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Relationship between family poverty and child development

Childhood development represents a sequence of changes in behavior and underlying processes, influenced by biological and environmental factors.

Screening and monitoring of neurodevelopment show effective procedures for early identification of different disorders of childhood development. This was a cross-sectional and exploratory descriptive study. A questionnaire was administered to parents to collect the personal, contextual and family data and an instrument to measure the level of family poverty. Of the 319 children assessed, 77.

It is hoped that this study will contribute to generate an impact in improving the ecological conditions of children and their families, reducing the risks to which they are exposed. The findings suggest that the delay in neuropsychomotor development NPMD occurs with greater frequency and severity when children live in extreme poverty and for a longer period of life 4.

The first experiences of children exposed to the deleterious effects of poverty can affect the overall health, not only in childhood but also in adulthood 5.

Thus, growing up in impoverished environments can trigger serious implications in the different dimensions of development 367such as in cognition, motor skills, social interaction and language.

A possible explanation for this is that the poorer the child is, the fewer opportunities there are to satisfy the basic childhood necessities. Thus, the study of poverty and its implications for human development is a complex task. There are contradictions in the very concept of this term, as well as in the different methods for its measurement 2313. For a long time poverty was considered to be a condition defined by income below a pre-established level 2.

This variable continues to be a widely used indicator. However, in recent years, poverty has been seen as a multidimensional phenomenon, with a more dynamic and structural concept 6.

Thus, poverty involves not only economic aspects, but also other dimensions, such as political, social, cultural, quality of relationship between family poverty and child development and well-being 13. As a result, poverty must be analyzed from the reality of each country, considering its historical, cultural and contextual characteristics 413. In Brazil, the disparate socioeconomic inequality present in the society causes the levels of poverty and the number of children developing in this critical condition to vary according to regions.

The North and Northeast of Brazil, for example, stand out as having the highest incidence of poverty and a higher rate of children aged under six years living in this situation 1415. According to the IPEA report 15Brazil achieved the extreme poverty reduction targets, mainly with the aid of income distribution programs. However, the Amazon region follows this trend slowly and is below the national average 16.

These aspects are associated with the high rates of poverty and socioeconomic conditions of the inhabitants 17.

Another aspect highlighted in the current literature on poverty measurement is that many researches consider poor people to be grouped in a broad socioeconomic category, not taking into account the different levels of relationship between family poverty and child development and the potential concentration of risk factors associated with each of them 6818.

In addition, it is assumed that urban poverty in particular affects the ecology of the development of the child, including its extrafamilial dimension kindergartens, schools, neighborhoodand therefore its measurement has been relationship between family poverty and child development concern for researchers from different areas 71920.

In ecological terms, urban poverty assumes the contours of the context in which the phenomenon is manifested 21assuming significant variations from one neighborhood or area to another. Therefore, to measure it and verify its various levels of manifestation can help comprehend the degree of effect that this phenomenon has on childhood development in a particular city or district.

The importance should be highlighted of evaluating NPMD and verifying how much it is associated with descriptive variables of the poverty level of a given population, in a specific context 89101112131415161718.

From this perspective, Sigolo and Aiello 22 emphasize the importance of using instruments that can evaluate NPMD and identify suspected delays in populations, especially when considering the significant number of children in early childhood exposed to risk factors for development 23. In addition to encompassing the broader aspects of neurodevelopment, Bricker, Squires and Clifford 24 reported that evaluative tools must have an appropriate relationship between brevity rapid application and precision satisfactory psychometric properties as a characteristic.

It should be noted that the Denver II is a screening test and is not presented as a definitive predictor instrument for adaptive or intellectual abilities, therefore, evaluators should take care not to use it to create labels or diagnoses.

To be valid, the test should be applied in a standardized manner and with the exact materials 25. It is considered that the Denver II is designed to reflect the development from a vast expanse of heterogeneous skills. Thus, the application allows the identification, from the performance of children in the tasks, of whether they act according to their age or not.

Accordingly, the need to study the effects of poverty on neurodevelopment from an ecological dimension can be perceived, especially with epidemiological studies or large samples and using methods of evaluation through tests or scales, such as the Denver Developmental Screening Test II.

Methods The study included 319 children of both genders, with 55. For the sample size calculation, the sampling by conglomerate process was used. The ECEUs involved in the study were distributed according to the total number in each district, and according to the number of children in the age group studied. Thus, the study included 19 ECEUs that were selected from a universe of 35, distributed throughout the city.

To evaluate the neuropsychomotor development the Denver II 26 was used, which covers the ages of zero to six. The test protocol consists of 125 tasks, divided into four areas: The test administration was carried out based on the observation of the examiner regarding the child, although some items could be scored from the statements of the parents or caregivers. Regarding the interpretation of the test, the individual items were analyzed first and the entire test analyzed last.

The individual items are interpreted as "passed", "failed", "no opportunity" and "refusal". The final interpretation of the test presents the indicators: The child whose score is interpreted as questionable, abnormal or not testable in the first test should be reassessed before resorting to other diagnostic evaluations 26.

According to the test, there can be three outcomes: However, in this study the group with suspected developmental delays including children with questionable and abnormal was considered, to facilitate the achievement of inferential statistical analysis and comparison with studies present in the national and international literature.

The household poverty level was measured by means of an instrument designed for poor urban populations 27translated and adapted in Brazil by Issler and Giugliani 8.

This instrument allows the analysis of a range of elements that are descriptors of the socioeconomic conditions of poor urban populations. It aims to generate a measure capable of measuring the variability of poverty, which is not limited to the consideration of the family income.

Linking Poverty and Children’s Development: Concepts, Models, and Debates

It consists of 13 items that involve in their composition variables that are recognized in the literature as factors that influence childhood development: Number of people that eat and sleep in the house; 2. Education of the parents the highest is considered when there is a difference ; 4.

Work of the parents; 5. Relationship with the home; 6. Type of house; 7.

Number of people sleeping in the house versus sleeping places; 8. Disposal of excreta; 10. The score for each item is given on a scale of zero to four, with the minimum points possible being seven and maximum 52.

The sum obtained in each of these items gives the level of urban poverty of the family. For statistical purposes, the division into quartiles of the study population is recommended, according to the score obtained in the classification of their level of poverty. Initially, authorization was requested for the study from the Municipal Education Department.

In addition authorization was requested from those responsible through an Informed Consent IC form. Next a pilot project was performed with five applications of each instrument. This allowed the reproduction of the conditions of the study and training of the research team, which was composed of three Master's students of the Graduate Program in Behavioral Theory and Research PPGTPCand seven undergraduate students. When this step was completed, the period of the actual data collection began.

From the nature of the variables inferential and descriptive statistical analyses were carried out. The dependent variable was the score of development obtained through the Denver II, considered here as a dichotomous outcome variable normal or suspected delay. The independent variables were derived from the other instruments.

To present the data obtained through the Denver II by AD, a map was designed that could represent the neuropsychomotor profile relationship between family poverty and child development children evaluated by means of an image.

This methodological decision follows a current trend among researchers from different areas of knowledge, particularly in public health.

  • As an epidemiological research instrument, the Denver II proved to be suitable for the early detection of any deviation in the development and insightful for longitudinal monitoring of the child, having its practicality of application as an advantage;
  • With regard to the scores obtained through the Denver II by AD, it was found that the district that presented the highest percentage of suspected delay was the DABEL district and the lower percentage was the DABEN district, contrary to that indicated in the literature 8 , 9 , 31 , 33;
  • Regarding the Administrative Districts, it was established that all were shown to be related to each other, in ecological terms, that is, there were no statistically significant differences between the poverty level of the family and the AD.

In this way, its evolution and gradations can be represented through geoprocessing of complex social processes data. This means generating geographic information systems capable of contributing to the production of maps, using specific tools. These are produced from the data collection, analysis, interpretation and representation of the information, being supported by the assumptions of cartography, and processed with resources now available through the computer 28.

With regard to the domains of development, the application of the Denver II revealed that the majority of the children were in the normal category in three of the four domains of development evaluated. The area of language was the only one with a significant number of suspected delays 59. Regarding the socio-economic and environmental data, the study population belonged to households with monthly incomes of one to three minimum wages 65.

  • Cumulative risk and child development;
  • This methodological decision follows a current trend among researchers from different areas of knowledge, particularly in public health;
  • In Brazil, the disparate socioeconomic inequality present in the society causes the levels of poverty and the number of children developing in this critical condition to vary according to regions;
  • When this step was completed, the period of the actual data collection began.

In addition, over half of them received some social benefits 57. Most families lived in their own 49. Regarding the characteristics of the parents, the majority of the mothers were within the 20 to 29 years age group 62. Among the fathers, men aged 30 years or more 47. A marked relationship between family poverty and child development of parents with low education was found, characterized by non-completion of elementary education, with some being illiterate.

Figure 1 shows the distribution of the poverty level score of the study population. In it the 25th percentile first quartile - Q1 and the 50th percentile second quartile - Q245 are marked.

The minimum score was 28 points and maximum 52 points. By Administrative District In the analysis of family poverty level by administrative district of the city, the results show that the percentages of the poorest families participating in this study were higher in the DABEL and DABEN districts 42. Table 1 shows the data representation. The results show that although there is no statistically significant difference between the variables, the children from the poorer families tended to have a higher risk of potential delay in NPMD.

The other districts also presented high percentages, as shown in Table 2. The different colors indicate the percentages of children whose NPMD was classified as suspected delay, with the color intensity being directly proportional to the percentage of children with this outcome. The stratification of the population by level of poverty showed that children from the poorest families may be at higher risk of having their psychomotor development threatened, i.

These data lead to a strong explanatory hypothesis that the situation of poverty presented by a portion of the families may have contributed to the children obtaining the result classified as suspected delay, especially in the language area. The results of this study are consistent with previous research using the Denver II 91112293031.

These studies show an association between predictors of poverty or socioeconomic status of the family and the acquisition of neurodevelopmental milestones, especially language. In addition, they highlight the influence of social and environmental aspects related to the fundamental stimuli for linguistic patterns to improve, as well as the interaction of the caregivers with the child.

The poverty level of the family can cause or worsen serious health problems, including those related to NPMD delays, due to less stimulation and increased exposure to risk factors 4. Regarding the Administrative Districts, it was established that all were shown to be related to each other, in ecological terms, that is, there were no statistically significant differences between the poverty level of the family and the AD. In other words, the city does not have defined areas that can be classified exclusively as affluent or impoverished, with it being possible to observe that families from different social classes live close together.

Thus, the ecological context in which children are inserted is characterized by lack of resources and by chronic and troubling social indicators, which does not always include the basic necessities for healthy development in early childhood.