Premature birth is a major cause of developmental delay, and the need remains for cost effective, replicable methods to promote development in preterm children. Despite the success of first generation interventions, little is understood about why early intervention does not affect all parents and preterms to the same degree. This randomized clinical trial aims to 1) evaluate the efficacy of an integrated, replicable intervention designed to facilitate parent-infant interaction, infant physical development, mental and motor development, and socioemotional development in a group of infants at medical and environmental risk for developmental delay; and 2) explore the role of mothers' and fathers' states of mind with regard to attachment and parents' commitment to the intervention, as moderators of intervention efficacy. The study will recruit 240 urban, single, African-American mothers and fathers of preterm (<37 weeks gestational age), low birthweight (< 2,500 grams at birth) infants admitted to the neonatal intensive care unit. Half of the families will be randomly assigned to an intervention group, and half to a control group. Both groups will be comparable with respect to race, maternal parity, education, income, presence/absence of partner, infant gestational age, infant small-for-date status, and infant gender. The intervention integrates a videotape about preterm infant competencies, serial administrations of the Brazelton Neonatal Behavioral Assessment Scale with increasing parental involvement, and parent-administered infant massage, beginning when infants are 32-to-36 weeks post-conceptual age (PCA) and terminating at 52-to-56 weeks PCA. Intervention efficacy, and the moderating roles of adult attachment and parental commitment to intervention, will be evaluated along dimensions of infant physical, mental, motor, and social development, and parental adjustment and sensitivity to the infant during the first two years.
| Candelaria, Margo; Teti, Douglas M; Black, Maureen M (2011) Multi-risk infants: predicting attachment security from sociodemographic, psychosocial, and health risk among African-American preterm infants. J Child Psychol Psychiatry 52:870-7 |
| Teti, Douglas M; Hess, Christine Reiner; O'Connell, Melissa (2005) Parental perceptions of infant vulnerability in a preterm sample: prediction from maternal adaptation to parenthood during the neonatal period. J Dev Behav Pediatr 26:283-92 |
