Effects of Early Intervention on Emotion Regulation in Very Low Birth Weight Preterm Infants at 6 Months of Corrected Age
Date Issued
2010
Date
2010
Author(s)
Ho, Yu-Wen
Abstract
Background and Purpose: Very low birth weight (VLBW) preterm infants (birth weight <1,500 g) sustain an increased risk of developmental and emotional/behavioral disorders in childhood and adolescence. Although previous studies have demonstrated small to moderate benefits of early intervention to the cognitive and motor function in VLBW preterm infants, these studies have rarely examined the socio-emotional outcome. This study was, therefore, aimed to examine the effect of early intervention on emotion regulation in VLBW preterm infants at 6 months of corrected age. Methods: A total of 178 VLBW preterm infants were randomly assigned to the usual care program (UCP), clinic-based intervention program (CBIP) and home-based intervention program (HBIP). Sixty-two full-term infants were also included to serve as the reference group. Early intervention consisted of child- and parent-focused services that began in hospitalization and ended at 12 months of corrected age. Infants were assessed for emotion regulation under the arm restraint procedure at 6 months of corrected age with their behaviors recorded using a video camera and physiological responses by an electrocardiography. The video records were coded for negative reactivity and regulatory behaviors; the heart rate data were analyzed for variability. Results: For infants who returned for follow up and had complete physiological data, full-term, UCP and CBIP groups showed an increase in negative vocalization (all p<0.05); whereas HBIP exhibited no change from the restraint to release period. Furthermore, UCP and CBIP groups manifested higher levels of negative vocalization than full-term and HBIP groups in the release period (all p<0.05). However, regulatory behaviors in response to arm restraint did not vary between groups. Physiologically, CBIP and full-term groups exhibited similar tendency showing an incline in high-frequency power of heart rate variability (lnHF) from the baseline to restraint period, which was followed by an incline from the restraint to release period (both p<0.05). In contrast, HBIP and UCP groups manifested no change in lnHF throughout the procedure. For those exhibiting increased lnHF from the baseline to restraint period, CBIP group showed more mother orientation and full-term group showed more object orientation in self regulation (both p<0.05).
Conclusion: Early intervention, specifically CBIP, appeared to favor emotion regulation in VLBW preterm infants at 6 months of corrected age. Physiological regulation was more sensitive to infants’ reactivity to arm restraint procedure than that of behavioral reactivity at 6 months.
Subjects
early intervention
preterm infants
emotion regulation
heart rate variability
Type
thesis
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