Development of content for an early intervention mother-infant programme for vulnerable infants

Abstract

Introduction: Early intervention in the first months of life focuses on the high-risk infant, often born premature or with significant risk factors present. Early developmental surveillance of infants is carried out briefly at vaccination appointments at 14 weeks, six months and nine months in South Africa. It is however not sensitive enough to pick up subtle challenges in the infants' functioning in autonomic stability, state regulation, motor control  or social interaction.

Methods: A Nominal Group was held in a workshop session at a national occupational therapy congress, where delegates chose to attend and participate. Nineteen participants attended the workshop, where a plenary session was followed by item generation and reaching a consensus on the inclusion of these items in an early intervention mother-infant group intervention programme.

Results: A master list of 45 activities was generated, which was reduced to nine activity groups, covering all domains of newborn functioning. Guiding principles were shared and agreed on. Consensus was reached during the workshop process, with subsequent emailed rounds only yielding comments on clarity in the item description.

Discussion: Massage, maternal education and empowerment, play and communication were essential for inclusion.

Conclusion: Consensus was reached on the inclusion of 45 activities, with 9 of these considered essential in mother-infant dyad group-based intervention for vulnerable infants.

Implications for practice

• Applicable across multiple settings in South Africa, this research informs occupational therapy service providers on the development of early itnervetion mother-infant dyad-based group intervention programs.


• Activities that are a priority for inclusion in a group-based mother-infant dyad early intervention programme are: vision, play, skin-to-skin/ KMC, communication, massage, midline/ containment, maternal education/ empowerment, auditory and movement based on an analysis of their qualities.