Estimulação precoce sensorial com bebês com síndrome de down por meio da terapia assistida com equinos

Abstract

The growth of babies with Down Syndrome (SD) is marked by various clinical manifestations that can interfere with their development. Various studies in the fields of health and education have shown that early stimulation plays an important role in minimizing developmental losses in this population. Among the strategies for intervention with children with DS is Equine-Assisted Therapy (TAE), which provides gains of various kinds (physical, psychological and educational) through the resources of the horse. This research aims to describe the physical and cognitive development of babies with Down's Syndrome who took part in a proposal for early sensory stimulation using Equine Assisted Therapy (TAE). Four babies with a diagnosis of DS took part in the study, aged between 1 and 2 years (12 – 24 months), with no other associated pathology, who had acquired the ability to sit, even with support, and who had no contraindications to taking part in the proposed therapy. The research instruments used were: 1) a script interview for a family anamnesis, in order to contextualize the participant's routine; 2) an observation and assessment form for perceptualmotor behaviour; 3) a form for assessing the sensory-motor stage; 4) an interview with the professional responsible for stimulating the baby on an outpatient basis, in order to gain a more complete understanding of their development; and 5) a checklist for monitoring the intervention sessions in order to assess the baby's responses to interaction with the team and the animal; 6) an interview with family members at the end of the intervention. After the consent letters were signed by the institutions, the participants were selected, followed by explanations about the research, signing of the informed consent forms (TCLE), anamnesis, initial perceptual-motor and sensorimotor assessment of the participating babies and an interview with a professional. After the intervention had been completed, a final perceptualmotor and sensorimotor assessment was carried out on the babies, followed by an interview with the participants' parents. The intervention was carried out in an existing space located in the mountainous region of Espírito Santo (ES), with an average duration of 20 sessions. The early sensory stimulation protocol with horses was presented as repetitive stimulation through sensory and playful tasks involving the animal and the environment in which it lives. By evaluating the babies' results during their participation, it was possible to see good interaction with the team, with constant displays of affection and the creation of a therapeutic bond. With regard to interaction with the animal, all the babies showed an interest in contact. In two of the four babies, this interest in contact with the animal, as well as in the proposed activities, gradually evolved over the course of the sessions and according to the learning acquired. In the other two babies, the interest was there from the very first session. As the intervention went on, they showed a greater motor repertoire and readiness to perform the movements needed to fulfill the tasks, such as feeding the animal, for example. This perception was also reported by the families throughout the sessions. Analysis of the results showed that in the final perceptual-motor assessment there was an improvement in the performance of the motor skills assessed, as well as the presence of skills previously classified as absent, and in the final sensory-motor assessment there was a change in the classification of the sub-stages of two babies. In the interview with the parents at the end of the intervention, they reported on what had been observed in their baby as a participant in the research. The families reported that their baby was more active at home, had more social interaction, was more intent on communicating and was babbling more. There were reports from schools and other therapies that they noticed a better readiness for the activities proposed in that environment. In this way, through sensory activities involving the animal and the environment in which it lives, the protocol for early sensory stimulation with horses sought to encourage babies to learn new cognitive and motor skills. The importance of stimuli in this sensory-motor phase should be emphasized, since this stage of cognitive development is the basis for the next stages. The stimulation and facilitation of exploration, based on the assessment and conduct directed by a multidisciplinary team, favors the baby's learning, from the perspective that knowledge is formed from experiences, thus highlighting the importance of multidisciplinary action in conducting this experience, as well as in the exchange of information between teams. In the same way, the direct participation of the family in early stimulation is of great importance in order to strengthen the bond and fully understand the baby's development, so that they can be the promoters of this development.