A research report submitted to the Faculty of Health Science, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science.
Johannesburg, 2017 / Background: The early childhood years, is an important period in a person’s formative life. These are the foundational years for development. There are many intrinsic and extrinsic factors that can negatively affect childhood development. Assessing the development of children is important. If a problem is detected, prompt intervention may prevent further impairments. The Platfontein community is a San bushmen community consisting of the !Xun and Khwe tribes. This is a very poor community that faces many challenges. Of these challenges, many have the potential to hinder healthy childhood development. The current level of development of healthy children in the Platfontein community is not known. This was a descriptive cross sectional study. A sample of convenience was used as all children that attended the crèches in the Platfontein community were invited to participate in the study. The objectives of the study were as follows 1) to determine whether the children that attend the crèches in the Platfontein community present with motor developmental delay 2) to determine the demographics (including morbidities) and anthropometric data of the study participants, 3) to determine the level of motor development in children between the ages of three and six years who attended the local crèches in the Platfontein community, 4) to establish the nature of the relationship between the existing morbidities and the motor development of the children attending the crèches in Platfontein and 5) to establish if there was a difference in motor development of children assessed between the two crèches, the two tribes, 6) to compare the motor development of the children attending the crèches in the Platfontein community to that of children in other national or international studies. Methods: The Movement Assessment Battery for Children-2 (M-ABC2®) was administered to determine the motor development of the children attending the !Xun and the Khwe crèches. Demographic and anthropometric data were also collected. Microsoft Office Excel 2007 and the SAS system statistical programme were used to analyse the data. The Fishers exact test was used to compare the morbidities between the two crèches as well as the association between the morbidities and the M-ABC2® percentile rank. The final M-ABC 2® categories were compared using the Chi-square test. A p-value of≤ 0.05 was deemed statistically significant.
Results: Demographic information was obtained for 64 participants, anthropometric data for 63 participants and 54 M-ABC-2® were successfully completed. In total 54% (n=29) participants did not have a risk for motor developmental delay, 24% (n=13) were at risk for motor developmental delay and 22% (n= 12) had a definite motor developmental delay. The test result of the manual dexterity subcategory was the task of most concern as 68.5% of the sample scored at or below the 5th percentile of the M-ABC2® manual dexterity components. Statistical analysis revealed no relationship between the following morbidities: malnutrition [p=0.19], stunting [p= 1.00] and a history of Tuberculosis (TB) [p=0.49] and motor development. There was no statistical significant difference between the M-ABC-2® scores of the children attending the Khwe and the !Xun crèches. Comparing these results too other South African studies, this sample scored much lower. Buys (2014) reported that 85% did not have a risk for developmental delay and that 15% were at risk for, or had a developmental delay. Gritzman (2012) reported that 80% did not have a risk for motor developmental delay and that 20% were at risk or impaired. The socio economic statuses of the samples in both studies were of a higher status than those of the Platfontein sample. Comparing the results to Brazilian studies, this sample also scored lower. Valentini et al (2012) reported that 64.2% of children in the study population did not have a risk for developmental delay and that 35, 8% were at risk for or had a developmental delay. Valentini, Clark and Whitall (2014) reported that 63.3% of children in the study population did not have a risk for developmental delay and that 36.7% were at risk for or had a developmental delay Conclusion: There is a motor developmental delay of the children attending the crèches in the Platfontein community as measured by the M-ABC-2® and when compared to national and international studies. An intervention programme is advised. / MT2017
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