Fussy Babies: To Treat or Not to Treat?

Abstract

In this prospective study, the developmental outcomes of 39 Infants with high Irritability and sensory processing problems, also described as regulatory disordered, were examined at 7-30 months and at 3 years using clinical Interdisciplinary assessment. Infants with regulatory disorders were defined as being behavIourally difficult with disturbances In sleep, feeding, state control, self-calmlng, mood regulation and sensory processing. The performance of samples of Infants with regulatory disorders, 13 untreated and 26 treated, and 11 normal children were compared at 3 years. All subjects In the clinical sample were offered 12 weeks of Intervention after the Initial assessment to address regulatory problems. Of the 39 subjects, 26 chose treatment, thus resulting In a self-iSelected treated sample.Post hoc analysis revealed that, at 7-30 months, untreated subjects had more sleep problems and were more Irritable whereas treated subjects had more feeding problems and their mothers reported feeling depressed. At 3 years, the children with regulatory disorders differed from their normal counterparts In sensory Integration, mood regulation, attention, motor control, sleep and behavioural control. untreated subjects showed more emotional and behavioural problems than treated subjects. Treated subjects had more motor and sensory Integrative problems than untreated subjects but, despite the fact that they had more constitutional problems, they did not show the emotional and behavioural problems that were found In the untreated group. The clinical Importance of these findings for occupational therapists Is discussed.

Criação de questionário para detecção de comportamentos atípicos em bebês

“…Other infants are less reactive to stimuli and need assistance to respond to social interaction. These signs have been studied and seem to indicate future occurrence of behavioral problems 4,5 . When such signs last for more than the 6 months of age they are called "Regulatory Disorders" (RD) and are defined in the Diagnostic Classification ZERO-TO-THREE [6][7][8] as "infant and young child difficulty in regulating their behavior and physiologic, sensorial, attention, motor or affective processes and in organizing themselves in a calm, alert or affective positive states".…”

“…The RD are manifested as sleep, food acceptance and self-consolation problems or as an infant difficulty in dealing with new situations. Moreover, atypical motor development, alterations in muscle tonus, hypo or hyper-responsiveness to sensorial stimuli and exacerbation of the affliction resultant of being away from parents can also be observed 4,5 . Such infants are considered "difficult" or irritable, have little adaptation ability, or may present hypo or hyper motor activity 3,4,7 .…”

“…At pre-school age, problems in balance, gross and fine motor coordination and motor planning as well as delayed language acquisition, tactile hypersensitivity or accentuated lack of attention became evident 5,8 . At school, writing and reading problems, attention deficits, emotional difficulties and impaired interaction with schoolmates appear 1,4 .…”

“…The relevance of the early detection of abnormal child development has been widely studied and emphasized by health and education professionals 4,5,11 . Furthermore, the increase in survival of high-risk infants, as a result of pre and perinatal care technologic evolution, led to an increase in the number of children with development disorders 5,11 .…”

“…Although RD are identified in infants without biological risk history, their incidence is high in low birth weight infants, in moderate or extreme premature babies and in children with definitive diagnostics such as cerebral palsy, Down and fragile X syndromes 7,12 . Children presenting moderate or mild disabilities are rarely early diagnosed; however, they are the children which are most benefited by early intervention programs and whose prognostic can be most drastically influenced 4,5,11 .…”