Every year, 15 million preterm infants are born, and most spend their first weeks in neonatal intensive care units (NICUs) 1. Although essential for the support and survival of these infants, NICU ...sensory environments are dramatically different from those in which full-term infants mature and thus likely impact the development of functional brain organization 2. Yet the integrity of sensory systems determines effective perception and behavior 3, 4. In neonates, touch is a cornerstone of interpersonal interactions and sensory-cognitive development 5–7. NICU treatments used to improve neurodevelopmental outcomes rely heavily on touch 8. However, we understand little of how brain maturation at birth (i.e., prematurity) and quality of early-life experiences (e.g., supportive versus painful touch) interact to shape the development of the somatosensory system 9. Here, we identified the spatial, temporal, and amplitude characteristics of cortical responses to light touch that differentiate them from sham stimuli in full-term infants. We then utilized this data-driven analytical framework to show that the degree of prematurity at birth determines the extent to which brain responses to light touch (but not sham) are attenuated at the time of discharge from the hospital. Building on these results, we showed that, when controlling for prematurity and analgesics, supportive experiences (e.g., breastfeeding, skin-to-skin care) are associated with stronger brain responses, whereas painful experiences (e.g., skin punctures, tube insertions) are associated with reduced brain responses to the same touch stimuli. Our results shed crucial insights into the mechanisms through which common early perinatal experiences may shape the somatosensory scaffolding of later perceptual, cognitive, and social development.
•Preterm infants’ first weeks can be in neonatal intensive care units (NICUs)•NICU treatments for improving neurodevelopmental outcomes rely heavily on touch•Prematurity and touch quality determine the extent of attenuated brain responses•Perinatal somatosensory experiences may scaffold later development
Maitre et al. show that the degree of prematurity at birth determines the extent of attenuated brain responses to touch. This directly depended on the quality of touch experiences, even when controlling for prematurity and analgesics. Perinatal experiences shape the somatosensory scaffolding of later perceptual, cognitive, and social development.
We conducted a randomized trial to test the hypothesis that mother's voice played through a pacifier-activated music player (PAM) during nonnutritive sucking would improve the development of sucking ...ability and promote more effective oral feeding in preterm infants.
Preterm infants between 34 0/7 and 35 6/7 weeks' postmenstrual age, including those with brain injury, who were taking at least half their feedings enterally and less than half orally, were randomly assigned to receive 5 daily 15-minute sessions of either PAM with mother's recorded voice or no PAM, along with routine nonnutritive sucking and maternal care in both groups. Assignment was masked to the clinical team.
Ninety-four infants (46 and 48 in the PAM intervention and control groups, respectively) completed the study. The intervention group had significantly increased oral feeding rate (2.0 vs. 0.9 mL/min, P < .001), oral volume intake (91.1 vs. 48.1 mL/kg/d, P = .001), oral feeds/day (6.5 vs. 4.0, P < .001), and faster time-to-full oral feedings (31 vs. 38 d, P = .04) compared with controls. Weight gain and cortisol levels during the 5-day protocol were not different between groups. Average hospital stays were 20% shorter in the PAM group, but the difference was not significant (P = .07).
A PAM using mother's voice improves oral feeding skills in preterm infants without adverse effects on hormonal stress or growth.
We performed a systematic review and evaluated the level of evidence of vision interventions and assessments for infants at high risk for or with a diagnosis of cerebral palsy from zero to two years ...of age.
Articles were evaluated based on the level of methodologic quality, evidence, and clinical utilization.
Thirty publications with vision assessments and five with vision interventions met criteria for inclusion. Assessments included standard care neuroimaging, electrophysiology, and neuro-ophthalmologic examination techniques that are utilized clinically with any preverbal or nonverbal pediatric patient.
The overall level of evidence of interventions was strong for neuroprotective interventions such as caffeine and hypothermia but weak for surgery, visual training, or developmental programs.
There are few evidence-based interventions and assessments that address cerebral/cortical visual impairment-related needs of infants and toddlers at high risk for or with cerebral palsy. Recommendation guidelines include the use of three types of standard care methodologies and two types of protective interventions.
Atypical maturation of auditory neural processing contributes to preterm-born infants' language delays. Event-related potential (ERP) measurement of speech-sound differentiation might fill a gap in ...treatment-response biomarkers to auditory interventions. We evaluated whether these markers could measure treatment effects in a quasi-randomized prospective study. Hospitalized preterm infants in passive or active, suck-contingent mother's voice exposure groups were not different at baseline. Post-intervention, the active group had greater increases in/du/-/gu/differentiation in left frontal and temporal regions. Infants with brain injury had lower baseline/ba/-/ga/and/du/-/gu/differentiation than those without. ERP provides valid discriminative, responsive, and predictive biomarkers of infant speech-sound differentiation.
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Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Clinical guidelines recommend using neuroimaging, Prechtls' General Movements Assessment (GMA), and Hammersmith Infant Neurological Examination (HINE) to diagnose cerebral palsy (CP) in infancy. ...Previous studies provided excellent sensitivity and specificity for each test in isolation, but no study has examined the pooled predictive power for early diagnosis.
We performed a retrospective case-control study of 441 high-risk infants born between 2003 and 2014, from three Italian hospitals. Infants with either a normal outcome, mild disability, or CP at two years, were matched for birth year, gender, and gestational age. Three-month HINE, GMA, and neuroimaging were retrieved from medical records. Logistic regression was conducted with log-likelihood and used to determine the model fit and Area Under the Curve (AUC) for accuracy.
Sensitivity and specificity for detecting CP were 88% and 62% for three-month HINE, 95% and 97% for absent fidgety GMs, and 79% and 99% for neuroimaging. The combined predictive power of all three assessments gave sensitivity and specificity values of 97.86% and 99.22% (PPV 98.56%, NPV 98.84%).
CP can be accurately detected in high-risk infants when these test findings triangulate. Clinical implementation of these tools is likely to reduce the average age when CP is diagnosed, and intervention is started.
Abstract Background High-risk infant follow-up programs provide early identification and referral for treatment of neurodevelopmental delays and impairments. In these programs, a standardized ...neurological examination is a critical component of evaluation for clinical and research purposes. Methods To address primary challenges of provider educational diversity and standardized documentation, we designed an approach to training and implementation of the Hammersmith Infant Neurological Examination with precourse materials, a workshop model, and adaptation of the electronic medical record. Conclusions Provider completion and documentation of a neurological examination were evaluated before and after Hammersmith Infant Neurological Examination training. Standardized training and implementation of the Hammersmith Infant Neurological Examination in a large high-risk infant follow-up is feasible and effective and allows for quantitative evaluation of neurological findings and developmental trajectories.
Early key visual skills, such as tracking objects, sustaining gaze, and shifting attention, rapidly develop within the first 6 months of infant life. These abilities play a significant role in the ...development of cognitive functions but are frequently compromised in infants at risk of developing neurodevelopmental disorders. This systematic review evaluates the potential of early vision function in the prediction of cognition at or above 12 months. Five databases were searched for relevant articles, and their quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool. Eight studies were suitable, including 521 preterm-born infants at varying risk of developing Cerebral Palsy (CP). Each study showed a significant correlation between vision and cognitive outcome. Predictive analysis including sensitivity and specificity was possible for three studies. Methodological quality was variable. Sensitivity ranged between 57 and 100% in the vision function assessments items, while specificity ranged from 59 to 100%. In conclusion, early vision showed strong correlation with cognition ≥ 12 months. While no single vision assessment was found to be superior, evaluation of specific functions, namely fixation and following, both at term age and between 3 and 6 months, demonstrated strong predictive validity.
Aim
To compare the effectiveness of an intensive‐intermittent vs. standard spaced protocolised music therapy intervention on supporting developmental milestone acquisition of infants >44 weeks ...postmenstrual age (PMA) hospitalised in a Neonatal Intensive Care Unit (NICU).
Method
This was a comparative effectiveness study of infants 44–66 weeks PMA with a projected NICU stay of at least one month from recruitment. Infants were randomised to one of two treatment groups: traditional therapy (2x/week) and intermittent‐intensive (4x/week, off, 4x/week, off). Both groups received the same number of sessions over a 4‐week period. Sessions at the start and end of the treatment period were video recorded. Two masked researchers reviewed and coded videos. Milestones used for video recording were adapted from the Developmental Assessment of Young Children.
Results
Twenty‐four infants participated, with groups matched for birth age, PMA at start of study, race, IVH severity, and respiratory support. Total and motor composite scores were higher post‐intervention (Cohen's d = 0.71 and 0.97, both p < 0.01), with the same degree of skill acquisition found for both intervention groups.
Conclusion
A developmental music therapy protocol supports developmental skills acquisition of post‐term infants in a NICU. Similar outcomes for both groups provide therapists with varying treatment dosing options to best support their patients.
The article addresses to the problem of theoretical study of the problem of academic procrastination and its neuropsychological prevention for students. It describes neuropsychological means of ...prevention of academic procrastination with the recommendation to take into account the results of psychodiagnostics and analysis of some conditions and causes of the studied phenomenon. The psychological portrait of a student-procrastinator is analised the components of which are individual psychological, psychophysiological and personal characteristics. The role of the relationship between self-regulation and student learning motivation in foreign literature is also summarized. Peculiarities of educational burnout of procrastination students on the basis of foreign and domestic works are noted. It was revealed the essence of development and introduction of neuropsychological means of academic procrastination – conditioning of dynamic process of emotional and cognitive transformations in self-regulation of the student’s personality and improvement of his/her educational success. The author’s system of neuropsychological exercises for neuropsychological prevention of academic procrastination is presented in the article considering the neuropsychological mechanisms of its development at the cognitive-emotional-bodily systemic level. It is noted that procrastination may be associated with a negative emotional and mental response to the introduction of quarantine and the transition to distance learning, and even with the new opportunities. It is emphasized that neuropsychological prevention of academic procrastination should be combined with programs for the formation of future professionals thinking and development of a high level of independence, discipline and responsibility in educational activities as a successful strategy to prevent burnout and actualize motivation to learn at the integration level.
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