Jeannette Milgrom1,2, Paul R Martin3, Carol Newnham1, Christopher J Holt1,4, Peter J Anderson5,6, Rod W Hunt6,7,8, John Reece4, Carmel Ferretti1, Thomas Achenbach9, Alan W Gemmill10. 1. Parent-Infant Research Institute, Department of Clinical & Health Psychology, Austin Health, Melbourne, VIC, 3081, Australia. 2. Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, 3010, Australia. 3. Research School of Psychology, The Australian National University, Canberra, ACT, 2000, Australia. 4. Discipline of Psychological Sciences, Australian College of Applied Psychology, Melbourne, VIC, 3000, Australia. 5. Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, VIC, 3800, Australia. 6. Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia. 7. Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, VIC, 3052, Australia. 8. Departments of Obstetrics and Gynaecology, and Paediatrics, University of Melbourne, Melbourne, VIC, 3052, Australia. 9. Department of Psychiatry, University of Vermont, Burlington, VT, 05405, USA. 10. Parent-Infant Research Institute, Department of Clinical & Health Psychology, Austin Health, Melbourne, VIC, 3081, Australia. alan.gemmill@austin.org.au.
Abstract
BACKGROUND: The landmark findings of the Mother-Infant Transaction Program (MITP) showing improved neurodevelopment of preterm infants following parent-sensitivity training delivered in the neonatal intensive care unit have not been consistently replicated. This study evaluated an MITP-type intervention in terms of neurobehavioural development to preschool age. METHODS: A randomised controlled trial involved 123 very preterm and extremely preterm infants allocated to either aparent-sensitivity intervention (PremieStart, n = 60) or to standard care (n = 63). When children were 2 and 4.5 years corrected age, parents completed the Child Behavior Checklist (CBCL). General development was assessed at 2 years with the Bayley Scales of Infant Development (Bayley-III). At 4.5 years, cognitive functioning was assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and executive functioning with the NEPSY-II. RESULTS: There were no significant between-group differences in behaviour problems at 2 or 4.5 years, general development at 2 years, or cognitive and executive functioning at 4.5 years. CONCLUSION: Advances in the quality of neonatal intensive care may mean that MITP-type interventions now have limited additional impact on preterm infants' long-term neurobehavioural outcomes. The gestational age of infants and the exact timing of intervention may also affect its efficacy.
RCT Entities:
BACKGROUND: The landmark findings of the Mother-Infant Transaction Program (MITP) showing improved neurodevelopment of preterm infants following parent-sensitivity training delivered in the neonatal intensive care unit have not been consistently replicated. This study evaluated an MITP-type intervention in terms of neurobehavioural development to preschool age. METHODS: A randomised controlled trial involved 123 very preterm and extremely preterm infants allocated to either a parent-sensitivity intervention (PremieStart, n = 60) or to standard care (n = 63). When children were 2 and 4.5 years corrected age, parents completed the Child Behavior Checklist (CBCL). General development was assessed at 2 years with the Bayley Scales of Infant Development (Bayley-III). At 4.5 years, cognitive functioning was assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and executive functioning with the NEPSY-II. RESULTS: There were no significant between-group differences in behaviour problems at 2 or 4.5 years, general development at 2 years, or cognitive and executive functioning at 4.5 years. CONCLUSION: Advances in the quality of neonatal intensive care may mean that MITP-type interventions now have limited additional impact on preterm infants' long-term neurobehavioural outcomes. The gestational age of infants and the exact timing of intervention may also affect its efficacy.