Premature Birth Clinical Trial
Official title:
Vermont Intervention: Effect on Joint Attention Skills Between Parents and Moderate/Late Preterm Infants Int the First Year of Life
The purpose of this study is to investigate if the effects of the Vermont intervention, implemented by nurses in a Neonatal Intensive Care Unit (NICU), can influence social interaction and joint attention skills between parents and preterm babies in the second half of the first year of life.
The bases of parental sensitivity and infants' joint attention skills are probably
established during the child's first year of life. Research suggests that the quality of
early social interaction is related to children's later development and mental health.
Preterm infants are at risk for developing interaction disturbances in the first year of
life, and such aberrancies often lay the foundation for later problems of adaptation.
Following preterm birth the infant is exposed to an atypical extra uterine environment. In
such an environment it is hard for an immature brain to modulate the infant's behaviour
properly.
Under such circumstances there are several factors to consider. The disturbances that may be
seen later may be mediated and moderated by the infant's state, parental circumstances and
conditions in the hospital environment. Parents of preterm infants experience interruption
of normal pregnancy and may be in a difficult emotional state after preterm birth, and often
they are not prepared for their role as parents. They are also vulnerable to stress and
worries concerning survival of their baby. These conditions are assumed to have a negative
influence on the social interaction between preterm infant and parents, and can make it
difficult for the caretakers to adapt to their low birth weight infant and to engage in
social interaction with their baby.
The purpose of this study is to evaluate the effects of a neonatal intervention program
(Vermont-intervention) on parental sensitivity and the interaction skills between parents
and preterm babies in the first year of life. The intervention is based on a transactional
model of development, which emphasizes the mutual regulation and interaction going on
between a child and its caretakers over time.
The study is a randomized controlled trial in a NICU environment. 100 preterm children born
between 30 and 36 weeks of gestation are randomly assigned to a control group and an
experimental group. The intervention is the Mother Infant Transaction Program (MITP) called
the Vermont intervention. In addition, 50 full term normal-weight infants are recruited into
a full term control group. The work of recruitment and randomizing of the 150 families to
the three groups is carried out by a paediatric research assistant who will also be
responsible for the organization and implementation of the interventions at hospital and at
home after discharge from hospital. To the extent it is possible, the nurse researcher is
not supposed to recognize the group identity of the participants in the three groups when
administering questionnaires and scoring video recordings of social interaction and joint
attention between mother and child at ages 6, 9 and 12 months.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator)
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