When babies are born early — at or before 32 weeks — they are at risk for challenges, including developmental and learning disabilities. While they receive lots of care in a neonatal intensive care unit (NICU), there’s about four to eight months that pass between their discharge home and the first receipt of services at home.
That’s why Stacey Dusing, PhD, PT, physical therapist and director of the Motor Development Lab at the USC Division of Biokinesiology and Physical Therapy, created SPEEDI, which stands for Supporting Play Exploration and Early Developmental Intervention. The intervention is designed to help parents beneficially engage with their babies, bit by bit.
“The biggest challenge was that parents were not really trained on what to do with their baby at home — and they were imitating the NICU environment, where babies mainly stayed in the crib,” Dusing said.
Now, Dusing has been awarded a grant, in collaboration with the University of Melbourne, to study telehealth for infants born preterm. Dusing and her Australian counterparts will enroll 450 infants and their families in Victoria, Australia, into this clinical trial. Half of the infants will participate in usual care; the other half will receive intervention in person while they’re at the hospitals and then move on to telehealth once they are home.
“It’s teaching parents how to play with a baby in a way that supports development,” Dusing said.
The platform was designed a year ago to be delivered remotely, and now with a pandemic raging, it makes even more sense to do therapy that way.
Study participants will have a telehealth visit every month to work with a therapist — but they will also have access to an app that has information and videos to help remind them of the lessons. And during each session, the therapist can actually see how the baby is progressing in skills.
Dusing hypothesizes that the SPEEDI intervention will result in better motor and cognitive skills at 12 and 24 months of age. They also hope to see lower levels of stress in parents. “The combination is a huge thing because these parents are at high risk for struggles with stress,” she said.
For decades, Dusing has practiced as a neonatal physical therapist.
“I spent a lot of time in parents’ homes with new babies, and it was shocking to me to see how little parents knew about supporting the baby’s development,” she said. “They were so overwhelmed.”
But she saw firsthand how the dynamic shifted when therapists gave parents ideas about how to take specific action.
She added that this is one of the first grants to investigate how telehealth works compared with traditional visits in this population of families with babies born early.
“We are at the forefront of being able to evaluate the question of telemedicine with this group,” she said. “Part of why this is important is if we can support babies from the very beginning maybe those kids will have fewer problems later in life.”
— Katharine Gammon