Accommodations provided and used to assess the cognitive performance of children with multiple disabilities resulting from Congenital Zika Syndrome

BACKGROUND: The lack of development assessment instruments aimed at children with disabilities in the early years of life means that standardized items are used for accommodation. OBJECTIVE: This study aimed to describe accommodations implemented in the administration of the Bayley Scales of Infant Development (BSID-III) cognitive scale and analyze their association with the cognitive performance of children affected by Congenital Zika Syndrome. METHODS: A total of 125 children were assessed at 12 months using BSID-III. Twelve types of accommodation strategies were adopted and organized according to participants' main disability conditions, such as sensory, motor, auditory, and general accommodations. RESULTS: This study identified that 59.2% of participants used some accommodation. "Lighting" (sensory accommodation) included the use of lighting during the test, and "not timing" includes disabling time tracking for tasks that involve time management. They were the most used accommodations, in addition to having presented a statistically significant association (p < = 0.05) with several items assessed by the instrument. A strong, statistically significant negative correlation (ρ = -0.73; p < 0.001) was found between the number of accommodations used and the cognitive performance score obtained by children. This indicates that the greater the use of accommodations, the lower the level of cognitive performance. It is understood that the more severe the congenital syndrome, the more accommodations are required during the assessment. CONCLUSION: These findings are consistent with the guidelines provided in the accommodation procedures, which aim to offer opportunities for adequate assessment of children and allow for an explanation of their actual level of development, without any compensation. Assessment using accommodation provides more reliable data on children's developmental strengths and weaknesses and has the potential to guide effective intervention programs. Such explanation favors a perspective of equity in the provision of care to children with disabilities.