospective and longitudinal study based in Puebla de Zaragoza, Mexico, including children between 2 and 4 years of age that presented to primary healthcare facilities from 8 of the 10 sanitary jurisdictions. The final sample contemplated 302 children (2 years 10.3%, 3 years 49.7%, 4 years 38%), 56% came from rural towns (populations under 2,500 people) and 46.7% from high or very high marginalization zones.
Materials and methods:
All children included were examined upon entering the study and six months later both by the child development evaluation (CDE, a qualitative screening test designed and validated on Mexico which gives a green, yellow or red semaphore result) and the Battelle infant development inventory 2nd edition (BIDI). Half of the children were assigned to the control group which received usual counseling and neurodevelopment management based on healthcare centers, the rest were assigned to the study group which additionally received six counseling sessions and given 8 pieces of didactic materials and complementary handouts detailing activities to be done with their primary caregivers.
The initial category assigned to each child and the category received after six months were recorded and the results compared. It was noted that more children from the study group than the control group improved their original category in the CDE. In the first BIDI evaluation 31.5% of children were found to have total development quotients (TDQ) below 80 while only 1.6% had a TDQ above 110 while in the final evaluation 10.2% had a TDQ of 110 or more and only 21.2% had a lower than 80 TDQ. This showed that the intervention improved significantly the development of children and also favored a rise in the proportion of children who had better than average development.
Conclusion:
Intervening in child development through didactic material and home activities plus usual development management have a better impact in children of poor resource environments than healthcare centers based management only.

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