Early intervention leads to long-term developmental improvements in very preterm infants, especially infants with bronchopulmonary dysplasia.

AIM: Various early intervention programmes have been developed in response to the high rate of neurodevelopmental problems in very preterm infants. We investigated longitudinal effects of the Infant Behavioral Assessment and Intervention Program on cognitive and motor development of very preterm infants at the corrected ages of six months to five and a half years. METHODS: This randomised controlled trial divided 176 infants with a gestational age <32 weeks or birthweight <1500 g into intervention (n = 86) and control (n = 90) groups. Cognitive development and motor development were assessed with the Bayley Scales of Infant Development at the CAs of six, 12 and 24 months and at five and a half years with the Wechsler Preschool and Primary Scale of Intelligence and the Movement Assessment Battery for Children. RESULTS: We found significant longitudinal intervention effects (0.4 SD, p = 0.006) on motor development, but no significant impact on cognitive development (p = 0.063). Infants with bronchopulmonary dysplasia showed significant longitudinal intervention effects for cognitive (0.7 SD; p = 0.019) and motor (0.9 SD; p = 0.026) outcomes. Maternal education had little effect on intervention effects over time. CONCLUSION: The Infant Behavioral Assessment and Intervention Program led to long-term developmental improvements in the intervention group, especially in infants with BPD.

Reliability, sensitivity and responsiveness of the Infant Behavioral Assessment in very preterm infants.

AIM: The aim of this study is to investigate the reliability, sensitivity and responsiveness of the Infant Behavioral Assessment (IBA) to evaluate neurobehavioural organization in very preterm infants. METHODS: Videotaped assessments of very preterm infants participating in a recent trial served to evaluate a standardized IBA observation. Inter-rater reliability was based on 40 videos scored by two independent observers, using percentage agreement and weighted Kappa's. Sensitivity was evaluated by comparing the IBA results of 169 infants at 35-38 weeks postmenstrual age, dichotomized according to two developmental risk factors. For responsiveness, the effect size (ES) was calculated between 0 and 6 months corrected age in all intervention and control infants and in subgroups of high-risk intervention and control infants with oxygen dependency ≥28 days. RESULTS: Inter-rater agreement was 93% in the total assessment; Kappa agreement was moderate to good in the behavioural categories. Significant differences were found between groups with or without risk factors. Larger differences between ESs in the randomized groups with oxygen dependency ≥28 days than in the total randomized groups reflect the responsiveness of the IBA. CONCLUSION: In this study, we found satisfactory to good clinimetric characteristics of the IBA in very preterm born infants.