The Journal of pediatrics · 2026
Does Timing Matter? A Clinical Trial of Supporting Play Exploration and Early Development Intervention for Infants Born Preterm in the First Months of Life.
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Dusing Stacey C, Burnsed Jennifer C, Spence Christine M, Molinini Rebecca M, Brown Shaaron E, Harper Amy, Hendricks-Muñoz Karen D, Stevenson Richard D, Thacker Leroy R, Kane Audrey E, Inamdar Ketaki
Аннотация
OBJECTIVE: To evaluate the efficacy of an early-delivered physical therapy intervention and to determine whether the timing of the intervention affects developmental outcomes.
STUDY DESIGN: This multisite, 3-arm, intervention-controlled trial compared the efficacy of Supporting Play, Exploration, and Early Development Intervention (SPEEDI) Early (neonatal intensive care unit start), SPEEDI_Late (starting 15 weeks later), and usual care to improve development, measured with the Bayley Scales of Infant and Toddler Development, third edition, and parent-child dyadic interaction on the Emotional Availability Scale. SPEEDI is a motor-based, problem-solving intervention provided by an interventionist in collaboration with a caregiver.
RESULTS: Eighty-three infants born very preterm, with a mean gestational age at birth of 26.5 ± 2.0 weeks, were enrolled between 35 and 42 weeks of corrected gestational age. Combining SPEEDI groups, there was no difference between SPEEDI and usual care. However, infants in the SPEEDI_Early group had significantly better cognitive scaled scores than infants in the SPEEDI_Late group through 24 months of age. Adjusting for baseline motor skills, infants in the SPEEDI_Early group had higher gross motor scaled scores through 24 months of age. A change in parent-child interaction in response to SPEEDI supports the intervention's theoretical model and provides a possible mechanism of action.
CONCLUSIONS: An intervention that engages parents in supporting development in infants born very preterm may result in long-term developmental improvements when started in the neonatal intensive care unit. Delaying services by even 3 months appears to reduce the efficacy of the intervention.
TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT03518736.
STUDY DESIGN: This multisite, 3-arm, intervention-controlled trial compared the efficacy of Supporting Play, Exploration, and Early Development Intervention (SPEEDI) Early (neonatal intensive care unit start), SPEEDI_Late (starting 15 weeks later), and usual care to improve development, measured with the Bayley Scales of Infant and Toddler Development, third edition, and parent-child dyadic interaction on the Emotional Availability Scale. SPEEDI is a motor-based, problem-solving intervention provided by an interventionist in collaboration with a caregiver.
RESULTS: Eighty-three infants born very preterm, with a mean gestational age at birth of 26.5 ± 2.0 weeks, were enrolled between 35 and 42 weeks of corrected gestational age. Combining SPEEDI groups, there was no difference between SPEEDI and usual care. However, infants in the SPEEDI_Early group had significantly better cognitive scaled scores than infants in the SPEEDI_Late group through 24 months of age. Adjusting for baseline motor skills, infants in the SPEEDI_Early group had higher gross motor scaled scores through 24 months of age. A change in parent-child interaction in response to SPEEDI supports the intervention's theoretical model and provides a possible mechanism of action.
CONCLUSIONS: An intervention that engages parents in supporting development in infants born very preterm may result in long-term developmental improvements when started in the neonatal intensive care unit. Delaying services by even 3 months appears to reduce the efficacy of the intervention.
TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT03518736.