PEDIATRICS Vol. 85 No. 3 March 1990, pp. 411-415
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Infant Stimulation Curriculum for Infants With Cerebral Palsy: Effects on Infant Temperament, Parent-Infant Interaction, and Home Environment

Frederick B. Palmer MD1, Bruce K. Shapiro MD1, Marilee C. Allen MD1, Barbara S. Mosher MSW1, Stacey A. Bilker MPH1, Susan E. Harryman MS, RPT1, Curtis L. Meinert PhD1, and Arnold J. Capute MD, MPH1

1 From the Clinical Research Unit of The Kennedy Institute for Handicapped Children, Department of Pediatrics of The Johns Hopkins University School of Medicine, and Department of Epidemiology of The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland

To assess the effects of intervention in cerebral palsy, 48 infants 12 to 19 months of age, with mild to severe spastic diplegia, were randomly assigned to receive either 6 months of infant stimulation followed by 6 months of physical therapy (test group) or 12 months of neurodevelopmental physical therapy (contrast group). The infant stimulation protocol consisted of cognitive, motor, sensory, and language activities. Outcome was assessed after 12 months by using Carey Infant Temperament Questionnaire subscores (activity, rhythmicity, adaptability, approach, threshold, intensity, mood, distractibility, and persistence); Roth Mother-Child Relationship Evaluation subscores (acceptance, overprotection, overindulgence, rejection); and Home Observation for Measurement of the Environment subscores (maternal responsiveness, avoidance of restriction and punishment, organization of environment, play materials, maternal involvement, and variety of daily stimulation). Motor and cognitive outcomes suggesting advantage for the test group have been reported previously. After 12 months of intervention, mothers with infants in the contrast group showed a greater improvement in emotional and verbal responsiveness as measured by the Home Observation for Measurement of the Environment (mean score change in control group = 1.2, test group = 0.3 P < .04). None of the 19 other measures differed significantly between treatment groups in change from baseline. This study demonstrates no short-term systematic effect on temperament, maternal-infant interaction, or home environment attributable to the inclusion of an infant stimulation curriculum in an intervention program for infants with spastic diplegia. It suggests that motor and cognitive advantages associated with infant stimulation are not mediated by measurable changes in the psychosocial variables studied.

Key Words: Cerebral palsy • spastic diplegia • physical therapy • infant stimulation • parenting • infant temperament




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