PTOTSLPSystematic ReviewDevelopmental medicine and child neurology2020

Effect of neonatal therapy on the motor, cognitive, and behavioral development of infants born preterm: a systematic review.

Sonia Khurana, Audrey E Kane, Shaaron E Brown and 2 others

PMID 32077096

WHAT IT FOUND

Therapist-designed programs where parents actively engage preterm infants in daily motor practice showed moderate-to-large short-term gains in motor and cognitive skills.

Interventions delivered only by therapists or started late showed little to no long-term benefit.

Key findings

01Parent-delivered motor interventions showed positive effects on motor outcomes at term, 6 months, and 12 months, with effect sizes ranging from 0.40 to 1.04.

02Therapist-delivered postural control interventions showed short-term motor gains at term but no significant differences after discharge at 4, 12, or 30 months.

03Developmental care programs showed inconsistent results, with some positive short-term behavioral and cognitive effects but no sustained impact on motor or cognitive development at 44 months.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The review could not perform a meta-analysis due to high heterogeneity in intervention types, doses, and outcome measures. Many studies had small sample sizes, ranging from 14 to 251 participants. Risk of bias was unclear or high in several studies, particularly regarding allocation concealment and blinding. The review excluded studies with only biological outcomes, potentially missing physiological benefits that do not translate to standardized developmental scores. Only English-language studies were included, which may limit generalizability.

Declared interests

The paper does not explicitly state a conflict of interest declaration in the provided text, but it notes support from the National Institutes of Health (NIH) in the publication types.

The easy way to misread this

Do not assume that all neonatal therapy is equally effective. Therapist-delivered postural control interventions showed large short-term gains but no long-term benefit, whereas parent-delivered interventions showed sustained gains. The key differentiator appears to be active parent engagement and continuation of care after discharge.

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