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Telehealth Delivery of the Homeostasis-Enrichment-Plasticity Approach for Premature Infants With Developmental Risks:
Aymen Balikci1, Gamze Cagla Sirma2, Izgi-Miray Demirbag1
1Sense On Ltd, Istanbul, Turkey.
Insights
Telehealth delivery of the Homeostasis-Enrichment-Plasticity (HEP) Approach proved feasible and safe for preterm infants, showing positive developmental and psychosocial outcomes. This family-centered model offers a promising accessible intervention for high-risk infants.
Area of Science:
- Developmental Pediatrics
- Telehealth Interventions
- Neuroplasticity Research
Background:
- Preterm delivery presents significant neurodevelopmental risks, necessitating early intervention.
- Logistical and financial barriers often limit access to crucial early intervention services.
- The Homeostasis-Enrichment-Plasticity (HEP) Approach is a family-centered model promoting infant development through enriched environments.
Purpose of the Study:
- To evaluate the feasibility, safety, and acceptability of the HEP Approach delivered via telehealth.
- To assess the sensitivity to change of developmental outcomes using the HEP Approach in preterm infants.
- To determine the effectiveness of a telehealth-based family-centered early intervention for at-risk premature infants.
Main Methods:
- A pre-post exploratory feasibility study involving 16 preterm infants (4-12 months corrected age).
- A 12-week intervention with weekly remote sessions focusing on enrichment, exploration, and parental guidance.
- Feasibility and acceptability assessed via questionnaire; developmental outcomes measured using standardized tools (YCPEM, ASQ, AIMS, IMP, DASS).
Main Results:
- High adherence (100%) and retention (87.5%) confirmed robust feasibility.
- Parents reported high satisfaction (86%-100%), affirming safety and acceptability with no adverse events.
- Significant improvements observed in infant participation, motor skills, communication, socio-emotional domains, and caregiver well-being (P<.05).
Conclusions:
- Telehealth implementation of the HEP Approach is feasible, safe, and well-accepted by families of preterm infants.
- The intervention demonstrated positive impacts on infant development and caregiver psychosocial status.
- Findings support the HEP Approach via telehealth as a viable, accessible framework, warranting further validation through RCTs.
Background:
Preterm delivery is an increasing worldwide health concern linked to increased neurodevelopmental risks. Early intervention is crucial for harnessing neuroplasticity to enhance developmental and functional performance outcomes; however, access to early intervention is frequently hindered by logistical, financial, and labor constraints. The Homeostasis-Enrichment-Plasticity (HEP) Approach is a family-centered early intervention model based on enriched environments, designed to improve infants' sensory-motor, cognitive, and socio-emotional development.
Objective:
This study aimed to assess the feasibility, safety, acceptability, and outcomes sensitivity to change of implementing the HEP Approach through telehealth for premature infants at developmental risk.
Methods:
A pre-post exploratory feasibility study was performed, including 16 preterm infants (aged 4-12 months corrected age), of whom 14 completed the study. The 12-week intervention included weekly remote sessions focused on environmental enrichment, active exploration, and parental guidance. The feasibility and acceptability were evaluated using a 24-item questionnaire. Developmental outcomes were assessed with the Young Children's Participation and Environment Measure, Ages and Stages Questionnaire (ASQ), Alberta Infant Motor Scale, Infant Motor Profile, and Depression Anxiety Stress Scales.
Results:
High adherence (14/14, 100%) and retention (14/16, 87.5%) rates demonstrated robust feasibility. Parents indicated 86%-100% agreement across all feasible criteria, affirming safety, satisfaction, and acceptability. No adverse incidents were reported. Changes were identified in participation (Young Children's Participation and Environment Measure), motor development (Alberta Infant Motor Scale, Infant Motor Profile, and ASQ), communication and social-emotional domains (ASQ), and caregiver well-being (Depression Anxiety Stress Scales) (P<.05).
Conclusions:
The telehealth implementation of the HEP Approach demonstrated feasibility, safety, and strong acceptance among families, along with quantifiable developmental and psychosocial changes. These initial findings endorse the model's viability as an accessible, family-oriented telehealth framework for infants born preterm. Future randomized controlled and longitudinal studies are necessary to validate intervention efficacy and scalability.
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