Early stimulation program for premature children and their parents: Establishing the impact on neurodevelopment at 18 months of corrected age

For the first time in Brazil, the study developed and implemented an intervention conducted by the parents, family and caregivers to stimulate preterm infants, beginning during the neonatal ICU and lasting until the child reached the age of two. The research measured the effects of the program in several areas, including motor, cognitive and emotional (bond between child and caregiver) development.

At the start, the research group developed explanatory and illustrated material to guide parents and caregivers on the techniques to stimulate premature infants. With the materials ready, 88 premature infants were assigned at random to participate in the stimulation program (intervention group) or in conventional care (control group). In addition to using the kangaroo methodology, caregivers learned the stimulation exercises that should be performed both at the hospital and at home. After discharge, a multi-professional team, including nurses, pediatrician and nutritionists (under the guidance of a physiotherapist), visited the children of the intervention group at home once a month, until they were 18 months old. The objective was to evaluate if the guidelines provided were understood and being followed at home.

The group of children who received specialized care from their parents registered more interaction than expected in the neonatal ICU and, at eight months, a significant improvement in motor skills. In the intervention group, only 24 percent of children developed below average as compared to 54 percent in the control group.

This is the first time that a study has evaluated the effects of a stimulation program for premature babies on neurocognitive development and the ability to strengthen bonds between mother and child.

The project offers an inexpensive stimulation program that is easily administered by parents and caregivers to reduce the impacts and harmful effects of prematurity on child development.

The results demonstrate that the program was effective in improving motor and cognitive development and in strengthening the bonds between children and their caregivers. Home visits after discharge were essential. It is possible to train health agents and professionals from Basic Health Units to visit and monitor the stimulation of premature infants in places with the highest social vulnerability.

With appropriate adaptations of the language and content of the stimulation material, it is possible to expand the program and the training of caregivers to other countries.

Researchers now want to investigate the effects of stimulation on children between the ages of three and four, when he or she starts attending school. In addition, they intend to produce a manual with practical and easy-to-understand guidelines so that the population has access to information in order to be able to perform these strategies at home.