Matricial support for community health agents on the auditory and language development milestones in early childhood

Silva, Lidiane Assis da; Silva, Vanessa de Lima

doi:10.1590/2317-1782/20232021135en

Lidiane Assis da Silva

collection

analysis and interpretation of data

writing

Programa de Residência Multiprofissional em Saúde da Família, Centro de Ciências da Saúde, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil.

https://orcid.org/0000-0002-7699-1731

Vanessa de Lima Silva

guiding

designing of the study

collecting

analyzing and interpreting data

writing

Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil.

https://orcid.org/0000-0002-1562-1761

Conflict of interest: nothing to declare.

Correspondence address: Lidiane Assis da Silva Centro de Ciências da Saúde, Universidade Federal de Pernambuco - UFPE Avenida Prof. Moraes Rego, Cidade Universitária, Recife (PE), Brasil, CEP: 50670-901. E-mail: lidiane_assis_@hotmail.com

Authors’ contributions

LAS participated in the collection, analysis and interpretation of data and writing of the article; VLS participated in guiding, designing the study, collecting, analyzing and interpreting data and writing the article.

Topic: “Hearing and language development milestones”
Learning goals:
Address hearing and language development milestones.
Address home visit procedures after identifying development milestones.
Material:
a) Card stock.
b) Labels.
c) Pens.
1^st moment: Sharing knowledge about hearing and language development milestones in early childhood
A group activity was initially carried out to, pasting labels on card stock. The CHAs were shown various paper labels with the hearing and language milestones. Then, they were asked to stick in the right place the ones related to hearing and the ones related to speech development.
2^nd moment: Discussing hearing and language development milestones in early childhood
The discussion was based on the CHAs’ previous knowledge. They sat in a circle, using the card stock of the 1^st moment to begin talking about each development milestone.
3^rd moment: Sharing about home visit procedures after identifying development milestones
This moment was based on examples of problem situations CHAs had experienced on their everyday home visits. According to the reports, they discussed the necessary procedure.
4^th moment: Closing group activity
Each participant defined the workshop in one word.

Variables	N	%
Sex
Males	0	0
Females	18	100%
Age range (in years)
Up to 40 years	0	0
41 to 50 years	16	88.9%
More than 60 years	2	11.1%
Educational attainment
Finished middle school	1	5.6%
Unfinished high school	1	5.6%
Finished high school	13	72.2%
Unfinished higher education	1	5.6%
Finished higher education	2	11.1%
Time working as CHA (in years)
6 to 8 years	2	11.1%
9 or more years	16	88.9%
TOTAL	18	100%

VARIABLES	KAP RESPONSE
	AFFIRMATIVE		NEGATIVE
	n	%	n	%
KNOWLEDGE
Infant hearing screening test	17	94.12%	1	5.88%
Infant tongue screening test	9	50%	9	50%
Hospitals perform infant hearing screening tests	18	100%	0	0%
Hospitals perform infant tongue screening test	14	71.43%	4	28.57
CHAs’ responsibilities include public health actions regarding hearing and language in their region and in the waiting room.	15	83.3%	3	16.7%
They know that children’s speech development may be related to their hearing health.	18	100%	0	0%
They know that children’s speech development may be related to the stimulation they receive.	18	100%	0	0%
ATTITUDES
Sought training regarding hearing and language development milestones in early childhood	8	44.4%	10	55.6%
Among those who sought it, where they acquired the information
Speech-language-hearing therapists in the NASF-AB team	10	55.6%	8	44.4%
Pamphlets, television, books, Internet	8	44.4%	10	55.6%
Feels trained to instruct about hearing and language development milestones in early childhood	6	33.3%	12	66.7%
Is interested in learning about hearing and language development milestones in early childhood	18	100%	0	0%
PRACTICES
Conducts actions to promote hearing health and language development in early childhood.	8	44.4%	10	55.6%
Uses hearing and language development milestones indicated in the personal child health record.	4	22.2%	14	77.8%
Instructs about risk factors for hearing health in early childhood.	13	72.2%	5	27.8%
Instructs about risk factors for language development in early childhood.	15	83.3%	3	16.7%
Verifies whether parents have any complaints regarding their children’s hearing or language during home visits.	16	88.9%	2	11.1%
Identifies when users need speech-language-hearing assistance.	18	100%	0	0%
When they suspect a child has communication difficulties, they discuss the signs they noticed with their team to refer them to the speech-language-hearing therapist at NASF-AB	18	100%	0	0%
Feels the need to learn about hearing and language development milestones.	18	100%	0	0%

Core ideas	Analysis categories before team cooperation	Analysis categories after team cooperation
Knowledge about early childhood	Children’s age	Following up on children from 0 to 5 years old.
	0 to 5 years old	Following up on children from pregnancy to 5 years old.
	0 to 10 years old
Actions aimed at early childhood in home visits	Instructions to families	Instruction to families
		Observing speech and hearing
		Listening to the parents, observing, instructing, and referring.
Instruction for the families of children in early childhood	Vaccination card	Vaccination card
	Neonatal care	Neonatal care
	Breastfeeding	Breastfeeding
	Diet	Diet
	Development milestones (crawling and babbling)	Development milestones indicated in the vaccination card
Knowledge of hearing development milestones	Nonexistent	Identifying sounds and locating sounds
Questions on hearing development in home visits	No questions were asked in home visits.	Asking the mother whether the child reacts when they hear a louder noise
	Do loud sounds or noise startle them?
	Questions focused on the child’s speech
Families’ questions about hearing development	No questions asked by the families.	Not applicable
Families’ questions about hearing development	They report more questions related to language (speech)	Not applicable
Knowledge of language development milestones	Nonexistent	The child says 1 or 2-syllable words.
	Nonexistent	The child says 2-word sentences ‘’mama water’’.
	Tongue-tie	Repeats 2-syllable words (mama, papa)
	Tongue-tie	Emits sounds, emits sounds and laughs aloud
Questions on language development in home visits	No questions were asked in home visits.	Is your child emitting sounds? What type of sounds? Can they say mama, papa? Do they say gaga?
	Questions asked according to the child’s age.	If they already speak, what do they say?
	Development milestone (babbling, saying mama, papa)	Have you examined your child to check if they can hear and speak well?
	Development milestone (babbling, saying mama, papa)	I ask: “Do they emit any sounds? Any noise? Do they call mommy or daddy?
Families’ questions about language development	Some families ask questions, others do not.	Not applicable
Families’ questions about language development	When parents perceive identify something, they ask questions	Not applicable
CHAs procedures when children do not reach development milestones	Referring the case to the nurse or physician.	Instruct the family and present the case to the team.
	Referring cases in NASF-AB + Family Health Team meetings	Present the case to the health team and then refer to NASF-AB
	Scheduling appointments with the physician	Present the case to my nurse or physician.
	Scheduling appointments with the physician	Instruct, refer and monitor
Did this team cooperation workshop contribute to your professional practice?	Not applicable	Further knowledge.
		More knowledge.
		It helped me learn.
		Confidence
		It enriched my knowledge

[1] Conflict of interest: nothing to declare.

Brasil

Brasil

Matricial support for community health agents on the auditory and language development milestones in early childhood

ABSTRACT

Purpose

Methods

Results

Conclusion