[Effects of early rehabilitative treatment on neurological development and cognitive and perceptual-motor functions of preterm infants at risk]

Abstract

Longterm effects of early rehabilitative treatment are evaluated in 37 premature infants at neurological risk. The late neurological and psychomotor development of this group of children (experimental group) is compared with that of another 35 at risk premature infants (control group), who received only conventional follow-up care. The two groups do not differ in birth-weight, gestational age, sex and neonatal disorders. At 6 years of age the children of the experimental group have a significantly better neurological status and score higher than the control group, on mean mental indices. They also have lower incidence of neurodevelopmental sequelae (learning disabilities and behaviour problems). However children both in the experimental group and the control group have poor visual-motor integration. Similar results are found also in children, who were low-risk premature infants and who have normal intelligence. Our data suggest that a prescribed early rehabilitative treatment for high-risk preterm infants appears enhance the quality of late development. Treated children have the greatest improvement in all measured outcomes at 6 years (included neurological status, motor and overall development), but do not achieve the same level of neurological and behavioral development as full-term control children. One might question whether the latter finding indicate limited efficacy of early treatment or rather the need to consider separate series of norms for the preterm infant in assessing its outcome. This question requires additional follow-up studies.