The participation of preschool children with developmental disorders and undergoing physiotherapy treatment from the perspective of the International Classification of Functioning, Disability and Health

Abstract

Introduction: Participation is one of the components of functionality and is defined by the “individual’s involvement in daily life situations”. However, children with neuromotor development disorders have limitations in mobility activities due to functional deficiencies related to joint, muscle or motor control components, which cause restrictions on participation in the home or community environment. Objective: To evaluate the participation of children aged 0 to 3 years with developmental disorders in outpatient physiotherapy treatment. Methods: Longitudinal, analytical-descriptive and observational study of the participation characteristics of patients aged 0-3 years treated at the Neurofunctional Physiotherapy outpatient clinic in a referral hospital for maternal and child health care. The following instruments were used for data collection: a questionnaire on clinical characteristics and application of the following instruments: Alberta Infant Motor Scale (AIMS), Denver II Test, Child Engagement in Daily Life (CEDL), Affordances in the Home Environment for Motor Development (AHEMD), with 2 assessments being carried out with an interval of 3 months between assessments. Results: Fourteen children were evaluated, with a predominance of males (71.43% (n = 10) and a mean age of 11.59 months (± 8.5 m). All patients met the criteria for physical therapy intervention, although only 42.86% (n = 6) had delayed motor development, according to AIMS. Language domain was another with a high prevalence of alteration (50% (n = 7) of the sample). Regarding contextual factors, opportunities for stimulation in the home environment were observed as ‘adequate and/or excellent’ for the availability of gross motor toys (64.28% (n = 9) and fine motor toys (50% (n = 7), and most of the children belonged to the lower social classes (D or E). Regarding participation, the highest frequencies observed were family activities at home in 78.57% (n = 11) and in the community 85.71% (n = 12) and indoor games with adults 100% (n = 14). There was a low frequency of participation in organized classes 85.71% (n = 12) and entertainment outings 92.86% (n = 13). A trajectory of increasing participation in outdoor games with other children was found 78.57% (n = 11) and with adults 85.71% (n = 12) with statistical significance in these activities. Conclusion: Most of the children in the study had developmental changes and low participation in extra-community activities and with other children, showing an increase in participation with other children throughout the study. Thus, it highlights the importance of a more detailed assessment under the perspective of the International Classification of Functioning, Disability and Health, which can help health professionals to assess and plan family-centered interventions, in addition to expanding opportunities for participation in children with developmental changes at an early age, with appropriate guidance.