**5. Conclusions**

monitor child neurodevelopment, so that the professional at the first level of care can detect biological or social obstacles, to advise the caregivers and enable an optimal development necessary to channel it to diagnostic studies and specialized attention and continue with the monitoring of the child to see how the adaptations

24.5. Child kick the ball standing unsupported MG 0.96 0.67 0.5 0.0072\*

24.8. Child run without falling MG 0.92 0.96 0.58 0.0013\*

2. Straightening reflex of the head acting on the body RD 0.96 1 0.64 0.0008\* 3. Landau's reflex RD 0.86 0.91 0.5 <0.0001\* 4. Straightening reflex of the body acting on the body RD 0.94 0.93 0.38 <0.0001\* 5. Defense forward reflex RD 0.84 0.75 0.25 <0.0001\* 6.Sides protection reflex RD 1 0.93 0.5 <0.0001\* 7. Backwards protection reflex RD 0.82 0.77 0.29 0.0008\* 8. Sitting balance reflex RD 1 0.96 0.8 0.0339\* 9. Balance in four points reflex RD 1 0.85 0.4 <0.0001\* 10. Standing up balance reflex RD 1 0.83 0.67 0.0003\*

**Area BR MR AR Significance**

**level**

24.6. Child can sit in a normal chair\* MG 1 0.88 0.83

*Update on Critical Issues on Infant and Neonatal Care*

1. Labyrinth optical reflex RD 0.94 0.9 0.77

When analyzing by areas of development, the VANEDELA's reagents in feeding (A) for infants of moderate risk taking the help of a cup and uncovering a sweet or easy fruit are kept low, as we have said it is not favored in the family possibly because it takes time and the caregivers prefer to solve the challenge quickly, in the consultation it has been found that the caregivers see it as an instrumental activity, not as moments for the child to put into play their motor, cognitive, and emotional skills for its development. In the sample of high risk, eating with a single cookie and candy, which is a behavior favored by parents, occurs with greater proportions. Cognitive (C) in moderate, the lowest proportions are in exploration behaviors taking the object to the mouth and attention and exploration of your face or another part of the body when the caregiver plays with him/her and is the antecedent of imitation, being an activity that little favor the caregivers, preferring to put the electronic systems. High risk, that in the sequence of development have greater proportions in permanence of the object to find partially hidden object, the contentcontinent to put and take the seeds or candy from a bottle, this skill is practiced with various objects and containers, the give and take relationship understanding the

In expressive language in moderate risk, the lowest proportions are in the emission of bisyllables and first words, highly related to the interaction with the caregiver and recognize their vocalizations and interpret them to give meaning, it is one of the scales that in Mexico leave lower, Rizzoli-Córdoba et al. [23] report it in their evaluation in open population. In receptive in moderate risk, a low proportion

<sup>1</sup> In Spanish, bebé or nene are synonymous commonly used to name a newborn, in English the

translation is similar baby in this case used the Spanish words to show the differences.

game and the use of a means to achieve an end.

work.

**78**

**Table 2.**

*Area and P-values correlations.*

It is proposed to the professional in clinical practice to go beyond the classification of risk or non-risk, analyzing the behavior that the child has constructed and the possible obstacles that it presents, whether of an organic or social nature.

The VANEDELA's neurodevelopment screening test allows the first-level care professional using its four formats to have specific development references to establish when the child is and what the proximal area is to favor, designing strategies that allow the infant go building more complex competences.

The VANEDELA's design allows children to be assessed quickly through their six age cohorts, in which the different skills have been consolidated. However, its main limitation is that if the child is of intermediate age, we should wait for the confirmation of the risk. At present, we are working on intermediate milestones that will allow professionals to determine the evolution moment of the behaviors.

It is very important to consider that for both low- and high-risk children, their development must be monitored independently of the preventive or corrective medicine procedures that are carried out, in order to obtain, as proposed by WHO, the optimum development.

*Update on Critical Issues on Infant and Neonatal Care*

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