A randomized controlled trial of clinic-based and home-based interventions in comparison with usual care for preterm infants: effects and mediators.
Clinic therapy lifts thinking and movement, while home therapy soothes sleep and mood—both beat usual care for preterm babies with delays.
01Research in Context
What this study did
Doctors randomly placed very-low-birth-weight preterm babies into three groups. One group got weekly clinic therapy. One group got the same lessons at home. The third group kept the hospital’s usual follow-ups only.
All babies had signs of developmental delay. The study ran long enough to see if extra help moved test scores.
What they found
Clinic babies scored higher on thinking tests and showed fewer motor delays. Home babies slept better and showed fewer anxious or withdrawn behaviors. Both therapy groups beat usual care on their target skills.
How this fits with other research
Hwang et al. (2013) also ran a home-versus-usual-care trial with delayed infants. They saw the same gain pattern: home visits lifted daily-living skills faster than clinic-only models.
Petrenko (2013) pooled seventeen parent-training studies and found medium-to-large behavior cuts across toddlers with delays. Ying-Chin’s home arm lines up with that trend, adding sleep and mood gains.
Kaplan-Kahn et al. (2026) pushed the idea further. They coached parents to give sixty hours of hand therapy to toddlers with cerebral palsy. Kids met big, custom goals and parents loved the load. Their high-dose success hints the light home program in Ying-Chin could be strengthened.
Why it matters
You can start therapy soon after the NICU. Clinic days boost brain and motor scores. Home days calm sleep and mood. Pick the target that worries the family most, then choose the setting that hits it. If a family dreads clinic travel, try the home route first—you still beat plain check-ups.
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02At a glance
03Original abstract
This study examined the effects and mediators of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with usual care in very-low-birth-weight (VLBW) preterm infants on developmental and behavioral outcomes at 24 months of age (corrected for prematurity). In this randomized controlled trial, VLBW preterm infants received either CBIP (n=57), HBIP (n=63), or usual care (n=58) from hospitalization to 12 months. At 12 months, infant emotional regulation was assessed using the toy-behind-barrier procedure and dyadic interaction was observed during free play. At 24 months, infant developmental and behavioral outcomes were assessed using the Bayley Scales of Infant and Toddler Development- 3rd edition and the Child Behavior Checklist for Ages 1.5-5, respectively. Compared with infants under usual care, the CBIP-group infants showed higher cognitive composite scores (difference, 95% confidence interval (CI)=4.4, 0.8-7.9) and a lower rate of motor delay (odds ratio (OR), 95% CI=0.29, 0.08-0.99); the HBIP-group infants had lower sleep problem scores (difference, 95% CI=-1.4, -2.5 to -0.3) and a lower rate of internalizing problems at 24 months (OR, 95% CI=0.51, 0.28-0.93) (all p<.05). The CBIP's effect on cognitive outcome was attenuated when maternal or dyadic interactive behavior was considered; whereas the HBIP's effect on sleep and internalizing behavior was attenuated when duration of orientation to a toy or object was considered. In conclusions, interventions enhanced the cognitive, motor, and behavioral outcomes of VLBW preterm infants. The effects on cognitive and behavioral outcomes might be mediated by early-improved mother-infant interaction and infant emotional regulation, respectively.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.06.009