One-year outcome of auditory-tactile-visual-vestibular intervention in the neonatal intensive care unit: effects of severe prematurity and central nervous system injury.
Thirty-seven infants with severe central nervous system injury or extreme prematurity were randomly assigned to a multisensory (auditory-tactile-visual-vestibular) intervention or control group. Intervention began in the hospital at 33 weeks' postconceptional age and continued twice daily in the home until 2 months' corrected age. Mother-infant interactions during feedings were videotaped, and the Bayley Scales of Infant Development were administered. Control mothers stimulated their infants more during feeding, but these significant differences dissipated by 4 months. The presence of periventricular leukomalacia was associated with significantly poorer mental development, regardless of group assignment. Experimental infants tended to exhibit better motor and mental performance and had 23% fewer cerebral palsy diagnoses at 1 year, but these trends were not statistically significant. The type of brain injury was more important in determining 1-year developmental outcome than type of postnatal experience, suggesting that periventricular leukomalacia presents a major challenge for infant development.
Nelson
M N
MN
Department of Pediatrics, Rush-Presbyterian-St. Luke's Medical Center, USA.
White-Traut
R C
RC
Vasan
U
U
Silvestri
J
J
Comiskey
E
E
Meleedy-Rey
P
P
Littau
S
S
Gu
G
G
Patel
M
M
D001720:Birth Injuries / Q000534:rehabilitation*; D002490:Central Nervous System / Q000293:injuries*; D002547:Cerebral Palsy / Q000209:etiology; D002657:Child Development; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000150:complications* / Q000209:etiology; D008297:Male; D009034:Mother-Child Relations; D019957:Motor Skills Disorders / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D012684:Sensory Thresholds; D016896:Treatment Outcome