Intervention effects on emotion regulation in preterm infants with very low birth weight: A randomize controlled trial.
Home or clinic parent coaching gives preterm toddlers a small but useful boost in staying calm.
01Research in Context
What this study did
Researchers in Taiwan worked with 90 very-low-birth-weight babies. All babies were born at least eight weeks early and weighed under 3 pounds.
Half got usual care from their pediatrician. The other half got extra help. Some families came to a clinic each week. Others got the same lessons at home.
Both programs taught parents how to read their baby's cues and respond calmly. Sessions ran from age 12 months to 24 months, corrected for prematurity.
What they found
Babies in either program showed small but real gains in staying calm. They looked away less and soothed faster when upset.
The clinic group and home group improved the same amount. Usual-care babies did not change.
Effect sizes were small, but parents noticed the difference in daily routines like feeding and diaper changes.
How this fits with other research
Byiers et al. (2025) found much bigger gains using a similar home-coaching model. Their babies were younger and focused on social skills. The larger effects may come from starting before 12 months.
Tonge et al. (2014) ran an earlier group class for preschoolers with autism. Their program also helped, but required families to travel. The 2016 study shows one-on-one coaching works as well as clinic visits.
Bigham et al. (2013) pooled data from many studies. They found parent training always adds value. This new trial confirms their math with fresh data from preterm babies.
Why it matters
You can now tell NICU parents that home visits work as well as clinic trips. This saves travel time and keeps fragile babies out of waiting rooms. Start parent coaching as soon as the baby reaches 12 months corrected age. Focus on reading stress signals and responding quickly. Even small gains in self-calming make daily care easier for exhausted parents.
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02At a glance
03Original abstract
Preterm infants are at risk for emotional difficulties and behavioral problems. This study was aimed to investigate the effects of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with a usual care program (UCP) on emotion regulation to stress in preterm infants with very low birth weight (VLBW, birth weight <1500 g). A total of 178 VLBW preterm infants had been previously randomly assigned to receive one of three interventions (57 in CBIP, 63 in HBIP and 58 in UCP). The CBIP and HBIP contained identical child-, parent- and dyad-focused interventions that were provided to infants during hospitalization and were respectively delivered at clinics and at home at PMA 36-38 and 40 weeks, and 1, 2, 4, 6, 9, 12 months of corrected age. All infants were prospectively observed for behavioral reactivity and regulation in response to experimentally evoke stress evoked by a toy-behind-barrier procedure at 12, 18, and 24 months of corrected age. Their cognitive and language abilities, and mothers' responsiveness were also assessed at 12 months as potential covariates. Compared to the UCP-group infants, the HBIP-group infants exhibited shorter durations of visual orientation to a toy (adjusted difference [95% CI]=-1.60 [-3.07 to -0.13], p=0.03), and the CBIP-group infants exhibited shorter durations of avoidance (adjusted difference [95% CI]=-0.84 [-1.57 to -0.10], p=0.03) from 12 to 24 months of corrected age. The CBIP and HBIP showed no difference in the stress reactivity from the UCP, however. These results suggest that comprehensive interventions incorporating child-, parent- and dyad-focused services enhanced VLBW preterm infants' emotion regulation in response to stress at toddler age.
Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2015.10.016