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Early Intervention Services Improve School-age Functional Outcome Among Neonatal Intensive Care Unit Graduates

Jonathan S Litt1, M Maria Glymour2, Penny Hauser-Cram3

  • 1Harvard School of Public Health, Boston, Mass; Harvard Medical School, Boston, Mass; Beth Israel Deaconess Medical Center, Boston, Mass.

Academic Pediatrics
|August 7, 2017
PubMed

Insights

Early intervention services significantly improve school-age functional outcomes for high-risk infants. Longer, more intense programs yield better academic and physical skills, highlighting the importance of timely referral after NICU discharge.

Area of Science:

  • Pediatrics
  • Developmental Psychology
  • Public Health

Background:

  • High-risk infants often require early intervention (EI) services to mitigate developmental delays.
  • Understanding the long-term impact of EI on functional outcomes is crucial for optimizing care.
  • Previous research has explored various aspects of EI, but school-age outcomes require further investigation.

Purpose of the Study:

  • To evaluate the effect of community-based early intervention (EI) services on the functional outcomes of high-risk infants at school age.
  • To determine if the duration, intensity, and breadth of EI services influence academic and physical skills in kindergarten.
  • To assess the association between delayed EI enrollment and school-age performance.

Main Methods:

  • Retrospective cohort study utilizing data from the National Early Intervention Longitudinal Study.
  • Inclusion criteria: NICU admission, birth weight >400g, gestational age >23 weeks.
  • Kindergarten outcomes assessed by teacher ratings; statistical analysis employed marginal structural models with inverse probability of treatment weighting to control for confounding.

Main Results:

  • 47% of participants had average/above-average academic skills, and 71% had average/above-average physical skills.
  • Delayed EI enrollment was associated with lower odds of average/above-average academic (aOR: 0.65) and physical skills (aOR: 0.61).
  • Greater service duration, intensity, and breadth were associated with higher academic and physical skills ratings, with some associations approaching statistical significance.

Conclusions:

  • Community-based early intervention services are associated with improved functional outcomes in high-risk children at school age.
  • Longer, more intense, and broader EI services correlate with better kindergarten academic and physical skills.
  • Findings support the effectiveness of large-scale EI programs and emphasize the importance of prompt referral after NICU discharge.
Abstract

Keywords:
early interventionpreterm infantschool outcomes

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