Predictors of developmental outcomes for medically fragile early intervention participants.

Little is documented about the determinants of developmental outcomes for medically fragile infants who receive early intervention. In this controlled longitudinal study 65 premature infants with intraventricular hemorrhage (IVH) were randomly assigned to intervention groups beginning at 3 months adjusted age (Early) or 12 months adjusted age (Delayed). The sample was 65% African American and 35% Caucasian, and over half the youngsters were being raised by single mothers. Although cost analyses revealed that it was almost twice as expensive to begin sensorimotor intervention at the earlier age, annual comprehensive assessments revealed no significant differences in developmental outcomes based on age at start. Stepwise multiple regression analyses revealed that Maternal Education and Neonatal Medical Problems were significant predictors of outcomes at years 1, 3, 5, and 7 regardless of age at start. Related findings from other studies are discussed along with implications for policy and future research.

Handling preterm infants in hospitals. Stimulating controversy about timing of stimulation.

The authors' research draws from a primary concern for the effects of the animate and inanimate caregiving environment on brain growth and central nervous system organization in hospitalized preterm infants. The current report presents data on physiologic trends in preterm infant heart rate and oxygenation as related to the timing and content of caregiver stimulation, specifically medical and social forms of touch. Results indicate that while most instances of bradycardia were not closely preceded by tactile stimulation, prebradycardia periods, which included touch, had lower pO2 levels than did baseline periods that included touch. These findings suggest that medical or "developmental" tactile stimulation presented when the infant was already physiologically compromised (with low pO2) may potentiate an underlying vulnerability to bradycardia. Timing, versus type, may be the better predictor of the physiologic effect of caregiver interventions on preterm infants.

Advances in neonatal and infant behavioral assessment: toward a comprehensive evaluation of early patterns of development.

Recognizing the impressive range of behavioral capacities of newborn infants, clinicians and researchers have long searched for valid assessment instruments to help evaluate infant behavior. Behavioral assessments with high predictive validity would aid the goals of developmental diagnostic, prognostic, and treatment programs for infants born at risk from biological or environmental circumstances. The failure of current assessments to predict developmental outcome based on infant behavior may be due to the limited information about higher central nervous system (CNS) functioning obtained from available measures, or to the very dynamic nature of CNS organization in young infants. We begin our review by discussing some major functional characteristics of neonates and then proceed to describe critically the commonly used methods of neurological and behavioral assessment. Noting the need for measures that are more predictive, we turn next to a discussion of a number of experimental techniques that seem to hold great promise for developmental prediction and clinical application.

Adult perceptions of pain and hunger cries: a synchrony of arousal.

180 male and female nonparent adults rated tape-recordings of the initial, middle, and final 10-sec segments of pain and hunger cries on 4 7-point Likert-type scale items describing how urgent, arousing, aversive, and sick the cry segments sounded. Multivariate analyses of variance showed that the final segment of the pain cry was perceived as less urgent, arousing, and aversive than the initial and middle segments. The hunger cry was perceived as increasingly more urgent, arousing, and aversive from the initial to the middle to the final cry segments, with the final segment receiving higher ratings than the final segment of the pain cry. The middle segment of both cries was the most sick sounding. While females were more aroused than males as the hunger cry intensified, and females were less aroused than males as the pain cry subsided, the initial segments of the pain cry were particularly potent stimuli to both males and females. These results suggest that different segments of cries resulting from the same stimulus provide different messages that communicate the presumed level of infant arousal.

The effects of within-group and between-group methodologies in the study of perceptions of infant crying.

Recent studies have indicated that various infant cry patterns can be reliably distinguished when directly compared with other infant cry patterns. The purpose of this study was to compare the effects of this within-group method of cry presentation (in which listeners are exposed to 2 types of cry patterns) with the effects of a between-group methodology (in which listeners are exposed to only 1 type of infant cry pattern). 4 groups of adult listeners rated the tape-recorded cries of low- and high-risk infants on 4 Likert-type scale items during experimental phases. In phase 1, subjects were exposed to either the cries of low-risk or high-risk infants but not both. In phase 2, subjects were exposed to both low-risk and high-risk infant cries. In phase 3, subjects were exposed to the cries they heard in phase 1. Whereas all scale items differentiated the low- and high-risk infant cries during the within-group analyses of phase 2, all scale items did not differentiate low- and high-risk infant cries during the between-group phase of the experiment. The specific pattern of results indicate that within-group methods of cry presentation accentuate the perceptual distance among cry types and may actually create many reliable differences that would not be found in between-group comparisons.