Cognitive, language and motor development of infants exposed to risk and protective factors.

Introduction: Risk factors are biological or environmental characteristics increasing the likelihood of delays in child development. Meanwhile, protective factors are conditions that can minimize risks and favor the acquisition of skills. Infants with risk indicators for hearing loss (RIHL) tend to live in less stimulating environments which may lead to lower cognitive, language, and motor development.

Objective: To compare the cognitive, language, and motor development of infants under the influence of risk and protective factors.

Method: A cross-sectional observational study in which 259 infants aged 8-10 months were assessed for cognitive, language, and motor development using the Bayley Scales of Infant and Toddler Development - Third Edition (BSITD-III). The groups were formed according to the presence or absence of RIHL and the quality of the resources, being: SG-AE (Study Group with Adequate Environment), SG-IE (Study Group with Inadequate Environment), CG-AE (Compared Group with Adequate Environment)) and CG-IE (Compared Group with Inadequate Environment). Affordances were assessed using the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The groups were compared using the Chi-square test or the Kruskal-Wallis test, followed by Dunn's multiple comparison test. The level of significance adopted was 5%.

Results: Infants from the CG-AE performed better than the other groups in cognition and motor skills. The CG-AE language was statistically superior to the SG-IE. SG-IE showed the highest frequency of delays in all domains. CG-IE and SG-AE showed a similar frequency of delays. Adequate environment associated with the absence of RIHL (CG-AE) leads to better cognitive, language, and motor performances.

Conclusion: Biological and environmental risk factors have a similar impact on development, but the accumulation of both tends to increase the risks of developmental delay. The absence of RIHL and quality environments worked as protective factors and favored the acquisition of skills.