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One-Year Outcome of Auditory-Tactile-Visual-Vestibular Intervention in the Neonatal Intensive Care Unit: Effects of Severe Prematurity and Central Nervous System Injury

Department of Pediatrics Rush-Presbyterian-St. Luke's Medical Center, Section of Pediatric Psychology, University of Illinois at Chicago, Chicago, IL

Rosemary C. White-Traut, DNSc, RN

College of Nursing, University of Illinois at Chicago, Chicago, IL

Ushanalini Vasan, MD

Department of Pediatrics Rush-Presbyterian-St. Luke's Medical Center, Section of Neonatology, University of Illinois at Chicago, Chicago, IL

Jean Silvestri, MD

Department of Pediatrics Rush-Presbyterian-St. Luke's Medical Center, Section of Neonatology, University of Illinois at Chicago, Chicago, IL

Elizabeth Comiskey, MD

Department of Pediatrics Rush-Presbyterian-St. Luke's Medical Center, Department of Radiology University of Illinois at Chicago, Chicago, IL

Patricia Meleedy-Rey, MPH

College of Nursing, University of Illinois at Chicago, Chicago, IL

Susan Littau, MJ, RN

College of Nursing, University of Illinois at Chicago, Chicago, IL

Guoguang Gu, BS

College of Nursing, University of Illinois at Chicago, Chicago, IL

Minu Patel, MSc

College of Nursing, University of Illinois at Chicago, Chicago, IL

Thirty-seven infants with severe central nervous system injury or extreme prematurity were randomly assigned to a multisensory (auditory-tactile-visual-vestibular) intervention or control group. Intervention began in the hospital at 33 weeks' postconceptional age and continued twice daily in the home until 2 months' corrected age. Mother-infant interactions during feedings were videotaped, and the Bayley Scales of Infant Development were administered. Control mothers stimulated their infants more during feeding, but these significant differences dissipated by 4 months. The presence of periventricular leukomalacia was associated with significantly poorer mental development, regardless of group assignment. Experimental infants tended to exhibit better motor and mental performance and had 23% fewer cerebral palsy diagnoses at 1 year, but these trends were not statistically significant. The type of brain injury was more important in determining 1-year developmental outcome than type of postnatal experience, suggesting that periventricular leukomalacia presents a major challenge for infant development. (J Child Neurol 2001;16:493-498).

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