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Is early occupational therapy in extremely preterm infants of benefit in the long run?
Teija Salokorpi1, Terttu Rautio, Eero Kajantie
1Department of Child Neurology, Hospital for Children and Adolescents, Helsinki University Central Hospital, PL 280 HUCH,00029 Helsinki, Finland. teija.salokorpi@cch.fimnet.fi
Insights
Occupational therapy using sensory integration (SI) and neurodevelopmental therapy (NDT) showed short-term social gains in extremely low birth weight (ELBW) infants. However, long-term neurological development showed no significant differences between groups.
Area of Science:
- Pediatrics
- Developmental Neuroscience
- Occupational Therapy
Background:
- Extremely low birth weight (ELBW) infants face risks for developmental delays.
- Early intervention is crucial for optimizing neurological development in high-risk infants.
- Sensory integration (SI) and neurodevelopmental therapy (NDT) are common therapeutic approaches.
Purpose of the Study:
- To investigate the long-term effects of occupational therapy (SI and NDT) on the neurological development of ELBW infants.
- To assess developmental outcomes at multiple time points from infancy through preschool age.
Main Methods:
- Prospective case-control study involving 126 ELBW infants.
- Matched pairing based on developmental risk scores at 3 months.
- Intervention group received 6 months of weekly occupational therapy (SI/NDT) from 6-12 months corrected age.
- Follow-up assessments at 12 months, 2 years, and 4 years (Miller Assessment for Preschoolers).
Main Results:
- Intervention group showed significantly better social development at 12 months.
- No significant differences in neurological, neuropsychological, or speech therapy assessments at 2 years.
- No significant differences detected by the Miller Assessment for Preschoolers at 4 years.
Conclusions:
- The studied occupational therapy intervention (SI/NDT) did not yield detectable long-term neurological development benefits in ELBW infants.
- While short-term social improvements were observed, these did not translate to sustained advantages in overall neurological development.
- Further research may be needed to explore optimal timing, intensity, or types of interventions for ELBW infants.
Abstract:
A total of 126 infants with extremely low birth weight (ELBW; <1000 g) were enrolled in a prospective case-control study in order to examine the effect of occupational therapy based on sensory integration (SI) and neurodevelopmental therapy (NDT) on neurological development. The children were grouped as matched pairs on the basis of determined developmental risk scores assessed at the age of 3 months. The intervention children had a 6-month period of weekly occupational therapy from the corrected age of 6-12 months. The follow-up showed that the social development of the intervention children was significantly better at the age of 12 months, but at the age of 2 years the groups had equal developmental scores in neurological, neuropsychological and speech therapy assessments. The Miller assessment for pre-schoolers (MAP) performed in a total of 96 (92%) of the study children at the age of 4 years failed to demonstrate any significant differences between the groups. It is concluded that this amount of occupational therapy in ELBW infants does not have any detectable effect on long-term neurological development.