Early Intervention in Children at Risk of Developmental Delay
Condition: Developmental Delay
Study type: Interventional

Summary: 
      Although it is stated in the literature that development should be considered as a whole and
      sensory, cognitive and motor outcomes are interrelated, it is seen that interventions for
      sensory and cognitive skills are not included in early intervention studies. For this reason,
      the study examined the effects of an early occupational therapy intervention program, which
      includes sensory, cognitive and motor strategies based on the principles of Goal, Activity
      and Motor Enrichment-GAME, an evidence-based early intervention program, on the sensory,
      cognitive and motor skills of babies at risk of developmental delay for 24-36 months.
    

Detailed description: 
      Children with developmental delays benefit from early intervention. Therefore, it is very
      important to detect developmental delays as early as possible. In recent years, there has
      been increasing interest in designing and providing early intervention programs to improve
      developmental outcomes for infants at risk for developmental delay for neurodevelopmental
      disorders. Early intervention includes services provided to children from birth to age five
      to promote the child's health and well-being, develop emerging skills, minimize developmental
      delays, correct existing or emerging disabilities, prevent functional impairment, and promote
      parental compliance. When the literature is examined, it is seen that early intervention
      approaches are mostly implemented in preterm babies and focus on motor skills. An example of
      studies carried out with this attitude is Neurodevelopmental Treatment (NGT), which is
      frequently used in early intervention approaches in Turkey. Another early intervention
      approach that includes intensive motor training is Goal, Activity and Motor Enrichment
      (GAME). GAME early intervention approach is also used in extremely preterm babies with a high
      risk of developmental delay; It has been used in studies as an intervention approach that
      includes goal-oriented motor training, environmental enrichment and family education. Another
      early intervention approach that addresses parent education and environmental enrichment
      principles is the Supporting Play, Exploration and Early Development Intervention (SPEEDI).
      The SPEEDI program was applied to preterm babies in a similar way to the GAME program. Other
      approaches used by occupational therapists for children at risk of developmental delay in the
      literature are home-based and routine-based approaches.

      When the literature is examined, it is seen that early intervention programs are mostly
      carried out with premature babies and/or for the diagnosis of cerebral palsy (CP). Early
      intervention approaches in the literature include intensive motor training, parent training,
      environmental enrichment, participation support and home visits. Although it is stated in the
      literature that development should be considered as a whole and sensory, cognitive and motor
      outcomes are interrelated, it is seen that interventions for sensory and cognitive skills are
      not included in early intervention studies. Therefore, the aim of our study is to improve the
      sensory, cognitive and motor skills of the early occupational therapy intervention program,
      which includes sensory, cognitive and motor strategies based on the principles of Goal,
      Activity and Motor Enrichment-GAME, which is an evidence-based early intervention program, in
      babies at risk of developmental delay of 24-36 months. to examine its effect.
    

Intervention name(s): Early Intervention; Home Programme
Intervention type(s): Other; Other
Intervention description(s): Based on the principles of the Goal, Activity and Motor Enrichment (GAME) approach, which is an evidence-based early intervention approach for children at risk of developmental delay between 24-36 months, activity-based training is aimed at the development of sensory and cognitive skills in addition to the training of motor skills, which are intensively discussed in the content of the approach. Individualized early occupational therapy intervention including strategies was implemented.; For the control group, evaluation tests were first applied to the babies selected by simple random sampling method. An individualized home program was given according to the evaluation results. Home programs include activities for every skill area and were prepared together with the parents, taking into account the criteria suggested for the success of the home program. Based on these criteria, it was checked whether the family had received another home program, and while preparing the program, care was taken not to overload the parents, importance was given to the family's willingness to receive the home program, activities and goals were decided in cooperation with the parent, thus facilitating the applicability of the activities in daily life, ensuring that the number of activities was 6. Care was taken to ensure that the activity was not too much, the parent was given the necessary time to implement the program, and a phone call was made to the parent every 3 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Sensory development is targeted in activity-based education based on the principles of the Goal, Activity and Motor Enrichment (GAME) approach, which is an evidence-based early intervention approach for children between 24-36 months at risk of developmental delay. The program was implemented in the pediatric unit for 45 minutes a day, twice a week for 12 weeks. For the control group, evaluation tests were first applied to babies selected by simple random sampling method. According to the evaluation results, a personalized home program was given. Post-evaluations were repeated for both groups after 12 weeks. The basic principles of the GAME approach are examined in 3 parts: goal-oriented intensive motor training, parent training, environmental enrichment. In our study, activities were also implemented based on the sensory integration approach and cognitive rehabilitation intervention principles to present sensory and cognitive strategies within the activity.
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: early intervention; developmental delay; motor development; cognitive development