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Markkula A, Pyhälä-Neuvonen R, Stolt S. Interventions and their efficacy in supporting language development among preterm children aged 0-3 years - A systematic review. Early Hum Dev 2024; 195:106057. [PMID: 38901388 DOI: 10.1016/j.earlhumdev.2024.106057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/26/2024] [Accepted: 06/03/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Preterm children have a higher risk for linguistic delays than full-term infants but are rarely provided with language intervention at an early age. Knowledge on early language interventions targeted to preterm children is scarce, and efficacy of the interventions is rarely reported. AIM This systematic review aims to identify interventions for preterm children aged 0-3 years with at least one language outcome. Efficacy of the interventions and quality of the study reports were evaluated. STUDY DESIGN The article search was carried out in six databases: EBSCOhost, Scopus, ERIC, LLBA, Ovid, and Web of Science. Effect sizes (Hedges' g) were calculated for language outcomes. Quality of the study reports was assessed using the levels of evidence system by the American Speech-Language-Hearing Association. RESULTS The 28 studies identified were divided into three groups: interventions at Neonatal Intensive Care Unit, interventions during the first year, and interventions during the second and/or third years. Most of the interventions focused on supporting child-care and general development. Of the interventions, 61 % were efficacious in supporting language development of preterm children. The most promising results regarding efficacy were interventions conducted during the second and/or third years (80 %). Quality of the reports varied from high/good (89 %) to low (11 %). CONCLUSION The 28 existing studies provide limited evidence of the efficacy of very early interventions promoting language development of preterm children. However, especially the results for interventions conducted during the second and/or third years show promise. More studies, particularly language-focused interventions with longer follow-ups, are needed.
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Affiliation(s)
- Anna Markkula
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Riikka Pyhälä-Neuvonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Suvi Stolt
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Bieleninik Ł, Kvestad I, Gold C, Stordal AS, Assmus J, Arnon S, Elefant C, Ettenberger M, Gaden TS, Haar-Shamir D, Håvardstun T, Lichtensztejn M, Mangersnes J, Wiborg AMN, Vederhus BJ, Ghetti CM. Music Therapy in Infancy and Neurodevelopmental Outcomes in Preterm Children: A Secondary Analysis of the LongSTEP Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2410721. [PMID: 38753331 PMCID: PMC11099691 DOI: 10.1001/jamanetworkopen.2024.10721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/08/2024] [Indexed: 05/19/2024] Open
Abstract
Importance Preterm children are at risk for neurodevelopment impairments. Objective To evaluate the effect of a music therapy (MT) intervention (parent-led, infant-directed singing) for premature children during the neonatal intensive care unit (NICU) stay and/or after hospital discharge on language development at 24 months' corrected age (CA). Design, Setting, and Participants This predefined secondary analysis followed participants in the LongSTEP (Longitudinal Study of Music Therapy's Effectiveness for Premature Infants and Their Caregivers) randomized clinical trial, which was conducted from August 2018 to April 2022 in 8 NICUs across 5 countries (Argentina, Colombia, Israel, Norway, and Poland) and included clinic follow-up visits and extended interventions after hospital discharge. Intervention Participants were children born preterm (<35 weeks' gestation) and their parents. Participants were randomized at enrollment to MT with standard care (SC) or SC alone; they were randomized to MT or SC again at discharge. The MT was parent-led, infant-directed singing tailored to infant responses and supported by a music therapist and was provided 3 times weekly in the NICU and/or in 7 sessions across 6 months after discharge. The SC consisted of early intervention methods of medical, nursing, and social services, without MT. Main Outcome and Measures Primary outcome was language development, as measured by the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) language composite score, with the remaining BSID-III composite and subscale scores as the secondary outcomes. Group differences in treatment effects were assessed using linear mixed-effects models using all available data. Results Of 206 participants (103 female infants [50%]; mean [SD] GA, 30.5 [2.7] weeks), 51 were randomized to MT and 53 to SC at enrollment; at discharge, 52 were randomized to MT and 50 to SC. A total of 112 (54%) were retained at the 24 months' CA follow-up. Most participants (79 [70%] to 93 [83%]) had BSID-III scores in the normal range (≥85). Mean differences for the language composite score were -2.36 (95% CI, -12.60 to 7.88; P = .65) for the MT at NICU with postdischarge SC group, 2.65 (95% CI, -7.94 to 13.23; P = .62) for the SC at NICU and postdischarge MT group, and -3.77 (95% CI, -13.97 to 6.43; P = .47) for the MT group at both NICU and postdischarge. There were no significant effects for cognitive or motor development. Conclusions and Relevance This secondary analysis did not confirm an effect of parent-led, infant-directed singing on neurodevelopment in preterm children at 24 months' CA; wide CIs suggest, however, that potential effects cannot be excluded. Future research should determine the MT approaches, implementation time, and duration that are effective in targeting children at risk for neurodevelopmental impairments and introducing broader measurements for changes in brain development. Trial Registration ClinicalTrials.gov Identifier: NCT03564184.
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Affiliation(s)
- Łucja Bieleninik
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Clinical and Health Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Christian Gold
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Andreas Størksen Stordal
- NORCE Energy, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Jörg Assmus
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Shmuel Arnon
- Meir Medical Center, Kfar-Saba, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Mark Ettenberger
- Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Clínica de la Mujer, Bogotá, Colombia
| | - Tora Söderström Gaden
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
| | | | - Tonje Håvardstun
- Department of Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | - Marcela Lichtensztejn
- Facultad de Ciencias de la Salud, Universidad de Ciencias Empresariales y Sociales, Buenos Aires, Argentina
| | | | | | | | - Claire M. Ghetti
- GAMUT—The Grieg Academy, Department of Music, University of Bergen, Bergen, Norway
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Orton J, Doyle LW, Tripathi T, Boyd R, Anderson PJ, Spittle A. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev 2024; 2:CD005495. [PMID: 38348930 PMCID: PMC10862558 DOI: 10.1002/14651858.cd005495.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
BACKGROUND Infants born preterm are at increased risk of cognitive and motor impairments compared with infants born at term. Early developmental interventions for preterm infants are targeted at the infant or the parent-infant relationship, or both, and may focus on different aspects of early development. They aim to improve developmental outcomes for these infants, but the long-term benefits remain unclear. This is an update of a Cochrane review first published in 2007 and updated in 2012 and 2015. OBJECTIVES Primary objective To assess the effect of early developmental interventions compared with standard care in prevention of motor or cognitive impairment for preterm infants in infancy (zero to < three years), preschool age (three to < five years), and school age (five to < 18 years). Secondary objective To assess the effect of early developmental interventions compared with standard care on motor or cognitive impairment for subgroups of preterm infants, including groups based on gestational age, birthweight, brain injury, timing or focus of intervention and study quality. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and trial registries in July 2023. We cross-referenced relevant literature, including identified trials and existing review articles. SELECTION CRITERIA Studies included randomised, quasi-randomised controlled trials (RCTs) or cluster-randomised trials of early developmental intervention programmes that began within the first 12 months of life for infants born before 37 weeks' gestational age (GA). Interventions could commence as an inpatient but had to include a post discharge component for inclusion in this review. Outcome measures were not prespecified, other than that they had to assess cognitive outcomes, motor outcomes or both. The control groups in the studies could receive standard care that would normally be provided. DATA COLLECTION AND ANALYSIS Data were extracted from the included studies regarding study and participant characteristics, timing and focus of interventions and cognitive and motor outcomes. Meta-analysis using RevMan was carried out to determine the effects of early developmental interventions at each age range: infancy (zero to < three years), preschool age (three to < five years) and school age (five to < 18 years) on cognitive and motor outcomes. Subgroup analyses focused on GA, birthweight, brain injury, time of commencement of the intervention, focus of the intervention and study quality. We used standard methodological procedures expected by Cochrane to collect data and evaluate bias. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS Forty-four studies met the inclusion criteria (5051 randomly assigned participants). There were 19 new studies identified in this update (600 participants) and a further 17 studies awaiting outcomes. Three previously included studies had new data. There was variability in the focus and intensity of the interventions, participant characteristics, and length of follow-up. All included studies were either single or multicentre trials and the number of participants varied from fewer than 20 to up to 915 in one study. The trials included in this review were mainly undertaken in middle- or high-income countries. The majority of studies commenced in the hospital, with fewer commencing once the infant was home. The focus of the intervention programmes for new included studies was increasingly targeted at both the infant and the parent-infant relationship. The intensity and dosages of interventions varied between studies, which is important when considering the applicability of any programme in a clinical setting. Meta-analysis demonstrated that early developmental intervention may improve cognitive outcomes in infancy (developmental quotient (DQ): standardised mean difference (SMD) 0.27 standard deviations (SDs), 95% confidence interval (CI) 0.15 to 0.40; P < 0.001; 25 studies; 3132 participants, low-certainty evidence), and improves cognitive outcomes at preschool age (intelligence quotient (IQ); SMD 0.39 SD, 95% CI 0.29 to 0.50; P < 0.001; 9 studies; 1524 participants, high-certainty evidence). However, early developmental intervention may not improve cognitive outcomes at school age (IQ: SMD 0.16 SD, 95% CI -0.06 to 0.38; P = 0.15; 6 studies; 1453 participants, low-certainty evidence). Heterogeneity between studies for cognitive outcomes in infancy and preschool age was moderate and at school age was substantial. Regarding motor function, meta-analysis of 23 studies showed that early developmental interventions may improve motor outcomes in infancy (motor scale DQ: SMD 0.12 SD, 95% CI 0.04 to 0.19; P = 0.003; 23 studies; 2737 participants, low-certainty evidence). At preschool age, the intervention probably did not improve motor outcomes (motor scale: SMD 0.08 SD, 95% CI -0.16 to 0.32; P = 0.53; 3 studies; 264 participants, moderate-certainty evidence). The evidence at school age for both continuous (motor scale: SMD -0.06 SD, 95% CI -0.31 to 0.18; P = 0.61; three studies; 265 participants, low-certainty evidence) and dichotomous outcome measures (low score on Movement Assessment Battery for Children (ABC) : RR 1.04, 95% CI 0.82 to 1.32; P = 0.74; 3 studies; 413 participants, low-certainty evidence) suggests that intervention may not improve motor outcome. The main source of bias was performance bias, where there was a lack of blinding of participants and personnel, which was unavoidable in this type of intervention study. Other biases in some studies included attrition bias where the outcome data were incomplete, and inadequate allocation concealment or selection bias. The GRADE assessment identified a lower certainty of evidence in the cognitive and motor outcomes at school age. Cognitive outcomes at preschool age demonstrated a high certainty due to more consistency and a larger treatment effect. AUTHORS' CONCLUSIONS Early developmental intervention programmes for preterm infants probably improve cognitive and motor outcomes during infancy (low-certainty evidence) while, at preschool age, intervention is shown to improve cognitive outcomes (high-certainty evidence). Considerable heterogeneity exists between studies due to variations in aspects of the intervention programmes, the population and outcome measures utilised. Further research is needed to determine which types of early developmental interventions are most effective in improving cognitive and motor outcomes, and in particular to discern whether there is a longer-term benefit from these programmes.
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Affiliation(s)
- Jane Orton
- Royal Women's Hospital, Parkville, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Tanya Tripathi
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Roslyn Boyd
- The University of Queensland, Brisbane, Australia
| | - Peter J Anderson
- Department of Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Alicia Spittle
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
- Murdoch Childrens Research Institute and the University of Melbourne, Parkville, Australia
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Zhou M, Wang S, Zhang T, Duan S, Wang H. Neurodevelopmental outcomes in preterm or low birth weight infants with germinal matrix-intraventricular hemorrhage: a meta-analysis. Pediatr Res 2024; 95:625-633. [PMID: 37935882 PMCID: PMC10899112 DOI: 10.1038/s41390-023-02877-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/29/2023] [Accepted: 10/19/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND This meta-analysis aimed to identify the near- and long-term neurodevelopmental prognoses of preterm or low birth weight (LBW) infants with different severities of intraventricular hemorrhage (IVH). METHODS Four databases were searched for observational studies that were qualified using the Newcastle-Ottawa Scale. RESULTS 37 studies involving 32,370 children were included. Compared to children without IVH, children with mild IVH had higher incidences of neurodevelopmental impairment (NDI), cerebral palsy (CP), motor/cognitive delay, hearing impairment and visual impairment, as well as lower scores of the mental development index (MDI) and psychomotor development (PDI). Moreover, compared to mild IVH, severe IVH increased susceptibilities of children to NDI, motor delay, CP, hearing impairment and visual impairment, with worse performances in MDI, PDI, motor score and IQ. Mild IVH was not associated with seizures or epilepsy. CONCLUSIONS Adverse neurodevelopmental outcomes positively associated with the occurrence and severity of IVH in preterm or LBW infants, providing evidence for counseling and further decisions regarding early therapeutic interventions. IMPACT Adverse neurodevelopmental outcomes later in life were closely associated with the occurrence and severity of IVH in preterm or LBW infants. Our results highlight the importance to make prediction of the neurodevelopmental outcomes of children born preterm or LBW with a history of IVH, which will guide affected parents when their children need clinical interventions to reach the full potential. We emphasize the importance of identifying specific developmental delays that may exist in children with IVH, providing detailed information for the development of comprehensive intervention measures.
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Affiliation(s)
- Meicen Zhou
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Shaopu Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Ting Zhang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Surong Duan
- Bingzhou Medical University, Bingzhou, 264003, China
| | - Hua Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan Province, China.
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Alberge C, Ehlinger V, Noack N, Bolzoni C, Colombié B, Breinig S, Dicky O, Delobel M, Arnaud C. Early psychomotor therapy in very preterm infants does not improve Bayley-III scales at 2 years. Acta Paediatr 2023; 112:1916-1925. [PMID: 37191836 DOI: 10.1111/apa.16848] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/17/2023]
Abstract
AIM To assess the efficacy of post-hospital psychomotor therapy in the development of very preterm infants at nine and 24 months. METHODS We conducted a randomised controlled study at Toulouse Children's Hospital between 2008 and 2014 among preterm infants aged under 30 weeks. All infants in both groups could benefitt from physiotherapy to prevent motor disorders. The intervention group received 20 early post-hospital psychomotor therapy sessions. The development was assessed by the Bayley Scale Infant Development at nine and 24 months. RESULTS The intervention and control group contained 77 and 84 infants, respectively, with 57 infants in each group undergoing assessment at 24 months. Boys accounted for 56% of the population. Median gestational age was 28 weeks, range 25-29. The development scores at 24 months did not significantly differ between the randomisation groups. At 9 months, we observed improvements in global motricity (mean difference 0.9 point, p = 0.04) and fine motricity for the subgroup containing educationally underserved mothers (mean difference 1.6 point, p = 0.008). There was no significant difference in neuromotor functioning between the two groups. CONCLUSION The benefits of psychomotor therapy were short-lived and did not persist post-intervention. Our results and this organisational model encouraged us to persevere towards similar multi-professional care.
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Affiliation(s)
- Corine Alberge
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | | | - Nathalie Noack
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | | | - Bruno Colombié
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | - Sophie Breinig
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Odile Dicky
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
- Neonatology Department, Toulouse University Children's Hospital, Toulouse, France
| | - Malika Delobel
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Catherine Arnaud
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
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Sandoval-Cuellar C, Castellanos-Garrido AL, Ospina Romero AM, Boude Figueredo ÓR, Serrano-Gómez ME, Fuya Caro CA, Molina Cárdenas DC, Pinto Rosas EM. Motor development in premature infants: Study protocol for an interdisciplinary hospital-home intervention. Pediatr Neonatol 2023; 64:577-584. [PMID: 37002053 DOI: 10.1016/j.pedneo.2022.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/01/2022] [Accepted: 12/08/2022] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Deviations occur in the neuropsychomotor development of premature infants; early interventions minimize delay motor. This study aimed to determine the effect of an interdisciplinary hospital-home intervention addressing motor development adaptation in premature infants in Colombia in comparison with traditional interventions. METHODS This study was based on a parallel design, with two groups, namely, experimental and control. The experimental group, hospital-home intervention (HHI) performed in two settings (i.e., hospital neonatal care units and homes), and the control group, traditional intervention, (TI) performed in institutions for premature infants. The sample will be composed of 130 randomly-allocated infants, 65 in the experimental group (HHI) and 65 in the control group (TI) of moderate to late preterm infants (gestational age between 34 and 37 weeks), weighing more than or equal to 1.800 g, who are hemodynamically stable and reside in the cities of Tunja and Bogotá-Colombia recruited between 2021 and 2022. For the pre- and post-intervention assessments, the TIMPSI and the CapDMP are the instruments used to assess motor development and the degree of parents' or caregivers' knowledge about motor development. The HHI is composed of 10 intervention strategies based on stimulation of motor development, performed twice a day for 10 min for two months, in combination with calls to a mobile device, using software (Baby Motor Skills) and an instant messaging system (WhatsApp). RESULTS This hospital-home intervention program proposes an approach focused on the motor development of premature infants, based on sensory and motor stimulation strategies, in addition to follow-up performed at home with the use of a mobile application that improves the motor development of premature infants. Register Clinical Trial: NCT04563364. CONCLUSION The HHI provides the opportunity to determine whether the individualized four-week from admission to follow up at home with parent training will improve the motor skills of premature infants.
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Lima CRG, Abreu RWFD, Verdério BN, Brugnaro BH, Santos MMD, Dos Santos AN, Morgan C, Rocha NACF. Early Intervention Involving Specific Task-Environment-Participation (STEP) Protocol for Infants at Risk: A Feasibility Study. Phys Occup Ther Pediatr 2022; 43:303-320. [PMID: 36329671 DOI: 10.1080/01942638.2022.2142084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aims: To verify the feasibility and preliminary effects of the STEP protocol, an intervention based on specific motor skills, environmental factors and participation, in infants at biological risk.Methods: Twenty-eight at-risk infants (STEP Protocol = 14; Standard Intervention = 14), aged 3-9 months and at risk for developmental delay. The following outcomes were assessed: motor skills (Alberta Infant Motor Scale-AIMS); frequency and involvement of participation (Young Children's Participation and Environment Measure-YC-PEM), and home environment opportunities (Affordances in the Home Environment for Motor Development-AHEMD-IS). For both groups, interventions were provided by parents. The intervention for group was based on the following principles: (1) standard intervention: stimulation of motor skills; (2) STEP: stimulation of motor skills, participation, mother-infant interaction, environmental enrichment. A mean comparison test was applied to verify difference between groups after the intervention.Results: The protocol showed good retention and recruitment rates. The STEP group had significantly higher outcomes after intervention on the AIMS (p = 0.014); frequency (p = 0.02) and engagement (p = 0.03) in participation, when compared to standard intervention.Conclusions: The results showed that the STEP protocol is feasible, and presents better results compared to the standard intervention, which reinforces the importance of promoting participation, specific motor skills and family involvement.
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Affiliation(s)
- Camila Resende Gâmbaro Lima
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | | | - Bruna Nayara Verdério
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | - Beatriz Helena Brugnaro
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | - Mariana Martins Dos Santos
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos-SP, Brazil
| | | | - Catherine Morgan
- School of Medicine, Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
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