[The timing of the start of rehabilitative intervention with the newborn infant at neurological risk].
The few studies related to the effect of the timing of intervention of high-risk infants, ie. early vs late, have produced equivocal results. The aim of this study was to investigate whether "critical periods" for intervention exist. Among the high-risk infants (previously assigned to one of 3 random samples), who achieved follow-up at 5 yrs of age, 36 received a prescribed intervention as soon in NICU (very early treatment group: ET Gr). The other 21 infants began to receive the treatment after discharge (postdischarge treatment group: PDT Gr.). The remaining 27 received only traditional care both during hospitalization and after discharge (control group: C Gr.). Treated infants both ET Gr. and PDT Gr., exhibit significantly better neurological status than control infants, as assessed by Touwen Neurological Examination. They also scored significantly higher at standard psychological tests and have a significantly lower incidence of developmental sequelae. Insteated not significant differences of any of the measured outcomes were found between the ET Gr. and the PDT Gr. Delay in initiating intervention does not appear to reduce the benefits. Recent advances in the field of the developmental psychology have resulted in some new understandings of the early human behavior and the role of learning experiences in the developmental processes. Although learned changes in behavior occur from the earliest 2 and 4 months, when major physiologic/maturational changes are occurring (Lipsitt, 1986). Our findings are in accordance with the above statement and suggest that the crucial period for intervention is in 2 to 4 first months of life. Further studies are needed to solve the many unanswered questions in this controversial filed.
Pisaturo
C
C
Divisione e Cattedra di Neuropsichiatria Infantile, Istituto G. Gaslini, Genova-Quarto.
Silvestri
G
G
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D009460:Neurologic Examination; D009468:Neuromuscular Diseases / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D011581:Psychological Tests; D011596:Psychomotor Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D012307:Risk Factors; D013997:Time Factors
L'epoca di inizio dell'intervento riabilitativo nel neonato a rischio neurologico.