Effectiveness of Individualized Developmental Care for Low-Risk Preterm Infants: Behavioral and Electrophysiologic Evidence
1 Departments of Psychiatry and Children's Hospital, Boston University, Boston, Massachusetts
2 Departments of Psychiatry and Children's Hospital, Departments of Psychiatry (Psychology), Harvard Medical School, Boston University, Boston, Massachusetts
3 Neurology, Children's Hospital Harvard Medical School, Boston University, Boston, Massachusetts
4 Department of Psychology, Boston University, Boston, Massachusetts
Objective. We assessed the effectiveness of individualized developmental support in the special care nursery for low-risk preterm infants.
Setting. A university-affiliated teaching hospital.
Participants. Twelve healthy full-term infants, and 24 low-risk preterm infants randomly assigned to a control or an experimental group.
Design. The preterm control group received standard care and the preterm experimental group received individualized developmental care at the same special care nursery.
Outcome Measures. Medical, behavioral (Assessment of Preterm Infants' Behavior and Prechtl's Neurological Examination of the Full-Term Newborn Infant), and electrophysiologic outcome (using quantitative electroencephalography with topographic mapping) of all three groups was assessed 2 weeks after the expected due date.
Results. No between-or among-group medical differences were seen for this low-risk, healthy sample. The preterm experimental group showed behavioral and electrophysiologic performances comparable to those of the full-term group, whereas the preterm control group performed significantly less well. Behavioral measures suggested significantly poorer attentional functioning for the preterm control group. Electrophysiologic results implicated the frontal lobe.
Conclusions. Individualized developmental intervention supports neurobehavioral functioning as measured at 2 weeks post-term. It appears to prevent frontal lobe and attentional difficulties in the newborn period, the possible causes of behavioral and scholastic disabilities often seen in low-risk preterm infants at later ages.
Submitted on May 31, 1994Accepted on December 27, 1994
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