|Year : 2020 | Volume
| Issue : 1 | Page : 41-46
Relationship between home environment and psychomotor development in Urban and Rural children: A cross-sectional study
Shruti Ramchandra Murthy1, Snehal Dharmayat2
1 Department of Pediatric Physiotherapy, KAHER, Belagavi, Karnataka, India
2 Department of Community Physiotherapy and Rehabilitation, KAHER, Belagavi, Karnataka, India
|Date of Submission||20-Jun-2019|
|Date of Decision||18-Feb-2020|
|Date of Acceptance||20-Feb-2020|
|Date of Web Publication||03-Jul-2020|
Dr. Shruti Ramchandra Murthy
Department of Pediatric Physiotherapy, KAHER, Belagavi, Karnataka
Source of Support: None, Conflict of Interest: None
Background and Purpose: Development of children has shown to be influenced by various factors, one of them being the environment. There are diverse cultural practices across different settlements that play a role in conditioning the child's pattern of development. A home serves to be the primary environment in which every child grows in, which influences development. This study intends to determine the relationship between home environment and psychomotor development in children and to compare the psychomotor development in children of urban and rural areas.
Materials and Methods: A door-to-door survey was conducted for the recruitment of participants from urban and rural areas as per inclusion criteria. Two hundred children were evaluated, 100 each from urban and rural areas. Home environment assessment made using Affordances in the Home Environment for Motor Development (AHEMD) scale versions as per the age of the child. The developmental assessment was done using the Developmental Assessment Scales for Indian Infants (DASII).
Results: A significant positive correlation was found between AHEMD and motor quotient (MoQ) (r = 0.2892) and mental quotient (MeQ) (r = 0.3940) on DASII. There was a significant difference in the AHEMD scores of urban and rural participants (P = 0.0038). The MoQ was between urban and rural participants which was statistically significant. A significant difference (P = 0.0006) was found in MeQ scores between urban and rural participants.
Conclusion: The present study concludes that there is a positive correlation between the environment at home and psychomotor development in children. The urban children had better mental and motor development scores than the rural children, although both the urban and rural children showed average development.
Keywords: Home environment, Psychomotor development, Rural, Urban
|How to cite this article:|
Murthy SR, Dharmayat S. Relationship between home environment and psychomotor development in Urban and Rural children: A cross-sectional study. Indian J Phys Ther Res 2020;2:41-6
|How to cite this URL:|
Murthy SR, Dharmayat S. Relationship between home environment and psychomotor development in Urban and Rural children: A cross-sectional study. Indian J Phys Ther Res [serial online] 2020 [cited 2020 Aug 3];2:41-6. Available from: http://www.ijptr.org/text.asp?2020/2/1/41/288864
| Introduction|| |
India is a developing country with a majority of its population residing in rural areas. A wide variety of cultural systems and beliefs exist between urban and rural areas. While the rural areas still practice the old and traditional ways of living, the urban areas are much more modern and have adapted technology-based practices. This leads to a wide diversity in the process of development of children living in these diverse cultural areas.
Development is defined as the growth of intellectual, perceptual, emotional, and behavioral capabilities and functioning during childhood which is an interplay between genetic and environmental factors. The early years of a child are crucial for their development in all domains such as motor, social, emotional, language and communication and cognition. According to the Vygotsky's Theory of Social Development, the environment and the experiences that the child encounters within it play a very important role in building the foundation for their subsequent learning.
Studies conducted across India estimate that 8%–10% of children have some delay in one or more domains of development. The prevalence of developmental delay in the world ranges from 3.5% to 10% of the general population. In a developing country such as India, there are various contextual factors that hinder the optimal development of a child. The cultural factors also play an important role in interaction between the environment and the child. These children are exposed to several risk factors such as impoverishment, poor health, undernourishment, and unstimulating home environments that deleteriously affect their motor, cognitive, emotional, and social development.
Among factors comprising the surroundings, home is the first environment that each child grows in, which serves as a base for his or her womb-to-tomb behaviors, particularly throughout early age. Research has found that crowding environments are linked to delay in psychomotor development as it disrupts parent–child interactions and allows less engagement in play with objects. Literature suggests that possession of materials stimulating play could prognosticate mental behavior and such stimulating learning materials are seldom accessible in markets of rural areas in India, China, and Thailand. Psychomotor development varies with the change in environment and across various settlements. Studies have shown that children living in rural areas have poor psychomotor development than their urban counterparts.
The Affordances in the Home Environment for Motor Development (AHEMD)-Infant Scale comprises five components along with a section on family and child characteristics. Scoring is done as per the standard recommended procedure. The AHEMD-self report also assesses the home environment primarily based on similar three dimensions, with total scores ranging from 5 to 20.,
Developmental assessment is necessary to measure the severity of a functional deficit and helps us to plan necessary interventions for the same. Early detection will help us to begin with interventions that can incorporate home programs with regard to the home environment and the availability of stimulating resources. This helps to improve the efficacy of treatment and accelerate the development of children. Hence, this study attempted to find the relationship between the home environment and psychomotor development in children of urban and rural areas of Belagavi, Karnataka.
| Materials and Methods|| |
A cross-sectional study was done to determine the relationship between the home environment and psychomotor development in 200 subjects of urban and rural areas in Belagavi. Sample size was estimated using the formula and a sample of 98 subjects in each group was derived, hence a sample of 100 in each group. Information about the different urban and rural areas of Belagavi was obtained from the Municipal Corporation where clusters were taken from North, South, East, and West wards. Each ward has different designated areas which were randomly selected and a door-to-door survey was done in the selected area.
Ethical clearance was obtained from the Research and Ethics Committee, Belagavi. Informed consent was obtained from all participants before enrolling in the study.
Subjects within the age 6–30 months of both genders were included in the study. Subjects with congenital motor abnormalities and neurological conditions were excluded from the study. A total of 327 subjects were screened for eligibility, of which 100 subjects from each rural and urban area were analyzed [Figure 1].
A door-to-door survey in urban and rural areas was done for recruiting participants as per the inclusion and exclusion criteria. After obtaining an informed assent, the AHEMD scale was administered for both urban and rural population by observation and interview method.
Prior to the commencement of data collection, the principal investigator was trained and certified for the Developmental Assessment Scales for Indian Infants (DASII). The developmental assessment was done using DASII in a quiet room in the presence of a parent/caretaker. The test items had specific procedures to be carried out in different positions that were carried out as per the manual.
The level of the child's performance to be judged and administering the items at that level were continued till the child failed a number of items continuously or till it was felt confidently that the child has reached the limits of his/her ability. For every item, the child was given three trials and the best performance was scored. Each item for which the child was credited a tick mark was given. The total scores on respective sections of the scale were counted by adding the number of items credited, irrespective of their serial position on the scale. The child's motor and mental developmental age was regarded as the age placement of the item at the total rank score of the scale. The respective ages were used to calculate his/her development quotient by dividing them with his/her chronological age (CA) and multiplying by 100 (MoA/CA × 100 = DMoQ and MeA/CA × 100 = DMeQ). The score corresponding to 50 percentiles of both motor quotient (MoQ) and mental quotient (MeQ) were considered.
IBM SPSS Statistics V21.0 (Armonk, NY, USA: IBM Corp.) was used for the analysis. The correlation between outcome measures was studied using Karl Pearson's correlation coefficient method. An independent t-test was used for comparison of outcome measures between rural and urban participants. The results were considered significant when P ≤ 0.05.
| Results|| |
Demographic details of the study participants are presented in [Table 1].
The total score of AHEMD positively correlated with both MoQ and MeQ scores of DASII (P = 0.0001). MoQ and MeQ scores showed a positive correlation with three components of AHEMD, namely Variety of Stimulation (VS), gross motor toys (GMT), and fine motor toys (FMT) with P < 0.05 [Table 2].
|Table 2: Correlation between Affordances in the Home Environment for Motor Development and its components with Developmental Assessment Scales for Indian Infant |
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No statistical correlation was seen between AHEMD score and its components and MoQ in rural participants (P > 0.05). MeQ showed a positive correlation with total AHEMD score (P = 0.0007), VS (P = 0.0098), GMT (P = 0.0004), and FMT (P = 0.0130), whereas no correlation was noted between physical space (PS) component and MeQ (P = 0.6392) [Table 3].
|Table 3: Correlation between Affordances in the Home Environment for Motor Development and its components with Developmental Assessment Scales for Indian Infant in rural participants |
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In urban population, MoQ scores showed a positive correlation with total AHEMD scores (P = 0.0001) and three components of AHEMD, namely VS (P = 0.0008), GMT (P = 0.0019), and FMT (P = 0.0025). The MeQ scores also positively correlated with total AHEMD score (P = 0.0001), VS (P = 0.0083), GMT (P = 0.0037), and FMT (P = 0.0001) [Table 4].
|Table 4: Correlation between Affordances in the Home Environment for Motor Development and its components with Developmental Assessment Scales for Indian Infant in urban participants |
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A significant difference was seen in the total AHEMD scores of urban (19.93 ± 8.02) and rural participants (16.71 ± 7.51) (P = 0.0038), whereas no difference was found in the VS and PS in urban and rural areas. The urban children had significantly higher number of GMT (P = 0.0002) and FMT (P = 0.0006) as compared to rural children [Table 5].
|Table 5: Comparison of outcome measures in urban and rural participants |
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The mean MoQ was 100.16 ± 15.20 in urban participants and 94.03 ± 13.50 in rural which was statistically significant (P = 0.029). A significant difference was also seen in MeQ scores between urban and rural participants with a mean of 100.31 ± 12.42 and 94.40 ± 11.71, respectively (P = 0.0006).
| Discussion|| |
The present study aimed to determine the relationship between the home environment and psychomotor development in urban and rural areas. We found that there was a positive correlation between the home environment and psychomotor development.
There was a significant distinction in the home environment of urban children as compared to rural children. As per results, the urban children had a better home environment in terms of availability of GMT and FMT play materials as compared to rural children. In the other aspects of home environment such as VS and inside and outside PS, it was found to have no difference between rural and urban children. Although both the urban and rural children showed an average age-appropriate development, the urban children proved to be better than the rural children in terms of psychomotor development. This can be attributed to the availability of quality and quantity of the play materials that stimulate development, suggesting that play materials play an important role alongside other home environment factors to facilitate development. Children in rural areas do not have a large variety of materials that stimulate various domains of development. The educational status of the parents also affects the play materials bought in the house for the children. The comparison between play materials in urban and rural households was distinctly observed during data collection.
The present study showed an affirmative link between the total AHEMD scores and the motor and MeQs of DASII indicating the magnitude at which home environment acts in influencing development. The motor and MeQs positively correlated with the components of VS, GMT, and FMT. Alterations and adaptations in behavior are attributed to the environmental interactions with the child. According to Piaget, cognitive development of a child undergoes the process of the organization as per the course of biological process and process of adaptation along the exposure to a variety of environments. In contrast, previous studies on deprived poor population showed that the environment did not contribute to the infant motor development. The present study results were similar to a study done by Sharma and Nagar who found an important positive relation between home environment and psychomotor development in infants up to 18 months. The development of skills is associated with the temporal factors related to environmental experiences.
Cultural variations in caregiving practices play a major role in conditioning adaptive, motor, cognitive, and language development. In the parts of West India, motor development of children due to formal handling techniques led to an earlier achievement of milestones as opposed to Western culture handling. Similarly, various cultural differences were found in urban and rural settings. The urban setting has a more structured/built-up environment designed specifically for children in terms of play areas, parks, and amusement centers that act as a synergist in providing VS. In case of rural settings, the area to explore is larger and more natural but unstructured as compared to urban settings. With both the parents having to work, the children are mostly left unattended giving them the time and opportunity to explore their surroundings and communicate with other people. It was observed that approximately almost 70% of rural families had both parents working as opposed to 50% of parents working in urban families. During that time, children are under the care of their grandparents/guardians.
We found that there was no correlation between the motor development and home environment in rural participants, suggesting that home environment did not contribute much to the development of motor skills in these children. Still, these children had an average range of motor development quotient suggesting the role of other factors rather than the home environment alone contributing to motor development. The handling practices, nutrition, and general health also may play a role in the development pattern. Although these different factors have not been analyzed, these factors should be considered with regard to the development. The MoQ showed a positive correlation with the overall home environment, VS, and the play materials and was not found to be significantly affected by the PS. The interaction with surroundings and ample exploration stimulates mental development.
The MoQ and MeQ scores of urban children positively correlated with the overall home environment in which the VS and play materials proved to be an important stimulus as opposed to the PS available.
The home environment has been found to be a catalyst in the development of children. After birth, there are critical periods in early infancy and childhood period which involves many sensitive periods where environmental experiences have a crucial role in the development and maturation of the brain. These experiences during the critical period lead to robust neural plasticity and build up stronger neuronal circuits and synaptic connections.
During the first 6 months after birth, the child is restrained to one particular place, most of the time in the crib or being carried by someone. Hence, the home environment does not play a major role during the first 6 months. Physical development and growth accelerate after 6 months of age which falls in the critical period. Once the child reaches the stage of locomotion by either creeping, crawling, or butt walking, he/she can explore the environment freely.
The children whether living in urban or rural areas are restrained either in the crib or floor where the child is in their sight or in the arms of parent/guardian.
Evaluation of a child's developmental status should also include the evaluation of the home. The use of the space available around the house and the way to utilize play materials in conditioning development should be emphasized. Other factors such as nutrition, general health status, immunization, and gestational age should be considered for further evaluation of development in future. The caregivers should be taught the importance of allowing their children to be in different positions and exploring their surroundings. In cases of delays or deviations, intervention should target the provision of stimulus materials in the home.
As DASII was administered in respective homes of the participants, interference from other members of the family during testing hindered the standardization of the testing procedures. Further studies can be administered to find the components of domains of development which are influenced by the home environment. Follow-up of the participants can be done to assess the pattern of development. Evaluation of general health status should be done prior to developmental assessment.
| Conclusion|| |
The present study concludes that there is a positive correlation between the home environment and psychomotor development in children. The urban children had better mental and motor development scores than the rural children, although both the urban and rural children showed average development. In every child identified of having a delay, an assessment of the home environment is a necessary component to influence the outcome of the child with or without therapy.
The authors wish to acknowledge all the study participants for being a part of the study. We wish to acknowledge the cooperation of Dr. Vinuta Deshpande during data collection. We thank the institute for providing an opportunity to conduct the research.
Financial support and sponsorship
Conflicts of interest
There are no conflict of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]