title: Clinical indicators of child development in the capitals of nine Brazilian states: the influence of regional cultural factors.
abstract: OBJECTIVE
  Evaluating the interaction between mother or caregiver and infant through the Clinical Indicators of Risks in Infant Development and investigating whether local and cultural influences during infant development affect these clinical indicators.
  
  
  BACKGROUND
  The Clinical Indicators of Risks in Infant Development was created in order to fully assess infants' development and the subjective relationship between the babies and their caregivers. The absence of two or more Clinical Indicators of Risks in Infant Developments suggests a possibly inadequate mental development. Given the continental size of Brazil and its accentuated cultural differences, one might question how trustworthy these indicators can be when applied to each of the geographical regions of the country.
  
  
  METHODS
  This was a cross-sectional study with 737 infants from the capitals of 9 Brazilian states. The size of the initial sample population was based on a pilot study carried out in the cities of São Paulo and Brasília. The ages of children were grouped: 0-3 months, 4-7 months, 8-11 months and 12-18 months. The chi-square test was used together with analyses by the statistical software SPSS 13.0.
  
  
  RESULTS
  Statistical analysis of results from the different municipalities against the total sample did not reveal any statistically significant differences. Municipalities represented were Belém (p=0.486), Brasília (p=0.371), Porto Alegre (p=0.987), Fortaleza (p=0.259), Recife (p=0.630), Salvador (0.370), São Paulo (p=0.238), Curitiba (p=0.870), and Rio de Janeiro (p= 0.06).
  
  
  CONCLUSIONS
  Care for mental development should be considered a public health issue. Its evaluation and follow-up should be part of the already available mother-child assistance programs, which would then be considered to provide "full" care to children.
  
  
  CONCLUSIONS
  Local habits and culture did not affect the results of the Clinical Indicators of Risks in Infant Development indicators. Clinical Indicators of Risks in Infant Development proved to be robust despite the specificities of each region.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. andre_decarvalho@yahoo.com.br
authors.forename: André Laranjeira de
authors.initials: AL
authors.lastname: Carvalho
authors.forename: Luiz Fernando Ferraz da
authors.initials: LF
authors.lastname: Silva
authors.forename: Sandra Josefina Ferraz Ellero
authors.initials: SJ
authors.lastname: Grisi
authors.forename: Ana Maria de Ulhôa
authors.initials: AM
authors.lastname: Escobar
mesh_terms: D001938:Brazil; D017028:Caregivers; D002657:Child Development; D002947:Cities; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008425:Maternal Behavior; D012959:Socioeconomic Factors