Assessing speech exposure in the NICU: Implications for speech enrichment for preterm infants.
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ABSTRACT: Objective
Quantify NICU speech exposure over multiple days in relation to NICU care practices.Methods
Continuous measures of speech exposure were obtained for preterm infants (n = 21; 12 M) born <34 weeks gestational age in incubators (n = 12) or open cribs (n = 9) for 5-14 days. Periods of care (routine, developmental) and delivery source (family, medical staff, cuddler) were determined through chart review.Results
Infants spent 13% of their time in Care, with >75% of care time reflecting developmental care. Speech counts were higher during care than no care, for mature vs. immature infants, and for infants in open cribs vs. incubators. Family participation in care ranged widely, with the highest speech counts occurring during periods of intentional voice exposure.Conclusions
Care activities represent a small portion of NICU experiences. Speech exposure during Developmental Care, especially with intentional voice exposure, may be an important source of stimulation. Implications for care practices are discussed.
SUBMITTER: Scala ML
PROVIDER: S-EPMC8189318 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundInfants born very preterm (< 32 weeks gestational age (GA)) are at risk for developmental language delays. Poor language outcomes in children born preterm have been linked to neurobiological factors, including impaired development of the brain's structural connectivity (white matter), and environmental factors, including decreased exposure to maternal speech in the neonatal intensive care unit (NICU). Interventions that enhance preterm infants' exposure to maternal speech show promise as potential strategies for improving short-term health outcomes. Intervention studies have yet to establish whether increased exposure to maternal speech in the NICU offers benefits beyond the newborn period for brain and language outcomes.MethodsThis randomized controlled trial assesses the long-term effects of increased maternal speech exposure on structural connectivity at 12 months of age (age adjusted for prematurity (AA)) and language outcomes between 12 and 18 months of age AA. Study participants (N = 42) will include infants born very preterm (24-31 weeks 6/7 days GA). Newborns are randomly assigned to the treatment (n = 21) or standard medical care (n = 21) group. Treatment consists of increased maternal speech exposure, accomplished by playing audio recordings of each baby's own mother reading a children's book via an iPod placed in their crib/incubator. Infants in the control group have the identical iPod setup but are not played recordings. The primary outcome will be measures of expressive and receptive language skills, obtained from a parent questionnaire collected at 12-18 months AA. The secondary outcome will be measures of white matter development, including the mean diffusivity and fractional anisotropy derived from diffusion magnetic resonance imaging scans performed at around 36 weeks postmenstrual age during the infants' routine brain imaging session before hospital discharge and 12 months AA.DiscussionThe proposed study is expected to establish the potential impact of increased maternal speech exposure on long-term language outcomes and white matter development in infants born very preterm. If successful, the findings of this study may help to guide NICU clinical practice for promoting language and brain development. This clinical trial has the potential to advance theoretical understanding of how early language exposure directly changes brain structure for later language learning.Trial registrationNIH Clinical Trials (ClinicalTrials.gov) NCT04193579 . Retrospectively registered on 10 December 2019.
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Project description:BACKGROUND:The aim of this study was to review the effects of developmental care in neonatal intensive care unit (NICU) setting on mental and motor development of preterm infants. METHOD:We searched PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane library until October 8th 2017, and included randomized controlled trials that assessed effects of developmental care in NICU on mental and motor development of preterm infants at 12 and 24?months of age, using the Bayley scale of infant development in this systematic review. In addition, data were pooled by random effects model and Standardized Mean Difference (SMD) with 95% confidence intervals (CI), calculated for meta-analysis. RESULTS:Twenty one studies were eligible to be included in this systematic review; however, only thirteen studies had data suitable for meta-analysis. According to statistical analysis, developmental care in NICU improved mental developmental index (MDI) (standardized mean difference [SMD] 0.55, 95% confidence interval [CI] 0.23-0.87; p?<?0.05), and psychomotor developmental index (PDI) (SMD 0.33, [CI] 95% CI 0.08-0.57; p?<?0.05) of BSID at 12?months of age and PDI at 24?months of age (SMD 0.15, 95% CI -0.02-0.32; p?<?0.1) of preterm infants. However, the benefit was not detected at 24?months of age on MDI (SMD 0.15, 95% CI -0.05-0.35; p?=?0.15). CONCLUSION:Current evidence suggests that developmental care in only NICU setting could have significant effect on mental and motor development of preterm infants, especially at 12?months of age. However, because of clinical heterogeneity, more studies are needed to evaluate the effects of developmental NICU care in the development of preterm infants.
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Project description:BackgroundDevelopmental support care for preterm infants contributes toward their health and shortens their hospital stay. In many countries, programs for preterm infant development such as Newborn Individualized Developmental Care and Assessment Program and Philips Wee Care have not yet been disseminated.ObjectivesTo evaluate the effectiveness of neonatal intensive care unit nurses' competence enhancement program for developmental support care of preterm infants.MethodsA quasi-experimental study using pretest and posttest designs with a nonequivalent control group was conducted in five neonatal intensive care units of university hospitals in South Korea. A total of 39 nurses (20 in the experimental group and 19 in the control group) participated. The program was composed of family support, healing environmental support, stress and pain management, sleep support, position support, nutrition optimization, skin protection, and sensory stimulation. In addition, four sessions were provided using Zoom, Padlet, online quizzes, and performance diaries.ResultsFor nursing knowledge, no significant interaction effect was observed between groups and time (F = 1.38, p = .258). However, the main effect on the group (F = 10.81, p < .001), and the main effect of time were significant (F = 12.97, p < .001). For nursing attitude, the interaction effect between group and time (F = 2.06, p = .142), and the main effect on the group were not significant (F = 0.23, p = .635). Finally, for nursing competence, the interaction effect between group and time was significant (F = 4.46, p = .019).ConclusionsThe educational program was effective in improving nursing knowledge and competence in developmentally supportive care for preterm infants. This program is expected to contribute toward the growth and development of premature infants.
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