Early intervention effects on emotion regulation for VLBW preterm infants at age 6 months during arm restrain procedure

Abstract

Background: Very low birth weight (VLBW) preterm infants (birth weight <1500 g) sustain an increased risk of developmental and emotional/behavioral disorders in childhood and adulthood. 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 examine the socio-emotional outcome. Purpose: This study was aimed to examine the effect of early intervention on emotion regulation in VLBW infants at 6 months of corrected age. Methods:A total of 178VLBWpreterm infants were randomly assigned to the usual care program (UCP), clinic-based intervention program (CBIP) and home-based intervention program (HBIP). 62 full-term infants were included to serve as the reference group. Early intervention consisted of childand 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. The video records were coded for negative reactivity and regulatory behaviors. Results: There are no differences in peak distress and mean of negative vocalization scores, but CBIP and HBIP showed a tendency of increased negative vocalization and shorter latency to mild distress. In the regulatory behaviors, all groupsmostly used orientation to objects which positively related to decrease their negative reactivity (all p< 0.05). Interestingly, comparing the regulatory strategies in each groups, full-term infants used orientation to experimenters and scanning to regulate. VLBW preterm infants may look more to mothers or scanning around which not related to distress. However, CBIP and HBIP used orientation to experimenters to increase latency to mild distress, instead, more effective strategies (orientation to experimenters and mom) were found in CBIP groups (all p< 0.05). Conclusion(s): VLBW preterm infants showed higher negative reactivity and different regulatory strategies with full-terms. Early intervention, specifically CBIP, appeared to favor emotion regulation in VLBW preterm infants at 6 months of corrected age. Implications: Six months of age appears to be an appropriate time for investigation of behavioral regulation during arm restraint procedure in preterm infants.