Tiekstra, C. (Carlijn) (2012) Het effect van vroegtijdige interventiestrategieën op het gedrag van ouders van kinderen met een hoog risico op cerebrale parese : Analyse middels observatieprotocol in het Vroege Interventie Project (VIP). thesis, Medicine.
Full text available on request.Abstract
Introduction: Cerebral palsy is one of the most common chronic disorders in childhood. The literature suggests that infants at risk for cerebral palsy are in need of early intervention by pediatric physical therapists. A recently developed early intervention program is COPCA (Coping with and Caring for infants with special needs - a family centered program). A previous study indicated that the COPCA-approach is associated with better motor and cognitive development of infants at high risk for developmental disorders compared to traditional infant physical therapy (TIP). Both intervention programs assign an important role to parents or caregivers, including the implementation of the intervention method in daily family routines. Aim: The aim of this study is to assess if the effects of early intervention in infants at risk of developmental disorders is mediated by parental behaviour. Design: A randomised controlled trial was conducted at the University Medical Centre Groningen. Method. Parental behaviour during bathing of 46 infants at risk for cerebral palsy included in the Vroege Interventie Project (VIP) who received early intervention (COPCA n=21, TIP n=25) between three and six months corrected age, was evaluated by means of the analysis of videotapes at three, six and eighteen months corrected age with a recently developed observation protocol “Qualitative Assessment of Behaviour of Caregiver and Infant during bathing session” (Becibath). Developmental outcome was assessed with the Dutch version of the Pediatric Evaluation of Disability Inventory (PEDI) The inter- and intrarater reliability of the Becibath were calculated with the intraclass correlation coefficient (ICC) of the scores. Differences between the scores of the COPCA and TIP intervention groups and in parental behaviour of parents with infants with or without cerebral palsy were analysed with the Fisher’s Exact Test. Longitudinal differences were assessed with the McNemar Test. Correlation of parental behaviour and the PEDI score of the infant was assessed with the Mann-Whitney U Test. A p<0,01 was considered significant. Results: Eleven videotapes were missing (COPCA n=5, TIP n=6). Interrater reliability of the Becibath ranged from no to full agreement [ICC -0,02-1,00], the intrarater reliability ranged from almost full to full agreement [ICC 0,85-1,00]. No significant differences were found in parental behaviour of the two intervention groups or in parental behaviour of parents with infants with or without cerebral palsy. Some correlations were found between parental behaviour and the infants PEDI scores. Parent-child interaction changed with increasing age of the infant. Discussion and conclusion: This study was not able to show that the effects of early intervention in infants at risk of developmental disorders were mediated by parental behaviour. It is possible that the heterogeneity in physical therapeutical actions in the two intervention groups obscured potential group differences. Further data analysis is warranted. An instructional guideline for the Becibath should be provided.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Hadders-Algra, prof. dr. M. and Locatie: Instituut voor Ontwikkelingsneurologie, Universitai |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/154 |
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