Does Timing Matter? A Clinical Trial of Supporting Play Exploration and Early Development Intervention for Infants Born Preterm in the First Months of Life.
Stacey C Dusing, Jennifer C Burnsed, Christine M Spence et al.
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In 30 seconds
This multisite, three-arm randomized controlled trial evaluated whether the timing of a caregiver-supported, motor-based intervention affected development in 83 infants born very preterm (mean gestational age 26.5 ± 2.0 weeks). Infants received SPEEDI beginning in the neonatal intensive care unit, SPEEDI starting 15 weeks later, or usual care. Combining the intervention groups showed no difference from usual care. However, early-start infants had significantly better cognitive scaled scores than later-start infants through 24 months; after adjustment for baseline motor skills, they also had higher gross motor scaled scores through 24 months.
Key findings
- Combining SPEEDI groups, investigators found no developmental difference between SPEEDI and usual care.
- SPEEDI begun in the neonatal intensive care unit was associated with better cognitive scaled scores than intervention begun 15 weeks later, through 24 months.
- After adjustment for baseline motor skills, the early-start group had higher gross motor scaled scores through 24 months.
- Changes in parent-child interaction in response to SPEEDI were consistent with the intervention's theoretical model and suggested a possible mechanism.
Why it matters
The findings suggest that, for infants born very preterm, when a parent-engaging developmental intervention begins may matter: earlier initiation was associated with better cognitive and gross motor outcomes than delayed initiation. This highlights the potential importance of timing in early developmental services, while the absence of an overall difference from usual care means the results should not be interpreted as establishing broad superiority of the intervention.
What to keep in mind
The abstract reports no difference between the combined SPEEDI groups and usual care; the reported timing-related benefits are comparisons between intervention start times.