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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predictive Value of Developmental Quotient at Three Months in Determination of Neurodevelopmental Outcomes at One
Suchit Suresh Tamboli1, Ram Dhongade2, Desle Vasant3
1Chiranjiv Child Development and Research Institute, Ahmednagar, MHS, India.
Insights
Early intervention programs involving mothers significantly improve neurodevelopmental outcomes in high-risk infants. These standardized stimulation programs enhance both mental and motor development quotients (DQ) by one year of age.
Area of Science:
- Neonatal care and developmental pediatrics.
- Infant neurodevelopmental assessment and intervention strategies.
Background:
- High-risk neonates require interventions to optimize developmental trajectories.
- This study compares neurodevelopmental outcomes in high-risk infants versus a control group at one year of age.
Discussion:
- The study highlights the effectiveness of maternal-led stimulation programs in improving infant neurodevelopment.
- Therapist involvement was crucial for cases with persistent delays despite initial stimulation.
Key Insights:
- Indian Standardized Stimulation Programs, utilizing mothers as therapists, significantly improved neurodevelopmental outcomes.
- Both mental and motor development quotients (DQ) showed significant reductions in developmental delay post-intervention.
- The positive impact on neurodevelopment was observed in both high-risk and low-risk groups, with similar improvements.
Outlook:
- Further research could explore long-term neurodevelopmental benefits and cost-effectiveness of such programs.
- Adaptation of these maternal-led stimulation programs for diverse cultural contexts may be beneficial.
- Integration of such programs into routine neonatal care could enhance developmental outcomes globally.
Abstract:
Background:High-risk neonates need intervention to improve their development. Objective:To compare the neurodevelopmental outcomes at one year of age in high-risk babies (cases) and normal babies (control group). Study design: Case comparison study. Materials and methods:Two groups of participants were formed by simple random sampling: one composed of 245 high-risk babies (cases) and the other one of 245 normal babies (controls). Babies were stratified into high and low risk according to the medical diagnosis given in the neonatal intensive care unit and at three months. Standard care was offered to both groups, and subjects in the high-risk group has additionally received stimulation programs from their mother, who were trained. A monthly follow-up of the stimulation program was done. Therapist involvement was needed when the delay was observed despite stimulation given by the mother. Outcomes:Stimulation programs given since birth improve mental and motor development quotient (DQ). Results:Results were interpreted taking the DQ of 70 as a cut-off value for assessing developmental delay. McNemar's test was used to compare changes in proportions of pre- and post-stimulation abnormal outcomes. After one year, a significant reduction in mental developmental delay was observed in both high- and low-risk groups (35.1% and 45.9%, respectively), with this reduction being similar in the two groups as 95% confidence intervals for change in the proportion of developmental delay were overlapping. Likewise, motor development delay has also significantly decreased in both groups by 32.9% and 41.9%, respectively. Conclusions:Indian Standardized Stimulation Programs considering the mother as a therapist helps improve neurodevelopmental outcomes based on DQ assessment using the Developmental Assessment Scale for Indian Infants (DASII), an Indian modification of Bayley scale of infant development (BSID).
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