Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review

Aim First, to systematically review the evidence on the effect of intervention applied during the first postnatal year in infants with or at very high risk of cerebral palsy (CP) on child and family outcome. Second, to assess whether type and dosing of intervention modify the effect of intervention....

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Bibliographic Details
Published in:Developmental medicine and child neurology 2017-03, Vol.59 (3), p.246-258
Main Authors: Hadders‐Algra, Mijna, Boxum, Anke G, Hielkema, Tjitske, Hamer, Elisa G
Format: Article
Language:English
Subjects:
Cerebral Palsy - therapy
Databases, Bibliographic - statistics & numerical data
Early Intervention (Education) - methods
Humans
Infant
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Summary:Aim First, to systematically review the evidence on the effect of intervention applied during the first postnatal year in infants with or at very high risk of cerebral palsy (CP) on child and family outcome. Second, to assess whether type and dosing of intervention modify the effect of intervention. Method Relevant literature was identified by searching the PubMed, Embase, and CINAHL databases. Selection criteria included infants younger than 12 months corrected age with or at very high risk of CP. Methodological quality including risk of bias was scrutinized. Results Thirteen papers met the inclusion criteria. Seven studies with moderate to high methodological quality were analysed in detail; they evaluated neurodevelopmental treatment only (n=2), multisensory stimulation (n=1), developmental stimulation (n=2), and multifaceted interventions consisting of a mix of developmental stimulation, support of parent–infant interaction, and neurodevelopmental treatment (n=2). The heterogeneity precluded conclusions. Yet, two suggestions emerged: (1) dosing may be critical for effectiveness; (2) multifaceted intervention may offer best opportunities for child and family. Interpretation The literature on early intervention in very high‐risk infants with sufficient methodological quality is limited, heterogeneous, and provides weak evidence on the effect. More studies are urgently needed. Suggestions for future research are provided. What this paper adds Evidence of effect of early intervention during the first postnatal year in infants at very high risk of cerebral palsy is weak. Suggests dosing may be critical in the effectiveness of early intervention. Suggests multifaceted intervention may be more effective than single component intervention. Video Podcast: https://youtu.be/imThrPRX0tc
ISSN:0012-1622
1469-8749
DOI:10.1111/dmcn.13331