Poverty can affect babies’ motor development as early as six months of age. This is the conclusion of the first Brazilian study that investigated, month by month, the quantity and quality of motor development and its relationship with socioeconomic vulnerability in the first months of life.
Conducted by researchers from the Federal University of São Carlos (UFSCar), the work followed 88 babies from three to eight months, 50 of which were in a situation of socioeconomic vulnerability. The results were in the magazine Acta Psychologica.
“In addition to these babies reaching motor milestones [como agarrar objetos, virar e sentar] later than those not exposed to poverty, they showed less diversity of movements, always repeating the same strategy to pick up a toy, for example”, explains Carolina Fioroni Ribeiro da Silva, a FAPESP scholarship holder whose study was the subject of her doctorate.
For Eloisa Tudella, professor at UFSCar and research advisor, these subtle delays in infants exposed to poverty can have important impacts later on, in the preschool and school periods. “Although it was not the direct focus of the research, evidence indicates that mild motor delays in the first year of life may influence global development and be associated with behavioral problems at school age, including attention deficit hyperactivity disorder. [] and coordination disorders”, he states.
Good news
The study also showed that there is room for reversal since, after eight months, the delays were no longer significant. This possibility of improvement is attributed to the engagement of mothers, who began to reproduce the instructions given during visits at home (no father presented himself as responsible for receiving the researchers).
“The majority of mothers exposed to poverty were teenagers and did not know how to stimulate their babies after birth. During the visits, we taught simple practices, such as placing the child on their stomach, using crumpled paper as a toy or talking and singing to the baby. All the mothers were very receptive, copied the actions during the assessments and began to interact more with their children, promoting their motor development”, says Silva, currently a postdoctoral fellow at Heinrich Heine University, in Germany.
Known as “ tummy time ”, the short periods in which the baby lies face down on a mat, awake and supervised, are indicated to strengthen the head, neck, shoulders, back and arms, contributing to the preparation of the muscles and coordination necessary for the baby to be able to roll over, sit, crawl and stand.
“In many homes, babies spent more time confined in strollers, with little opportunity to explore the environment, strengthen their muscles and experiment with different ways of moving, as there was no space for that,” says Silva.
The work used the Infant Motor Profile (IMP) for the first time in Brazil, an instrument developed by researchers at the University of Groningen, in the Netherlands. Unlike scales that only assess whether the baby has reached a certain motor milestone, the IMP also analyzes the quality of movements – variation, fluidity, symmetry and performance. This allows neuromotor risks to be identified early, plan more precise interventions and monitor children’s progress over time.
According to Tudella, another advantage of the instrument is to reduce the need for more expensive and complex evaluations, such as MRI in babies, which generally require sedation.
Domestic chaos
Throughout the 334 assessments carried out in the study, the researchers identified male sex as a risk factor, as boys were 2.57 times more likely to present atypical motor development compared to girls. The researchers cannot explain exactly the reason for this difference. However, previous studies suggest that male babies would be biologically more susceptible to inflammatory processes, which, combined with poverty and low-stimulating environments, would increase the risk of motor delay.
The presence of many adults in the same household was another aspect that was associated with worse results, possibly because it creates a more chaotic environment with less safe space and opportunities for the baby to move.
Among the protective factors identified are the supply of toys that stimulate fine motor skills – even improvised and more economical ones – and the older age of mothers. In the study, the average maternal age was 24 years old, with a variation of seven years, with the majority of mothers exposed to poverty being teenagers. Those with better socioeconomic conditions were close to 38 years old.
Parents living in the same house and higher maternal education were also associated with better results.
Silva explains that the first two years of life are the period of greatest neuroplasticity for an individual, when they intensely “absorb” stimuli from the environment. “As it is not possible to immediately eliminate structural factors such as poverty or teenage pregnancy, home monitoring programs would be great palliatives”, says the researcher, who advocates the creation of programs with community health agents and physiotherapists, giving greater visibility to the needs of this population.