Academic journal article Pre- and Peri-natal Psychology Journal

Stimulus Differentiation by Preterm Infants Can Guide Caregivers

Academic journal article Pre- and Peri-natal Psychology Journal

Stimulus Differentiation by Preterm Infants Can Guide Caregivers

Article excerpt

ABSTRACT: Advances in modern medicine in recent years have resulted in a remarkable increase in the number of human infants who survive a premature birth. Many of these infants undergo stressful perinatal and prenatal experiences, and require special care and attention in order for their physical and mental development to be optimal. If that goal is to be met, care-givers need to receive feedback from the infants, indicating how they are affected by treatment and stimulation. In this study, preterm infants displayed behavioral differentiation of various tactile stimuli. A number of behaviors are highlighted, which are indicative of physiological integration of environmental stimuli, and which can be used by care-givers as guides in their interaction with the infants.

INTRODUCTION

Due to advances in modern medicine in recent years, there has been a remarkable increase in the number of human infants who survive a premature birth. Many of these infants are expelled from the womb after only 6 month of gestational development. Not only do they undergo stressful prenatal and perinatal experiences, but in addition they often suffer postnatal complications which have been shown to adversely affect their development (Rose, 1980; Field, Hallock, Ting, George, Dempsey, Dabiri and Shuman, 1978; Fox, 1983). While some of these problems are short-lived, others persist throughout childhood, and sometimes into adulthood.

The development of preterm infants resembles that of fullterms in some ways. But in other ways, preterms often lag behind their fullterm counterparts in physiological, motoric and intellectual capacities (Aylward, 1981; Berkson, Wasserman and Behrman, 1974; Dorros, 1977; Dreyfus-Brisac, 1968; Fox and Lewis, 1983; Gottfried, 1973), especially if they have experienced seizures and brain hemorrhaging (Volpe, 1981). The preterm infant is an organism which has been deprived of its last 2-3 months in the womb. Hence, the extrauterine environment into which it enters is one for which the infant may not be fully developmentally prepared. Not only are there demands made on the infant which are physiologically taxing and overwhelming, but often, preterm infants in the Neonatal Intensive Care Unit (NICU) do not receive the proper type of stimulation necessary to enhance their development. In some cases, they receive less than a third of the caregiving that fullterms receive at home (Lawhon, 1986), and are restricted to prone-lying, which limits self-generated tactile stimulation (Anderson and Aulster-Leibhaber, 1984).

It is crucial that potential developmental problems in preterm infants be identified early, so that appropriate therapy may be administered to those infants who are at-risk for deficit. In this regard there are two primary issues to consider. First, appropriate measures of physiological and motoric integrity must be utilized in assessing preterm infants. The use of inappropriate measures could result in incorrect assessment of the infants, and consequently in administration of either insufficient or inappropriate therapeutic treatment. Conversely, appropriate therapy could enhance and bolster a preterm infant's progress and development, and has greater chances of ensuring optimal postnatal development (Lazzara, Ahmann, Dykes, Brann and Schwartz, 1980).

Research on the growth achievement of preterm infants has become quite robust in the past 20 years, and has enabled us to highlight specific variables associated with developmental deficits at certain postnatal ages (Als and Brazelton, 1981; Anderson, 1986; Barnard and Bee, 1983; Brazelton, 1973; Mednick, 1977; Rose, Schmidt, Riese and Bridger, 1980). Initially, numerous investigators were primarily interested in examining discrete aspects of physiological and behavioral integrity and functioning, such as measuring heart rate and respiratory systems, (Bridger and Reiser, 1959; Cabal, Siass, Zanini, Hodgmman and Hon, 1980; Fox and Porges, 1985; Lacey and Lacey, 1980) as well as arousal and attention levels (Fox, 1983; Graham and Jackson, 1970). …

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