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Initial Efficacy Study of Supporting Play, Exploration, & Early Development Intervention (SPEEDI)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02153736
Recruitment Status : Completed
First Posted : June 3, 2014
Results First Posted : September 18, 2017
Last Update Posted : January 29, 2018
Foundation for Physical Therapy, Inc.
Children's Hospital Foundation
Information provided by (Responsible Party):
Virginia Commonwealth University

Brief Summary:
The primary aims of this randomized controlled trial are to evaluate efficacy potential of SPEEDI at enhancing reaching and play based problem solving compared to infants receiving usual care.

Condition or disease Intervention/treatment Phase
Infant, Premature, Diseases Brain White Matter Disease Periventricular Behavioral: SPEEDI Intervention Not Applicable

Detailed Description:
The primary aims of this randomized controlled trial are to evaluate efficacy potential of SPEEDI at enhancing reaching and play based problem solving compared to infants receiving usual care. The secondary aim is to assess the efficacy potential of SPEEDI to impact motor and cognitive development as assessed using commonly used clinical outcome measures. The exploratory aims are to assess the impact of SPEEDI on parent child interactions and feeding skills. The findings will provide crucial initial efficacy estimates to be used in a larger definitive clinical trial of SPEEDI.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 14 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Initial Efficacy Study of Supporting Play, Exploration, & Early Development Intervention (SPEEDI) - Phase 1 Clinical Trial
Study Start Date : April 2014
Actual Primary Completion Date : October 2016
Actual Study Completion Date : October 2016

Arm Intervention/treatment
No Intervention: Usual Care Group
This group of subjects will receive usual care provided in the medial system and community.
Experimental: SPEEDI Intervention
This group will receive and parent and physical therapy provided intervention to increase the infants opportunities for play which will enhance development.
Behavioral: SPEEDI Intervention
Behavioral intervention provided through a collaboration between the mother of enrolled subjects and a physical therapist. Intervention starts in the Neonatal Intensive Care Unit and continues after discharge. SPEEDI includes both parent education and developmental activities.

Primary Outcome Measures :
  1. Reaching (Toy Contact Duration) [ Time Frame: 1 month post intervention ]
    Duration the infant is in contact with the target is used to quantify changes in reaching.

  2. Early Problem Solving Indicator (EPSI) [ Time Frame: End of intervention, 1 and 3 months post intervention ]
    Problem-solving behaviors were assessed using the Early Problem Solving Indicator (EPSI). The EPSI is the cognitive subtest of the Individual Growth and Development Indicators designed to measure infant and toddler play-based problem-solving through 36 months of age. It defines problem-solving as consisting of visual exploration, object manipulation and memory. The infant was video-recorded interacting with 3 standard toys: pop-up animals toy, 6 seriated, plastic cups, and a gum ball machine with 5 balls. Infants were given each toy for 2 minutes. The frequency of 4 mutually exclusive behaviors (look, explore, function, solution) were coded using definitions from the EPSI protocol. time. The total number of problem solving behaviors was calculated as a sum of look, explore, function, and solution for each infant at each visit and reported as the total EPSI frequency with a higher frequency reflecting more problem solving behaviors.

Secondary Outcome Measures :
  1. Early Feeding Skill Assessment (FES) [ Time Frame: Baseline, End phase 1, End of intervention, 1 and 3 months post intervention ]
    The Early Feeding Skills (EFS) was used to assess the infant's oral feeding skills during the video recorded feeding described above. The EFS is a 26-item observational tool that can be used from the start of oral feeding through the maturation of feeding skills. Each item can score 1-3 with one representing the least skill or high frequency of problem (an area of clinical concern), and three representing mature skill or absence of problem (area of strength). Subscales included were ability to maintain engagement in feeding, ability to organize oral-motor functioning, ability to coordinate swallowing, and ability to maintain physiological stability. The sum of all the items in a subscale divided by the number of items in the subscale gives the subscale score of 1-3. The sum of all subscales was used to create an EFS total score which could range from 2 to 12 with a higher score reflecting a better feeding performance.

  2. Parent Child Early Relational Assessment (PCERA) [ Time Frame: Baseline, End phase 1, End of intervention, 1 month post intervention ]
    The Parent-Child Early Relational Assessment (PCERA; Clark, 2010; Clark, 1999) was designed to assess mother-infant interaction. In this study PCERA was scored from a video of the feeding interaction. The PCERA is a 65-item observational rating scale (29 parental, 27 infant, and 8 dyadic), designed to assess the amount, duration, and intensity of interaction. Each item was rated on a 3-point ordinal scale with 1-2 indicating an area of concern, 3 indicating an area for some concern and 4- 5 indicating an area of strength. Eight subscales constructed from items of the PCERA have been theoretically derived and confirmed by factor analysis (Clark, 1999; Clark et al., 1997). For ease of analysis this scale was transformed to a -1 to +1 range. Scores were recorded as 1 or 2 = -1, 3= 0, 4 or 5 = 1. The total PCERA score is the mean of all the subscale mean scores and ranged -1 (highest risk of atypical interactions) to +1 (most positive interactions).

  3. Bayley Scales of Infant and Toddler Development (Bayley). [ Time Frame: 3 month post intervention ]
    The Bayley-III is a norm references standardized developmental assessment of Motor, Cognitive, and Language skills. Composite scores for each domain have a mean of 100 and a standard deviation of 15. A score of 85-115 is considered average. Higher composite scores represent higher or better performance on that subtest. The Bayley was administered at the final follow-up visit and 3 months after the intervention ended.

  4. Test of Infant Motor Performance (TIMP) [ Time Frame: Baseline to End of intervention ]
    The TIMP is a standardized and norm references test of motor control and posture in infants 4 months of age and younger which is commonly used with infants starting at 34 weeks of post-menstrual age. Change in raw score from baseline to end of the intervention is reported. The TIMP raw score ranges from 0 to 142. A higher score represented greater performance in motor control and posture.

Information from the National Library of Medicine

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Ages Eligible for Study:   up to 18 Weeks   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • born extremely preterm (˂29 weeks of gestation) OR 10 born preterm and diagnosed with a neonatal brain injury including intraventricular hemorrhage grade 3 or 4, periventricular white matter injury, or hydrocephalus requiring a shunt.
  • Medically stable by 40 weeks of gestation, including being off ventilator support
  • Live within 50 minutes of the hospital.
  • English Speaking mother
  • Mother willing and able to participate in the study with the infant subject

Exclusion Criteria:

  • Genetic syndromes or musculoskeletal deformities

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02153736

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United States, Virginia
Virginia Commonwealth University
Richmond, Virginia, United States, 23298
Sponsors and Collaborators
Virginia Commonwealth University
Foundation for Physical Therapy, Inc.
Children's Hospital Foundation
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Principal Investigator: Stacey C Dusing, PhD PT Virginia Commonwealth University
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Virginia Commonwealth University Identifier: NCT02153736    
Other Study ID Numbers: HM20001308
First Posted: June 3, 2014    Key Record Dates
Results First Posted: September 18, 2017
Last Update Posted: January 29, 2018
Last Verified: January 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Given the small sample from a specific time range the data will not be shared due to difficulty de-identifying with demographics of individual infants attached.
Additional relevant MeSH terms:
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Infant, Premature, Diseases
Infant, Newborn, Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases