Creative Music Therapy for Premature Infants
Condition: Developmental Delay (Disorder)
MeSH terms: Premature Birth
Study type: Interventional

Summary: 
      This study investigates whether creative music therapy applied to premature infants will
      facilitate brain growth and development at term equivalent assessed by magnetic resonance
      imaging. Secondary objective are improvement of neurobehavioral outcomes of premature infants
      at 24 months, as well as at 5 years of age.
    

Detailed description: 
      Premature infants are a highly prevalent and vulnerable group in paediatric care, and face
      several short- and long-term challenges. Research on brain development in premature infants
      demonstrates a high incidence of white and grey matter abnormalities and neurobehavioral
      delay, as well as an increased risk of brain injury. There is growing awareness that
      premature infants need individualized nurturing interactions with their caregivers while they
      are in a neonatal intensive care unit (NICU) to support healthy development and prevent
      future difficulties. One particular intervention that may have considerable potential in the
      NICU is creative music therapy (CMT), an individualized, interactive, resource- and
      needs-oriented music therapy approach. Results demonstrate that CMT can facilitate relaxation
      and stabilization in premature infants; by experiencing inter-subjectivity through music, the
      infants can be empowered to engage in meaningful and nurturing interactions (Haslbeck, 2013
      a,b) .

      Several researchers (Als, 2012; Trevarthen, 2008; Schore, 2003) have described how
      interactive and multi-sensory experiences of the fetus particularly facilitate brain
      development and learning about socio-emotional figures, respectively, in prematurely born
      infants. It is assumed that positive auditory experiences can promote premature infants'
      early brain maturation and contribute to their healthy neurodevelopment (Xu et al., 2009).
      Studies in music and neuroscience have demonstrated that music promotes neurobiological
      processes and modulates synaptic plasticity, neuronal learning and readjustment in the human
      brain (Rickard et al., 2005). The individualized approach in active music therapy may
      especially activate brain structures involved in emotional, sensorimotor and cognitive
      processing (Koelsch, 2009; Fachner et al., 2012).

      Since, on one hand, individualized interactive experiences and, on the other hand, music may
      alter brain development in the fetus and very young infants, the question arises as to
      whether CMT might actually promote a premature infant's brain development by facilitating
      nurturing socio-emotional and auditory interactive experiences at the same time. Therefore a
      randomized, controlled, clinical trial will be conducted. 30 premature infants receive CMT
      during their hospitalization time and 30 premature infants without music therapy serves as
      control group. The primary objective is to explore if the experience of CMT in premature
      infants improves their brain growth and development at 38-42 weeks of corrected gestational
      age. The main secondary objective is to explore if CMT improves the neurobehavioral outcomes
      of premature infants at 9 and 24 months, as well as at 5 years of age. Magnetic resonance
      imaging is used to evaluate the infants' cerebral cortical development and myelination.
      Electroencephalography (EEG) is used to evaluate the infants' brain function and maturation.
      Insights into possible long-term and sustainable outcomes will be gained via
      neuro-developmental follow-up examinations. It is hypothesized that the experience of CMT in
      neonatal care improves both short- and long-term neurological outcomes. We expect that the
      experimental group will demonstrate superior brain growth and development at 38-42 weeks of
      corrected gestational age as well as improved cognitive, behavioral and motor developmental
      outcomes later on. This paper will introduce first insights and preliminary results of the
      ongoing study. Strategies and challenges inherent in conducting a controlled clinical trial
      within this vulnerable group will be discussed.
    

Intervention name(s): Music Therapy
Intervention type(s): Procedure
Intervention description(s): 2 to 3 sessions per week of individualized creative music therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Music therapy; premature infant; brain development