Early developmental intervention programmes post-hospital discharge to prevent motor and cognitive impairments in preterm infants

Spittle, Alicia J; Orton, Jane; Anderson, Peter J.; Boyd, Roslyn N.; Doyle, Lex W.

doi:10.1002/14651858.cd005495.pub3

Cited by 157 publications

(171 citation statements)

References 106 publications

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“…In early infancy, preterm infants tend to be less attentive, less responsive and need more breaks from interaction than term infants (Wolf, et al, 2002). As these children grow older, they are at risk of learning disabilities, which can in turn affect cognitive, motor and social competencies (Michele A Lobo & Galloway, 2013;Spittle, Orton, Anderson, Boyd, & Doyle, 2012). Studies indicate that preterm infants are also at risk of delayed play skills (Korja, Lehtonen, & Latva, 2012;Vig, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Pediatric physical therapist (PT)s aim to alleviate preterm infants' movement problems, enhance motor development and support the infants' participation in age-appropriate activities (Blauw-Hospers, De Graaf-Peters, Dirks, Bos, & Hadders-Algra, 2007;Campbell, Palisano, & Orlin, 2012;Spittle, et al, 2012). In this work, attention and motivation are key factors for the infants' motor learning, mastery of new skills and sense of self-efficacy (Atun-Einy, Berger, & Scher, 2013;Brodal, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Let’s play! An observational study of primary care physical therapy with preterm infants aged 3–14 months

Håkstad

Obstfelder

Øberg

2017

Infant Behavior and Development

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Introduction: Sensory-motor play is at the core of child development and an important element in physical therapist(PT)s' work to improve infants' motor skills. In this study, we investigate how PTs scaffold and use play in physical therapy intervention with preterm infants at corrected age (CA) 3-14 months. Material and Methods:We collected data by observing 20 physical therapy sessions. In the analysis, we connected to enactive theory on cooperation.Results: Successful use of sensory-motor play in physical therapy requires cooperation toward common goals. This is achieved via an enactive therapeutic sensory-motor play approach, in which the PTs plan and tailor the intervention to match the infant's interests; attune themselves to the infant's intentions; and incorporate therapeutic measures in sensory-motor play interactions with the child. Conclusions:Via cooperation and mutuality in therapeutic interactions, PTs can provide play situated learning opportunities that support the infants' development and understanding of the world.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Let’s play! An observational study of primary care physical therapy with preterm infants aged 3–14 months

Håkstad

Obstfelder

Øberg

2017

Infant Behavior and Development

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“…This is the first systematic review and metaanalysis that has attempted to define and measure the effect of EE on motor development of infants with CP. Previous systematic reviews have focused more broadly on motor and cognitive outcomes in preterm populations 27 or those at risk for a broader range of developmental disorders. 46,47 In these previous studies, favorable cognitive outcomes programs have been consistently demonstrated for a range of early-intervention programs, but motor outcomes rarely improve.…”

Section: Discussionmentioning

confidence: 99%

“…18 Similarly, training parents to practice specific motor tasks with typically developing infants accelerated the rate of motor development in both the short and long term. 19,20 In the small amount of literature about the benefits of EE for infants at risk for brain injury, we know that premature infants demonstrate neurobehavioral benefits from sensory-specific EE activities, such as massage 21 26,27 Because only ∼8% to 15% of premature infants will go on to have CP, 28 it is not clear whether interventions aimed at preterm infants will have clear benefits for infants with CP. In contrast, "traditional" physical and occupational therapy earlyintervention approaches, such as neurodevelopmental treatment (NDT), have not been shown to be effective in improving motor outcomes in infants or older children with CP, despite the theoretical possibility of providing sensory-enrichment cues for learning motor skills.…”

Section: Methodsmentioning

confidence: 99%

“…Similarly, systematic reviews show favorable short-term cognitive benefits from generic EE programs offered to premature infants. 26,27 Because only ∼8% to 15% of premature infants will go on to have CP, 28 it is not clear whether interventions aimed at preterm infants will have clear benefits for infants with CP. In contrast, "traditional" physical and occupational therapy earlyintervention approaches, such as neurodevelopmental treatment (NDT), have not been shown to be effective in improving motor outcomes in infants or older children with CP, despite the theoretical possibility of providing sensory-enrichment cues for learning motor skills.…”

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confidence: 99%

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Enriched Environments and Motor Outcomes in Cerebral Palsy: Systematic Review and Meta-analysis

2013

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BACKGROUND AND OBJECTIVES: Neuroplasticity evidence from animals favors an early enriched environment for promoting optimal brain injury recovery. In infants, systematic reviews show environmental enrichment (EE) improves cognitive outcomes but the effect on motor skills is less understood. The objective of this review was to appraise the effectiveness evidence about EE for improving the motor outcomes of infants at high risk of cerebral palsy (CP). METHODS:A systematic review was conducted. Cochrane Central Register of Controlled Trials (PubMed), Cumulative Index to Nursing and Allied Health Literature, Education Resource Information Center, SocINDEX, and PsycINFO databases were searched for literature meeting inclusion criteria: randomized controlled trials; high risk of /diagnosis of CP; .25% participants #2 years; parent or infant interventions postdischarge; and motor outcomes reported. Data were extracted using the Cochrane protocol regarding participants, intervention characteristics, and outcomes. Methodological quality was assessed using risk of bias assessment and GRADE.RESULTS: A total of 226 studies were identified. After removing duplicates and unrelated studies, 16 full-text articles were reviewed, of which 7 studies met inclusion criteria. The risk of bias varied between studies with the more recent studies demonstrating the lowest risk. Enrichment interventions varied in type and focus, making comparisons difficult. A meta-analysis was conducted of studies that compared enrichment to standard care (n = 5), and totaled 150 infants. A small positive effect for enrichment was found; standardized mean difference 0.39 (95% confidence interval 0.05-0.72; I 2 = 3%; P = .02)CONCLUSIONS: EE looks promising for CP, and therefore high-quality studies with well-defined EE strategies are urgently required. Ms Morgan and Dr Novak were involved in quality assessment, data extraction, data analysis, and manuscript preparation; Dr Badawi was involved in quality assessment and manuscript critique. All authors were involved in study conception and design, interpretation of data, critical revision, and final approval of the submitted manuscript. Children with cerebral palsy (CP) reach ∼90% of their gross motor potential by age 5 and even younger for the more severely impaired, 1 so effective interventions for optimizing early motor development are vital. As with typically developing children, the first 2 years are critically important for cognitive and motor development 2 because the brain is experiencing continuous spontaneous plasticity. Pediatricians, who are responsible for making the diagnosis of CP and referral to rehabilitation, therefore require up-todate evidence about effective early interventions for children with CP.The value of enriched environments in enhancing brain recovery at both structural and chemical levels has been repeatedly demonstrated in animal studies. 3,4 Effects of enrichment include improved memory and motor function. 4 Replication of animal data findings within humans is still...

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Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden

Serenius

Källén²,

Blennow³

et al. 2013

JAMA

477

356

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PROACTIVE APPROACH TO resuscitation and intensive care of extremely preterm infants (Ͻ27 gestational weeks) has increased survival and lowered the gestational age of viability. 1-4 There are concerns that increased survival may come at the cost of later neurodevelopmental disability among survivors. Approximately 25% of extremely preterm infants born in the 1990s had a major disability at preschool age, such as impaired mental development, cerebral palsy (CP), blindness, or deafness. 5,6 More recent studies report decreasing, 7,8 unchanged, 2 or increasing rates of neurodevelopmental disability 9-11 at preschool age compared with previous decades. The most immature infants, ie, those born before 25 weeks Author Affiliations and Members of the EXPRESS Group appear at the end of this article.

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Early developmental intervention programmes post-hospital discharge to prevent motor and cognitive impairments in preterm infants

Cited by 157 publications

References 106 publications

Let’s play! An observational study of primary care physical therapy with preterm infants aged 3–14 months

Let’s play! An observational study of primary care physical therapy with preterm infants aged 3–14 months

Enriched Environments and Motor Outcomes in Cerebral Palsy: Systematic Review and Meta-analysis

Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden

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