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Updated: Oct 20, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Sensory-based interventions in the NICU: systematic review of effects on preterm brain development
Mercedes I Beltrán1, Jeroen Dudink2, Tamara M de Jong3
1Graduate School of Life Sciences, Utrecht University, Utrecht, The Netherlands.
Insights
Sensory interventions in the neonatal intensive care unit (NICU) show potential for improving preterm infant neurodevelopment. However, varied study designs and outcomes limit current clinical practice guidelines for these non-pharmacological approaches.
Area of Science:
- Neonatal neuroscience
- Developmental psychology
- Clinical neonatology
Background:
- Preterm infants face risks for abnormal brain development and neurobehavioral issues.
- Non-pharmacological, sensory-based interventions are used in neonatal intensive care units (NICUs) to enhance early neurodevelopment.
- The impact of these sensory interventions on the developing preterm brain remains largely uninvestigated.
Approach:
- A systematic review of randomized controlled trials (RCTs) published in the last 20 years was performed.
- Studies focused on early, non-pharmacological, sensory-based interventions for preterm infants in the NICU.
- Twelve RCTs examining auditory, tactile, and multisensory interventions were included.
Key Points:
- Heterogeneity in intervention types and outcome measures across studies was significant.
- Auditory, tactile, and multisensory interventions were identified as key areas of focus.
- Evidence suggests potential short-term neurodevelopmental benefits, but brain development effects are not well-defined.
Conclusions:
- The diversity in interventions and outcome measures complicates the synthesis of results for clinical application.
- Existing literature and methodological challenges hinder the development of evidence-based guidelines for sensory interventions in the NICU.
- This review underscores the need for standardized methodologies in future RCTs to better understand sensory intervention effects on preterm infant brain development.
Background:
Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear.
Methods:
A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth.
Results:
Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions.
Conclusions:
Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU.
Impact:
This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development. Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice. This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.
