A systematic review 1 including 34 studies was abstracted in DARE. There were 23 RCTs (n=2,552), 4 prospective cohort studies with a control group (n=501) and 7 case studies with control participants, or cohort studies with a historical control group (n=202). Studies that included infants with high biological risk for, or with, developmental disabilities were eligible for inclusion.
Interventions applied at the neonatal intensive care unit (NICU (17 studies). Interventions proven effective in these studies included stress reduction combined with general sensory stimulation and general infant development using general sensory stimulation, stimulation of motor development, passive handling techniques and enhancement of parent-infant interaction.
Interventions applied between discharge from the NICU and a corrected age of 9 months (8 studies). Four fair- to high-quality studies evaluated the effects of neurodevelopmental treatment (NDT); however, none found statistically significant effects. Two high-quality studies assessed programmes that stimulated infant motor development; both studies reported statistically significant effects.
Interventions started between the corrected ages of 9 and 18 months (6 studies). One high-quality study demonstrated a positive effect of specific motor training on motor development of infants with Down syndrome, while another high-quality study found that a general infant stimulation programme facilitated motor development more than NDT. The other high-quality study showed no significant effect. One of the 3 lower quality studies found a beneficial effect of general programmes on stimulating motor development.
Comment: The quality of evidence is downgraded by heterogeneity of interventions, poor reporting of review methodology and possibility of publication bias. The authors conclude that pre-term infants seem to benefit most from interventions aimed at simulating the intra-uterine environment, whereas for infants after term age, intervention by means of specific or general developmental programmes has positive effects on motor development.
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