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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Sustained developmental effects of the infant behavioral assessment and intervention program in very low birth weight
Janeline W P Van Hus1, Martine Jeukens-Visser, Karen Koldewijn
1Department of Rehabilitation, Academic Medical Center, University of Amsterdam, and Department of Neonatology, Emma's Children's Hospital, Amsterdam, The Netherlands. J.W.vanhus@amc.uva.nl
Insights
The Infant Behavioral Assessment and Intervention Program (IBAIP) improved cognitive and motor skills in very low birth weight (VLBW) infants by age 5.5 years corrected age (CA). This early intervention positively impacted performance IQ, ball skills, and visual-motor integration.
Area of Science:
- Developmental Pediatrics
- Neonatal Follow-up
- Child Psychology
Background:
- Very low birth weight (VLBW) infants face developmental challenges.
- Early neurobehavioral interventions aim to mitigate these risks.
- Long-term outcomes of such programs require evaluation.
Purpose of the Study:
- To assess the Infant Behavioral Assessment and Intervention Program's (IBAIP) impact on VLBW infants.
- To evaluate cognitive, neuromotor, and behavioral development at 5.5 years corrected age (CA).
Main Methods:
- A randomized controlled trial involving VLBW infants.
- Intervention group received IBAIP post-discharge until 6 months CA.
- Control group received standard care; assessments at 5.5 years CA included cognitive, motor, and visual-motor integration tests.
Main Results:
- The intervention group showed significantly fewer instances of low verbal and performance IQ scores.
- Adjusted analysis revealed a significant positive effect on performance IQ.
- Improved scores were observed in specific cognitive (block design, vocabulary), motor (aiming, catching), and visual-motor integration tasks.
Conclusions:
- The IBAIP demonstrates a positive, lasting effect on VLBW infant development.
- Key improvements noted in performance IQ, ball skills, and visual-motor integration at 5.5 years CA.
- Early neurobehavioral intervention is beneficial for long-term developmental outcomes.
Objective:
To evaluate the effect of the Infant Behavioral Assessment and Intervention Program (IBAIP) in very low birth weight (VLBW) infants on cognitive, neuromotor, and behavioral development at 5.5 years corrected age (CA).
Study Design:
In a randomized controlled trial, 86 VLBW infants received post discharge IBAIP intervention until 6 months CA, and 90 VLBW infants received standard care. At 5.5 years CA, cognitive and motor development, and visual-motor integration were assessed with the Wechsler Preschool and Primary Scale of Intelligence, third Dutch version, the Movement Assessment Battery for Children, second edition, and the Developmental Test of Visual Motor Integration. Neurologic conditions were assessed with the neurologic examination according to Touwen, and behavior with the Strengths and Difficulties Questionnaire.
Results:
At 5.5 years CA, 69 children in the intervention and 67 children in the control group participated (response rate 77.3%). Verbal and performance IQ-scores<85 occurred significantly less often in the intervention than in the control group (17.9% vs 33.3%, P=.041, and 7.5% vs 21.2%, P=.023, respectively). However, after adjustment for differences, only the OR for performance IQ was significant: 0.24, 95% CI: 0.06-0.95. Adjusted mean scores on Wechsler Preschool and Primary Scale of Intelligence, third version subtasks block design and vocabulary, the Movement Assessment Battery for Children, second edition component aiming and catching, and the Developmental Test of Visual Motor Integration were significantly better in the intervention group. No intervention effect was found on the Strengths and Difficulties Questionnaire.
Conclusion:
The IBAIP leads, 5 years after the early neurobehavioral intervention, to improvements on performance IQ, ball skills, and visual-motor integration at 5.5 years CA.
