Sensory integration intervention and the development of the extremely low to very low birth weight premature infant

[摘要] English: This study aimed to investigate the effect of ASI intervention on the development of premature infants with ELBW to VLBW, within the first 12 months. ASI intervention approach is from the sensory integration theoretical and practice frame of reference used in occupational therapy. ASI provides playful meaningful activities aimed at enhancing sensory processing abilities of the brain and ultimately lead to appropriate adaptive functioning in daily life. From the literature review it was evident that newborn premature infants are at risk for possible SI difficulties and developmental delays due to their immature CNS and possible times of medical instability, discomfort, pain and stress during the first weeks or months after birth. Research on effective developmental intervention strategies for premature infants is however limited and previous research related to ASI intervention on the development of the premature infant post discharge from the NICU could not be found by the researcher. Since SI forms the underlying foundation for learning and social behavior (Ayers, 2008:7), research in this field is essential for prevention of developmental delays and learning difficulties of premature infants. The research proposal for this study was approved by the Ethics Committee, Faculty of Health Sciences of the University of the Free State (ECUFS no. 117/2011). Permission was obtained from appropriate authorities to conduct the study at the Occupational Therapy Department of Universitas Academic Hospital. A pilot study was done to determine the feasibility of the study. A quantitative research approach was used to determine the effect of ASI intervention on the development of the ELBW to VLBW premature infant. Through a pre-test/post-test experimental design, the population of 24 premature infants was randomly divided into an experimental and control group with 12 infants in each group respectively. Infants were matched according to their corrected ages and gender. Participants had corrected ages between four and 10 months, VLBW to ELBW, adhered to the inclusion criteria for the study and were referred from the High-Risk Infant Clinic at Universitas Academic Hospital. The developmental status of participants was determined with the Bayley III Scales of Infant and Toddler Development (Bayley, 2006a), Test of Sensory Function in Infants (TSFI) (DeGangi & Greenspan, 1989) and Infant /Toddler Sensory Profile (Dunn, 2002) before and after a 10 week ASI intervention period with infants in the experimental group. The results of the Fidelity Measure indicated that the interventions sessions complied with the requirements for ASI intervention. The pre- and post-test results were analyzed, interpreted and compared. The anthropometric and demographic profiles of the infants in both groups indicated that there was no statistical difference between the two groups except for the time hospitalized which was in favour of the control group and therefore the researcher was able to make reliable conclusions in terms of the study results. This study has found that ASI intervention had a positive effect on the sensory processing and developmental progress of ELBW to VLBW premature infants especially in terms of cognitive-, language-, motor- and adaptive behaviour development within a short period of 10 weeks. Parents showed more interest and a better understanding of the developmental progress and sensory processing of their infants. This study has therefore provided sufficient evidence that early intervention in terms of ASI plays a critical role in the intervention approach of the sensory integration trained occupational therapists, working with premature infants and their parents. The study results did not only indicate the importance of ASI intervention for better developmental outcomes for ELBW to VLBW premature infants, but also revealed that a lack of ASI intervention leads to a deterioration of developmental and behavioural outcomes.

[发布机构] University of the Free State