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Reuters
21 December 2011
By Amy Norton
(Reuters Health) – Giving parents of newborn preemies some help right from the start may make a difference in their children's behavior by school age, a new study suggests.

Children born prematurely tend to have higher rates of behavioral problems, like attention–deficit hyperactivity disorder (ADHD), than their peers who were born full–term.

But not much has been known about whether intervening early with parents –– helping them interact better with their infants –– can make a difference in preemies' behavior in the long run.

For the new study, researchers in Norway tested a program that gave parents of preemies help right away, starting in the hospital.

After parents took their babies home, they received four home visits from a nurse over three months. The nurses gave them training in things like "reading" cues from their infant and interacting with the baby through play.

“Preterm infants are often more fussy, give less eye contact and are harder to understand for parents,“ explained lead researcher Dr. Marianne Nordhov, of the University Hospital of North Norway in Tromso.

“They display signs of stress in a subtle way, such as color changes, 'jittery' movements, and increased respiration rate,“ Nordhov told Reuters Health in an email.

The idea of the program was to help parents better understand their preemies –– and to give them a chance to “vent“ their worries and stresses, Nordhov explained.

She and her colleagues randomly assigned parents of 146 preemies (born weighing less than 4.4 pounds) to either take part in the program or stick with standard care alone. They also recruited parents of 75 full–term infants to study for comparison.

At the age of 5, Nordhov's team found, children whose parents had been in the program were showing fewer behavior problems, like inattention, aggression or withdrawn behavior.

Based on parents' reports, 29 percent of those kids scored in the “borderline“ range on the behavior–problem scale. That compared with 48 percent of premature kids whose parents had not been in the program.

Scores in the borderline range point to an increased risk for behavior problems like ADHD, Nordhov said.

In an earlier study that followed these children to age 2, the researchers had found no clear benefit. But the current findings underscore the importance of following kids' longer–term progress, according to Nordhov.

“Our study has shown that only 12 hours of parental education improves their knowledge and confidence, which in turn improve the interaction with their infant in a beneficial way,“ Nordhov said.

“It is important that nurses and doctors spend time with parents and teach them how to better interact and understand this 'difficult' task of language,“ she added.

A child psychologist not involved in the study agreed that early help is key.

“I'm not really surprised by the findings. They make total sense,“ said Lori Evans, of the New York University Child Study Center.

But what's different in this study is that the program focused on parenting skills right from the beginning of an infant's life. In the U.S., Evans told Reuters Health, the most common comparable program is called Parent Child Interaction Therapy –– which research suggests does improve kids' behavioral issues.

That's generally offered later, starting when children are about 3 years old and already have behavioral problems.

“Starting parent training early would be a wonderful thing,“ Evans said.

With children's behavioral problems, in general, she noted, “what we know is, the earlier we get them, the better.“

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