title: Early communication in preterm infants following intervention in the NICU.
abstract: BACKGROUND
  Despite ongoing improvements in clinical care, preterm infants experience a variety of stressors in the first weeks of life, including necessary medical procedures, which may affect development. Some stress-reduction programmes based in the Neonatal Intensive Care Unit (NICU) have reported a positive impact on development. In particular, trials of the Mother-Infant Transaction Program (MITP) have shown positive short and longer term effects, and are based on training parents to recognise and minimise stress responses in preterm infants.
  
  
  OBJECTIVE
  To evaluate the impact on early developmental milestones of an enhanced MITP (PremieStart) delivered over an extended period in the NICU.
  
  
  METHODS
  This was a parallel 2-group randomised controlled trial involving 109 women with 123 infants born at <30weeks gestation assessed initially at term-equivalent age and then at 6 months' corrected-age.
  
  
  RESULTS
  Intervention mothers were more sensitive in providing infant care, stressed their infants less, showed greater awareness of, and responded more appropriately to, negative infant cues (p < 0.05 in each case). Intervention infants displayed significantly lower stress when being bathed by mothers at term-equivalent age (p < 0.05). At 6 months corrected-age, intervention infants showed higher mean scores on the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist. The strongest effects appeared in Symbolic behaviour (p = 0.05) and this was reflected in the Total score (p < 0.05).
  
  
  CONCLUSIONS
  As significant cognitive and language deficits are reported in longitudinal studies of preterm children, an intervention that improves early infant communication abilities is promising, especially since previous research suggests that the strongest benefits may emerge at later ages.
authors.affiliation: Parent-Infant Research Institute, Department of Clinical & Health Psychology, Austin Health, Melbourne, Victoria 3081, Australia. jeannette.milgrom@austin.org.au
authors.forename: Jeannette
authors.initials: J
authors.lastname: Milgrom
authors.forename: Carol
authors.initials: C
authors.lastname: Newnham
authors.forename: Paul R
authors.initials: PR
authors.lastname: Martin
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
authors.forename: Rod W
authors.initials: RW
authors.lastname: Hunt
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Achenbach
authors.forename: Carmel
authors.initials: C
authors.lastname: Ferretti
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Holt
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Inder
authors.forename: Alan W
authors.initials: AW
authors.lastname: Gemmill
mesh_terms: D000328:Adult; D002657:Child Development; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods*; D007804:Language Development; D008297:Male; D009034:Mother-Child Relations; D013315:Stress, Psychological / Q000628:therapy
keywords: Child development; Early communication; Early intervention; Maternal sensitivity; Neonatal Intensive Care Unit; Preterm infants; Randomised controlled trial; The Mother–Infant Transaction Program