Effectiveness of individualized developmental care for low-risk preterm infants : behavioral and electrophysiologic evidence

• Published in: Pediatrics (Evanston) Vol. 96; no. 5; pp. 923 - 932
• Main Authors: BUEHLER, D. M, ALS, H, DUFFY, F. H, MCANULTY, G. B, LIEDERMAN, J
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL American Academy of Pediatrics 01-11-1995
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Babies; Behavior; Biological and medical sciences; Care and treatment; Child Development; Electrophysiology; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; Hospitals; Humans; Infant Behavior; Infant, Newborn; Infant, Premature - physiology; Infant, Premature - psychology; Infants (Premature); Intensive care medicine; Intensive Care, Neonatal - methods; Male; Medical sciences; Neurology; Nurseries; Pediatrics; Premature infants; Risk Factors; Services; Treatment Outcome; Human; Premature; Cartography; Pregnancy disorders; Low birth weight; Neonatology; Electroencephalography; Method; Stress; Newborn diseases; Newborn; Nursing; Prematurity; Body movement; Behavior; Comparative study; Adaptation
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.96.5.923

We assessed the effectiveness of individualized developmental support in the special care nursery for low-risk preterm infants.
A university-affiliated teaching hospital.
Twelve healthy full-term infants, and 24 low-risk preterm infants randomly assigned to a control or an experimental group.
The preterm control group received standard care and the preterm experimental group received individualized developmental care at the same special care nursery.
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.
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.
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.