Escala de Desenvolvimento Motor: adaptação para crianças com baixa visão dos 07 aos 10 anos de idade

Abstract

Low vision is an irreversible dysfunction in visual function, which can influence the health conditions of the child and require adjustments in the environment. The usage of instruments adapted to this population is essential so that professionals can evaluate and monitor their motor development. Thus, the current study intends to adapt the Motor Development Scale (MDS) for children with low vision from 7 to 10 years of age. For this, two studies were elaborated, the first one is an integrative review that had as objective to know, to understand and to analyze the studies that utilized the Motor Development Scale as instrument of motor evaluation. The databases Scielo, Pubmed, Lilacs, Science Direct, Web of Science, Scopus and Cochrane were used to identify the studies. Thirty three studies met the inclusion criteria. The evaluation of the methodological quality of cross-sectional studies was analyzed by the Loney Scale, clinical trials by the Physiotherapy Evidence Database (PEDro) and longitudinal studies by Newcastle Otawwa Scale (NOS). The prevalence was of cross-sectional studies that had as main outcome the analysis of the motor development of schoolchildren with ADHD, learning difficulties, overweight and obese children, premature babies, and Down syndrome. The studies presented clear criteria to measure the outcome with statistically consistent results, although the studies did not reach a minimum score (seven points) established by the evaluation scales. The second study aimed to adapt the MDS to children with low vision from 7 to 10 years of age. Twenty-two children with low vision were recruited from a sample obtained an of specialized institutions and schools that provide care for people with visual impairment. After the consent of those responsible, the children were evaluated with the application of MDS. For this, a pre-test was performed in three children with low vision, through the original application of the MDS scale, in order to identify which motor evidence could present difficulties of understanding and visualization when being executed. From the pre-test, some preliminary adaptations were made with the purpose of favoring the comprehension and the visual perception of the motor tests. The adaptations were sent to five specialists in the area (a psych pedagogue, three physiotherapists and a medical ophthalmologist), and after evaluation, and after evaluation, verified that they did not agree (≤80%) in the fine motor tests (6 and 10 years); in the global motor skills (7, 10 and 11 years); in the body schema (2 to 5 years and 6 to 11 years); in spatial organization (11 years) and in temporal organization (6 to 11 years in stage 2, symbolization of spatial designs and structures and in stage 3 in the symbolization of temporal structures). New adaptations were proposed and resubmitted to the same judges. After a new evaluation round, the scale was adapted withan agreement level ≥ 80% in all items evaluated by the scale. The adapted MDS was reapplied in the three children who presented better understanding and visualization for the tests. Subsequently, the scale was reapplied in 19 children with low vision by two evaluators and the results showed good reliability of the adapted instrument. The results were analyzed using inter-rater reliability tests and test-retest in motor ages and EDM motor quotients. The interrater (CCI≥1,000) and retest (CCI≥0,990) for motor age and excellent inter-rater reliability (CCI≥1,000) and retest test (CCI≥0,997) for motor quotient values were found to be very good. Conclusion: The integrative review identified that EDM has been widely used in Brazil, in cross-sectional studies, with prevalence in children aged from 6 to 11 years old in populations with typical and atypical motor development, emphasizing research on ADHD and difficulties learning in the school environment. The MDS was adapted for children with low vision from 7 to 10 years of age and presented good reliability.