Early intervention to prevent disability in preterm infants

The incidence of prematurity is 7.8%, and about 20 million newborns are born in China every year, and about 1.5 million are born prematurely. Due to immature brain development at birth, premature infants are prone to hypoxia, intracranial hemorrhage, infection and jaundice, making the immature brain more susceptible to damage leading to mental retardation and cerebral palsy and other disabilities. The incidence of mental retardation in preterm infants is 6.7%, and the incidence of cerebral palsy is about 3%. Other disabilities include visual and hearing impairments. These disabilities cause great pain and burden to the child and the family. It is also the last thing doctors want to see as a consequence of their efforts to resuscitate a viable preterm infant. Early intervention methods begin in the neonatal period and include motor, cognitive, language, and emotional interaction skills. Audiovisual stimulation begins after birth. The child is shown brightly colored toys when awakening, listen to the sound of shaking toys, and often look at and talk to the child to promote parent-child communication. The educational content of infancy is mainly childcare stimulation and play, so that children feel the colorful external environment, that is, a variety of colors, a variety of shapes and different sounds, to give some common objects, the development of the child’s mouth, eyes, and hands exploration ability. When feeding and caring for the child, constantly talk to the child affectionately and tease the child to vocalize happily. The child’s social adaptation and communication skills can be promoted through social interaction and singing, and the child’s perceptual discrimination skills can be developed through various kinds of play. 1 to 2 years of age are given priority to language training and coordination of movements. Children’s curiosity and self-confidence are stimulated through storytelling and games, and they develop good character such as independence, perseverance and courage. Early intervention is instructed for parents to implement at home. The study found that through the above early intervention, the preterm infants had an IQ development index of 104.5 points at the age of 2, which was 14.6 points higher than that of the conventional parenting group of 89.9 points, fully catching up and even surpassing the normal children’s 98.8 points at the age of 2. In the conventional childcare group of preterm infants, the IQ development index was 9 points lower than that of normal infants, of which 6.7% were mentally retarded, while none of the cases in the early intervention group were below normal intelligence. Early intervention methods: include massage, gymnastics, and active motor training. It was implemented at home by the doctor instructing the parents. If the doctor conducts neuromotor examination every one to two months and finds suspected signs of cerebral palsy, the rehabilitation teacher can do the corresponding rehabilitation training and teach the parents to do intensive rehabilitation at home. These methods are safe, economical, simple and easy to implement. Parents can learn them, and they are easy to promote and apply. Why can early education, massage, gymnastics and active movement training be so effective in preventing and reducing mental retardation and cerebral palsy? The brain develops faster at a younger age, with 370 grams at birth, doubling in weight at 6 months, and tripling at 2 years of age. There are 100 billion nerve cells in the brain. At birth, it is like a small tree, and DD synapses, the connections between nerve cells, increase 7 times at 6 months of age, and reach a peak at 2 years of age, with 15,000 synapses per nerve cell, one and a half times the number of adults. These synapses begin at 3 to 4 years of age and remain pruned to adult levels until puberty. Thus, the brain has a very high degree of plasticity during the first 2 years of life. Brain damage sustained by preterm infants can be compensated for through perceptual-motor stimulation and scientific early education and active motor training. This can achieve twice the result with half the effort.