The developmental status and prevalence of sensory integration difficulties in premature infants in a tertiary hospital in Bloemfontein, South Africa (original) (raw)
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The developmental status and prevalence of sensory integration
Introduction and aim: Research indicates that premature infants are at risk of neurological abnormalities and developmental and functional delays during infancy and early childhood. Annually, in South Africa, approximately 15% of infants are born prematurely, the majority being from low socio-economic homes. Basic needs and survival of the infant take priority over developmental progress of infants. Since developmental progress is dependent on sensory integration, the aim of this study was to determine the occurrence of developmental and sensory integration difficulties in premature infants in South Africa. Methods: A descriptive, observational study was conducted. Relevant information on medical history and environmental factors were obtained through parent questionnaires. Three standardised assessments, the Bayley III Scales of Infant and Toddler Development, the Test of Sensory Function in Infants and the Infant/Toddler Sensory Profile, were used. Results: Infants presented with low average to average performance in all developmental subtests. The majority (67.7%) of infants presented with typical sensory seeking behaviour. Sensory processing difficulties were identified in terms of high neurological thresholds resulting in low registration behaviour as well as low neurological thresholds, resulting in sensory sensitivity and sensory avoiding behaviour. This influenced their adaptive motor functions and normal development. Conclusion: Premature infants participating in this research presented with challenges regarding developmental and sensory integration.
Sensory integration intervention and the development of the premature infant: A controlled trial
South African Medical Journal, 2017
RESEARCH Small-for-gestational-age and extremely-low-birth-weight (ELBW) premature infants are at increased risk of developmental and cognitive delays, and difficulties in the mother-infant relationship. [1] These infants not only face survival and developmental challenges, [2] but are also at risk of developing sensory integration (SI) difficulties. Their immature, disorganised nervous systems are not ready to process the sensory information bombardment of neonatal intensive care units (NICUs), [2] and they are therefore likely to develop at a slower rate than full-term infants. Although advances in perinatal care have improved premature infant survival rates, these infants still experience more neurosensory impairments than full-term infants. [3] The progression of normal SI functions during infancy is essential for optimal development, since most activities in the first 7 years of life are part of the process of organising sensations in the nervous system for adaptive responses. Research indicates that during the first 1 000 days of life (from conception to age 3), children's brains can form 1 000 neural connections per second. A critical window of opportunity is therefore available, and appropriate stimulation from the earliest possible moment could improve cognitive capacity and the chance to live a fuller, more productive life. [4] Sensorimotor organisation occurs through adaptive responses, e.g. babies hear a sound and turn their heads towards the sound. Every child has an inherent drive towards engaging in sensory experiences that will promote SI. The relationship of SI to engagement in daily occupations is well described in the literature, and enables cognitive, motor, social, emotional and body scheme development. [5,6] Ayres [5] explained the SI process as four levels that link the different sensory systems (vestibular, proprioceptive, tactile, auditory and visual) to very specific SI abilities and functions that allow for purposeful participation in activities. The end products of SI include academic learning, self-esteem, self-control and self-confidence. [5] Infants manage behavioural reactions to sensation according to their sensory thresholds through the process of sensory modulation. [7,8] The 'four As' of infancy [8] describe the primary ways in which infants and toddlers perceive and modulate sensory information: arousal (maintaining alertness and making transitions between states); attention (focusing selectively on a desired stimulus or task); affect (emotional component of behaviour); and action (engaging in adaptive, goal-directed behaviour). Self-regulation activities include finger or dummy sucking, finger playing, self-rocking and looking at or listening to preferred visual or auditory stimuli. These activities enable infants to modulate mood, self-calm, delay gratification and tolerate transitions in activities. Infants with regulatory disorders, however, are unable to use these methods to calm themselves and require extreme efforts by their mothers to calm them. These infants may seem fussy and irritable, and transition quickly from a pleasant mood to an intense cry. Difficulties experienced with self-regulation may negatively affect the development of cognition, language, skilled movement, behaviour and emotional control, and also sensorimotor modulation up to the age of 3 years. [9] Through discrimination of sensory information followed by perception thereof, the infant interprets the qualities of the sensory information and adds meaning to it. Infants have to use past experiences and memories, form associations about the spatial and/ or temporal qualities of what they are currently experiencing, and then act on that. Refined use occurs once integration of sensory information contributes to skills and praxis. [5,10-12] This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. Background. Premature infants are at risk of sensory processing difficulties and developmental delays due to an immature central nervous system and possible episodes of medical instability, discomfort, pain and stress during the first weeks or months after birth. Objective. To investigate the effect of Ayres Sensory Integration (ASI) on the development of premature infants in the first 12 months of life. Methods. A pre-/post-test experimental design was used to randomly divide 24 premature infants from a low socioeconomic setting in Bloemfontein, South Africa, into experimental and control groups after being matched by corrected age and gender. Developmental status was determined with the Bayley III Scales of Infant and Toddler Development, the Test of Sensory Functions in Infants and the Infant/ Toddler Sensory Profile. The experimental group received 10 weeks of ASI intervention. Results. ASI intervention had a positive effect on the sensory processing and development of premature infants, especially in terms of cognitive, language and motor development. Conclusions. ASI intervention at an early age enhances the developmental progress of premature infants.
2012
My sincere thanks to: o My study leader, Ms. Annemarie van Jaarsveld (Head of Department: Occupational Therapy, University of the Free State). Thank you for your valuable guidance and time invested in this study. Your specialist knowledge, insight, passion and dedication to the field of sensory integration is an inspiration. o My co-study leader, Dr. Rita van Heerden (Department of Occupational Therapy, University of the Free State). Your input and guidance, especially in regards to the research process and academic writing was of immense value. Thank you for your continuous interest and care throughout this research project. o Dr. Jacques Raubenheimer (Department of Biostatistics, University of the Free State). Thank you for your specialist input, sharing of knowledge, time and advice. Your patience and hard work with every aspect of processing the results and the answering of numerous questions related to the statistics and technical aspects of the dissertation are appreciated and sincerely valued. o Dr. Nic van Zyl
Patterns of sensory integration dysfunction in children from South Africa
South African Journal of Occupational Therapy, 2014
While patterns ofsensory integration (SI) function and dysfunction have been studied in the US for more than 50 years, exploration of whether or not similar patterns exist in cultures and communities outside of this countryhas been limited, with no studies conducted in South Africa to date. The purpose of this paper was to investigate and describe the similarities and differences of patterns of SI dysfunction between children in South Africa and those in the US. A quantitative, analytical study was conducted on a convenience sample of 223 of children who were identified as experiencing sensory integration difficulties. The Sensory Integration and Praxis Tests (SIPT) were used as the measuring instrument and correlation and factoranalysis were applied in order to describe similarities and differences. Consistencies in tests loading on patterns of Visuodyspraxia, Somatodyspraxia, BilateralIntegration and Sequencing dysfunctions and Tactile and Visual Discrimination dysfunctions were f...
EPRA International Journal of Research & Development (IJRD), 2021
This study aimed to find out the efficacy of developed semi structured sensory enrichment intervention over premature Indian infants an early first year of life for their sensory development . A pre-/post-test design was used on fifty premature infants from a low socioeconomic setting in specialized NICU setup into one group after being matched by corrected age and inclusion criteria by convenient sampling . Before and after the intervention, the preterm infants sensory processing functions were evaluated using the Infant/ Toddler Sensory Profile (ITSP). The preterm infants underwent an eight weeks of sensory enrichment intervention. Semi- structure sensory enrichment intervention had a positive effect on the sensory processing and development of premature Indian infants, especially in terms of Sensory development. The feasibility of the identification of sensory process¬ing issues in the early years of life should be highlighted, as it favors early referral for intervention. The pu...
The Efficiency of Sensory Integration Interventions in Preterm Infants
Perceptual and Motor Skills, 2016
This study aimed to explore the effects of individualized sensory integration interventions on the sensory processing functions of preterm infants. Thirty-four preterm infants (intervention group) at a corrected age of seven months and 34 term infants (control group) were included. The preterm infants underwent an eight-week sensory integration intervention. Before and after the intervention, the preterm infants’ sensory processing functions were evaluated using the Test of Sensory Functions in Infants and compared with those of term infants. Preterm infants had significantly poorer sensory processing function preintervention when compared with term infants. There was a significant improvement in preterm infants’ sensory processing functions after the sensory integration intervention. In conclusion, preterm infants should be evaluated for sensory processing disorders and individualized sensory integration interventions should be implemented.
A B S T R A C T Background: Preterm infants are exposed to a variety of sensory stimuli that they are not developmentally prepared to handle, which puts them at risk for developing a sensory processing disorder. However, the patterns and predictors of sensory processing disorder and their relationship to early behavior at term equivalent age are poorly understood. Objectives: The aims of the study are to: 1) describe the incidence of sensory processing disorder in preterm infants at four to six years of age, 2) define medical and sociodemographic factors that relate to sensory processing disorder, and 3) explore relationships between early neurobehavior at term equivalent age and sensory processing disorder at age four to six years. Methods: This study was a prospective longitudinal design. Thirty-two preterm infants born ≤30 weeks gestation were enrolled. Infants had standardized neurobehavioral testing at term equivalent age with the NICU Network Neurobehavioral Scale. At four to six years of age, participants were assessed with the Sensory Processing Assessment for Young Children (SPA). Results: Sixteen children (50%) had at least one abnormal score on the SPA, indicating a sensory processing disorder. There were no identified relationships between medical and sociodemographic factors and sensory processing disorder. More sub-optimal reflexes (p = 0.04) and more signs of stress (p = 0.02) at term equivalent age were related to having a sensory processing disorder in early childhood. Conclusion: Preterm infants are at an increased risk for developing a sensory processing disorder. Medical and sociodemographic factors related to sensory processing disorder could not be isolated in this study, however relationships between sensory processing disorder and early neurobehavior were identified.
Sensory Processing Patterns in Children Born Very Preterm
The American journal of occupational therapy : official publication of the American Occupational Therapy Association
We describe the prevalence and type of sensory processing differences in children born very preterm and determine associations with neonatal risk factors. We assessed sensory processing patterns using the Short Sensory Profile in a retrospective cohort of 160 children age 4 yr born very preterm (≤32 wk gestational age). Data analyses included descriptive statistics to describe the prevalence of sensory processing patterns and logistic regression to examine associations with neonatal risk factors. Almost half of our cohort (46%) exhibited atypical sensory processing patterns. Lower Apgar scores (p = .03) and longer length of stay in the neonatal intensive care unit (NICU; p = .02) independently predicted atypical sensory processing patterns. Children born very preterm are at increased risk for sensory processing differences, which are associated with perinatal risk factors and length of stay in the NICU. Routine evaluation for sensory processing differences of children born preterm i...
Research Paper Sensory Profile in Infant/Toddler: Birth to 36 Months
Iranian Rehabilitation Journal, 2022
Sensory processing patterns refer to a person's ability to receive and respond to sensory events which are important to succeed in daily routine activities. This study aims to determine the sensory processing patterns in infants/toddlers. Methods: This is a cross-sectional study. A total of 518 infants/toddlers participated in this study. Their ages ranged from birth to 36 months. Parents completed the infant/ toddler sensory profile for all participants. Results: No significant difference was observed between girls and boys in sensory processing from birth to 6 months; however, there is a significant difference between girls and boys in low registration, sensory sensitivity, and sensory avoidance from 7-36 months. In addition, no significant difference was detected between children born by cesarean and those born through natural childbirth in terms of sensory processing (quadrants and scores) from birth to 6 months and 7-36 months. There is a significant difference between preterm and full-term children (birth to 6 months) in auditory processing. The findings also indicate only a significant difference in oral sensory processing between the preterm and full-term children (7-36 months). Discussion: We discussed sensory processing patterns in children and their differences based on different factors. The results of this study can provide considerations for Iranian occupational therapists and psychologists.
Neurodevelopmental outcome of late preterm infants in Johannesburg, South Africa
BMC Pediatrics, 2018
Background: Late preterm infants, previously considered low risk, have been identified to be at risk of developmental problems in infancy and early childhood. There is limited information on the outcome of these infants in low and middle income countries. Methods: Bayley scales of infant and toddler development, version III, were done on a group of late preterm infants in Johannesburg, South Africa. The mean composite cognitive, language and motor sub-scales were compared to those obtained from a group of typically developed control infants. Infants were considered to be "at risk" if the composite subscale score was below 85 and "disabled" if the composite subscale score was below 70. Infants identified with cerebral palsy were also reported. Results: 56 of 73 (76.7%) late preterm infants enrolled in the study had at least one Bayley assessment at a mean age of 16.5 months (95% CI 15.2-17.6). The mean birth weight was 1.9 kg (95%CI 1.8-2.0) and mean gestational age 33.0 weeks (95% CI 32.56-33.51). There was no difference in the mean cognitive subscales between late preterm infants and controls (95.4 9, 95% CI 91.2-99.5 vs 91.9.95% CI 87.7-96.0). There was similarly no difference in mean language subscales (94.5, 95% CI 91.3-97.7 vs 95.9, 95% CI 92.9-99.0) or motor subscales (96.2, 95% CI 91.8-100.7 vs 97.6, 95% CI 94.7-100.5). There were four late preterm infants who were classified as disabled, two of whom had cerebral palsy. None of the control group was disabled. Conclusions: This study demonstrates that overall developmental outcome, as assessed by the Bayley scales of infant and toddler development, was not different between late preterm infants and a group of normal controls. However, 7.1% of the late preterm infants, had evidence of developmental disability. Thus late preterm infants in low and middle income countries require long term follow up to monitor developmental outcome. In a resource limited setting, this may best be achieved by including a parental screening questionnaire, such as the Ages and Stages Questionnaire, in the routine well baby clinic visits.